Dr. Gressler on postop opioid prescribing after urology procedures

In this video, Laura Gressler, MS, PhD, discusses the background and notable findings from the Urology Practice paper, “National Long-Term Trends in Postoperative Opioid Prescribing in Ambulatory Urology Procedures.” Gressler is an assistant professor at the University of Arkansas for Medical Sciences College of Pharmacy in Little Rock.

Transcription:

Please describe the background for this study.

The study focuses on the trends in postoperative opioid prescribing after common urology ambulatory procedures. With over 60% of urological procedures performed in ambulatory settings, understanding these trends is crucial amid the ongoing opioid crisis in the United States. A 2016 JAMA study highlighted a concerning rise in opioid prescriptions following low-risk surgeries, showing a significant increase in both the proportion of patients receiving opioid prescriptions and the total amount prescribed. This underscores the importance of studying postoperative opioid use to prevent potential dependency and adverse outcomes. By analyzing trends in opioid prescribing practices and comparing factors such as stent vs no stent and open vs endoscopic procedures, we can better understand how to mitigate the risks associated with opioid use and ideally improve pain management protocols to enhance patient safety and health outcomes. So overall, this study aimed to comprehensively describe the postoperative patterns and trends in opioid and non-opioid prescribing. We also examined the cohort by approach and type of commonly performed urological ambulatory procedures to help delineate where best to focus future efforts in terms of mitigating narcotic prescriptions.

What were some of the notable findings? Were any of them surprising to you and your coauthors?

There were 3 main notable findings from the study, and they include a significant overall decrease in opioid prescriptions from 32% in 2015 to 19% of 2021. Then we had a rise in the prescription of non opioid medications from 4.6 in 2015 to 9.5 in 2021, and then we found higher rates of opioid prescriptions for open procedures compared to endoscopic ones. A surprise finding was the increase in opioid fulfillment beyond the 7-day postoperative period, which was really unexpected, and this indicates a need for more specific guidelines addressing pain management beyond that immediate postoperative period.

This transcription was edited for clarity.