Resident Opioid Prescribing Habits Do Not Reflect Best Practices in Post-Operative Pain Management: An Assessment of the Knowledge and Education Gap

Victoria Huynh; Kathryn Colborn; Nicole Christian; Kristin Rojas; Mark Nehler; Michael Bronsert; Ethan Cumbler; Gretchen Ahrendt; Sarah Tevis

doi:10.1016/j.jsurg.2020.12.014

Resident Opioid Prescribing Habits Do Not Reflect Best Practices in Post-Operative Pain Management: An Assessment of the Knowledge and Education Gap

J Surg Educ. 2021 Jul-Aug;78(4):1286-1294. doi: 10.1016/j.jsurg.2020.12.014. Epub 2020 Dec 30.

Authors

Victoria Huynh¹, Kathryn Colborn², Nicole Christian², Kristin Rojas³, Mark Nehler², Michael Bronsert², Ethan Cumbler², Gretchen Ahrendt², Sarah Tevis²

Affiliations

¹ Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado. Electronic address: Victoria.d.huynh@cuanschutz.edu.
² Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
³ Dewitt-Daughtry Department of Surgery, Division of Surgical Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida.

PMID: 33386285
DOI: 10.1016/j.jsurg.2020.12.014

Abstract

Objective: To evaluate deficiencies in knowledge and education in opioid prescribing and to compare surgical resident opioid-prescribing practices to Opioid Prescribing Engagement Network (OPEN) procedure-specific guidelines.

Design: Anonymous web-based survey distributed to all general surgery residents to evaluate prior education received and confidence in knowledge in opioid prescribing. The number of 5 milligram oxycodone tablets prescribed for common procedures was assessed and compared with OPEN for significance using Wilcoxon signed rank tests.

Setting: General surgery residency program within large university-based tertiary medical center.

Participants: Categorical general surgery residents of all postgraduate years.

Results: Fifty-six of 72 (78%) categorical residents completed the survey. Few reported receiving formal education in opioid prescribing in medical school (32%) or residency (16%). While 82% of residents felt confident in opioid side effects, fewer felt the same with regards to opioid pharmacokinetics (36%) or proper opioid disposal (29%). Opioids prescribed varied widely with residents prescribing significantly more than recommended by OPEN in 9 of 14 procedures.

Conclusions: Tackling the evolving opioid epidemic requires a multidisciplinary approach that addresses prescribing at all steps of the process, starting with trainee education.

Keywords: Opioid Epidemic; Opioid Prescribing Engagement Network; Resident Education; Surgical Education.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Analgesics, Opioid* / therapeutic use
Drug Prescriptions*
Habits
Humans
Pain, Postoperative / drug therapy
Practice Patterns, Physicians'

Substances

Analgesics, Opioid