Implementing and Evaluating a Multihospital Standardized Opioid Curriculum for Surgical Providers

Robinson, Kortney; Carroll, Michaela; Ward, Stephanie B.; Osman, Samia Y; Chhabra, Karan R.; Arinze, Nkiruka; Almedi, Alind; Kaafarani, Haytham M.A.; Smink, Douglas S.; Kent, Tara S.; Aner, Musa; Brat, Gabriel

doi:10.1016/j.jsurg.2019.12.012

Cited by 6 publications

(9 citation statements)

References 11 publications

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“…Our previous study demonstrated improvements in objective knowledge and subjective comfort level with opiate prescribing following a 75-minute educational session. 15 The current study demonstrates that residents maintain the knowledge obtained during these educational sessions, however based on sub-category assessment performance, they displayed similar knowledge gaps in opiate prescribing. Further, surgical interns continued to report feeling uncomfortable with their knowledge pertaining to pain control and opiate prescribing.…”

Section: Discussionmentioning

confidence: 55%

“…Previously, our study investigated the opioid prescribing knowledge and comfort of surgical interns following a 75-minute educational session during orientation week demonstrated improvements in objective knowledge and subjective comfort level with opiate prescribing. 15 The present study compares surgical interns' comfort level with opioid prescribing and knowledge about opioids for treatment of acute pain after an opioid education session to their knowledge and comfort half way through their intern year.…”

Section: Introductionmentioning

confidence: 99%

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Retention of Knowledge After Opioid Education in Surgical Interns

Arndt

Robinson

Yorkgitis

et al. 2023

The American Surgeon™

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Background In many academic centers, opioid prescribing is managed primarily by residents with little or no formal opioid education. The present study evaluates intern knowledge and comfort with appropriate opioid prescribing 7 months after an organized opioid education effort. Materials and Methods A repeat knowledge and attitude survey was sent to surgical interns who had completed an initial opioid education training session 7 months before the study. Results were compared to post-education assessment results in the same cohort. Setting 16 general surgery and podiatric surgery interns at a single academic medical center. Results The mean percentage of correct answers on follow-up was 67.6% identical to the average post-session score of 67.6%. Interns reported comfort with opioid prescribing increased to a mean score of 5.9 (out of 10) on follow-up compared to post-session score of 5.19. Conclusions Surgical interns have significant gaps in knowledge for optimal prescribing and management of opioid prescriptions. Targeted education demonstrates significant and lasting improvement in opioid assessment scores, but there remains room for improvement.

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Section: Discussionmentioning

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Retention of Knowledge After Opioid Education in Surgical Interns

Arndt

Robinson

Yorkgitis

et al. 2023

The American Surgeon™

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“…Educational seminars, prescribing guidance cards, feedback emails, and an online prescribing guidance dashboard 24 for residents are all informed by this consumption data. 19 We have chosen to use consumption data gathered at our institution to build these resources, since we have previously shown that most national consensus guidelines for post-surgical opioid prescribing significantly overestimate patients' opioid needs. 25 After a year of consumption-based feedback on resident opioid prescribing, the size of the largest opioid prescriptions at our institution fell by over 50%.…”

Section: Consumption Data-based Interventionsmentioning

confidence: 99%

“…&Prescription drug monitoring programs15 Patient culture change & Educating residents on pain management conversations with patients and setting goals for post-surgical pain control and functional status2,[16][17][18][19] …”

mentioning

confidence: 99%

Surgical Residency Programs Should Leverage Recent Advances in National Policy, Real-World Data, and Public Opinion to Improve Post-Surgery Opioid Prescribing

Marwaha

Kennedy²,

Brat

2022

Journal of Graduate Medical Education

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“…8,9 The consumption data it produced proved useful in guiding many institutional prescribing protocols and in evaluating the validity of existing guidelines and prescribing practices. 2,8,10 However, the telephone-based method of data collection was not easy to scale to include additional procedures or institutions without a concomitant increase in staffing. In an effort to reduce the manual component of data collection, we developed a new, automated method of data collection.…”

Section: Introductionmentioning

confidence: 99%

Nonresponse adjustment using clinical and perioperative patient characteristics is critical for understanding post-discharge opioid consumption

Kennedy

et al. 2021

Preprint

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Background: Post-discharge opioid consumption is an important source of data in guiding appropriate opioid prescribing guidelines, but its collection is tedious and requires significant resources. Furthermore, the reliability of post-discharge opioid consumption surveys is unclear. Our group developed an automated short messaging service (SMS)-to-web survey for collecting this data from patients. In this study, we assessed its effectiveness in estimating opioid consumption by performing causal adjustment and comparison to a phone-based survey as reference. Methods: Patients who underwent surgical procedures at our institution from 2019-2020 were sent an SMS message with a link to a secure web survey to quantify opioids consumed after discharge. Several patient factors extracted from the EHR were tested for association with survey response. Following targeted learning (TL) nonresponse adjustment using these EHR-based factors, opioid consumption survey results were compared to a prior telephone-based survey at our institution as a reference. Results: 6,553 patients were included. Opioid consumption was measured in 2,883 (44%), including 1,342 (20.5%) through survey response. Characteristics associated with inability to measure opioid consumption included age, length of stay, race, tobacco use, and missing preoperative assessment. Among the top 10 procedures by volume, EHR-based TL nonresponse bias adjustment corrected the median opioid consumption reported by an average of 57%, and corrected the 75th percentile of reported consumption by an average of 11%. This brought median estimates for 6/10 procedures closer to telephone survey-based consumption estimates, and 75th percentile estimates for 3/10 procedures closer to telephone survey-based consumption estimates. Conclusion: We found that applying electronic health record (EHR)-based machine learning nonresponse bias adjustment is essential for debiased opioid consumption estimates from patient surveys. After adjustment, post-discharge surveys can generate reliable opioid consumption estimates. Clinical factors from the EHR combined with TL adjustment appropriately capture differences between responders and nonresponders and should be used prior to generalizing or applying opioid consumption estimates to patient care.

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Implementing and Evaluating a Multihospital Standardized Opioid Curriculum for Surgical Providers

Cited by 6 publications

References 11 publications

Retention of Knowledge After Opioid Education in Surgical Interns

Retention of Knowledge After Opioid Education in Surgical Interns

Surgical Residency Programs Should Leverage Recent Advances in National Policy, Real-World Data, and Public Opinion to Improve Post-Surgery Opioid Prescribing

Nonresponse adjustment using clinical and perioperative patient characteristics is critical for understanding post-discharge opioid consumption

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