Reduction of opioid utilization after vaginal delivery with an electronic health record intervention

Rimsza, Rebecca R.; Perez, William M.; Shyken, Jaye M.; Vricella, Laura K.

doi:10.1016/j.ajogmf.2021.100402

Cited by 1 publication

(5 citation statements)

References 16 publications

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“…The 8 studies that evaluated multimodal stepwise interventions were all retrospective cohort studies 16–23 and included initiating scheduled ibuprofen and acetaminophen, with the administration of an opioid on an as‐needed basis for breakthrough pain. These interventions include multiple changes in a bundled fashion and specified stepwise approaches.…”

Section: Resultsmentioning

confidence: 99%

“…Ten studies examined interventions to reduce postpartum opioid use following discharge. These interventions were composed of enhanced counseling and shared decisionmaking, 19,27,[32][33][34][35] the elimination of opioids prescriptions at discharge, 36,37 individualized opioid prescriptions at discharge, 38 and legislative changes. 39 (Table 2 )…”

Section: Interventions To Reduce Discharge Postpartum Opioid Usementioning

confidence: 99%

“…Sixteen studies identified interventions to reduce postpartum opioid use during the inpatient period. The majority included implementation of multimodal stepwise protocols (n = 8) [16][17][18][19][20][21][22][23] or changes in dosages or timing of medication administration (n = 4). [24][25][26][27] Four additional studies included interventions that compared nonopioid medication with placebo, 28 use of lidocaine patches, 29 abdominal binder, 30 and battlefield acupuncture, in which needles are placed only on the surface of the ear (Table 1 ).…”

Section: Interventions To Reduce Postpartum Opioid Use During the Inp...mentioning

confidence: 99%

“…[24][25][26][27] Four additional studies included interventions that compared nonopioid medication with placebo, 28 use of lidocaine patches, 29 abdominal binder, 30 and battlefield acupuncture, in which needles are placed only on the surface of the ear (Table 1 ). 31 The 8 studies that evaluated multimodal stepwise interventions were all retrospective cohort studies [16][17][18][19][20][21][22][23] and included initiating scheduled ibuprofen and acetaminophen, with the administration of an opioid on an as-needed basis for breakthrough pain. These interventions include multiple changes in a bundled fashion and specified stepwise approaches.…”

Section: Interventions To Reduce Postpartum Opioid Use During the Inp...mentioning

confidence: 99%

“…The included studies reported results from a total of 60,378 patients. Sample sizes ranged from 48 to 19,192…”

Section: Search Summary and Study Characteristicsmentioning

confidence: 99%

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Interventions to Reduce Inpatient and Discharge Opioid Prescribing for Postpartum Patients: A Systematic Review

Badreldin

DiTosto

Holder

et al. 2023

J Midwife Womens Health

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Introduction As deaths related to opioids continue to rise, reducing opioid use for postpartum pain management is an important priority. Thus, we conducted a systematic review of postpartum interventions aimed at reducing opioid use following birth. Methods From database inception through September 1, 2021, we conducted a systematic search in Embase, MEDLINE, Cochrane Library, and Scopus including the following Medical Subject Heading (MeSH) terms: postpartum, pain management, opioid prescribing. Studies published in English, restricted to the United States, and evaluating interventions initiated following birth with outcomes including an assessment of change in opioid prescribing or use during the postpartum period (<8 weeks postpartum) were included. Authors independently screened abstracts and full articles for inclusion, extracted data, and assessed study quality using the Grading of Recommendations, Assessment, Development, and Evaluation tool and risk of bias using the Institutes of Health Quality Assessment Tools. Results A total of 24 studies met inclusion criteria. Sixteen studies evaluated interventions aimed at reducing postpartum opioid use during the inpatient hospitalization, and 10 studies evaluated interventions aimed at reducing opioid prescribing at postpartum discharge. Inpatient interventions included changes to standard order sets and protocols for the management of pain after cesarean birth. Such interventions resulted in significant decreases in inpatient postpartum opioid use in all but one study. Additional inpatient interventions, including use of lidocaine patches, postoperative abdominal binder, valdecoxib, and acupuncture were not found to be effective in reducing postpartum opioid use during inpatient hospitalization. Interventions targeting the postpartum period included individualized prescribing and state legislative changes limiting the duration of opioid prescribing for acute pain both resulted in decreased opioid prescribing or opioid use. Discussion A variety of interventions aimed at reducing opioid use following birth have shown efficacy. Although it is not known if any single intervention is most effective, these data suggest that implementation of any number of interventions may be advantageous in reducing postpartum opioid use.

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Section: Resultsmentioning

confidence: 99%

Section: Interventions To Reduce Discharge Postpartum Opioid Usementioning

confidence: 99%

Section: Interventions To Reduce Postpartum Opioid Use During the Inp...mentioning

confidence: 99%

Section: Interventions To Reduce Postpartum Opioid Use During the Inp...mentioning

confidence: 99%

“…The included studies reported results from a total of 60,378 patients. Sample sizes ranged from 48 to 19,192…”

Section: Search Summary and Study Characteristicsmentioning

confidence: 99%

See 3 more Smart Citations

Interventions to Reduce Inpatient and Discharge Opioid Prescribing for Postpartum Patients: A Systematic Review

Badreldin

DiTosto

Holder

et al. 2023

J Midwife Womens Health

View full text Add to dashboard Cite

show abstract

Reduction of opioid utilization after vaginal delivery with an electronic health record intervention

Cited by 1 publication

References 16 publications

Interventions to Reduce Inpatient and Discharge Opioid Prescribing for Postpartum Patients: A Systematic Review

Interventions to Reduce Inpatient and Discharge Opioid Prescribing for Postpartum Patients: A Systematic Review

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