Local Interventions Can Reduce Opioid Rx After Urologic Surgery

A systematic review and meta-analysis show direct interventions have a greater impact on opioid prescribing than indirect interventions

Doctor With Clipboard Giving Prescription To Male Patient
Adobe Stock

MONDAY, April 18, 2022 (HealthDay News) -- Successful reduction in opioid prescriptions following urological surgery can be achieved through a variety of interventions without compromising pain control, according to a comprehensive review and meta-analysis published in the May issue of The Journal of Urology.

Kevin M. Carnes, M.D., from Albany Medical College in New York, and colleagues conducted a systematic literature review to identify studies examining opioid prescriptions and urological surgery.

Based on a meta-analysis of data from 19 studies (8,318 patients), the researchers found that the overall mean reduction per patient in prescribed opioids was −67.59 morphine milligram equivalents (MME). Direct interventions, implemented by providers within their local department or hospital, were more effective than indirect, or systemic, interventions in reducing prescribed opioids (mean, −76.68 versus −46.72 MME). There was a significant mean reduction observed (−18.31 MME) in opioid consumption per patient after the intervention. Before and after the intervention, patient satisfaction with analgesia remained unchanged.

"Collectively, these data suggest that physician-led interventions are impactful in limiting opioid prescriptions, and identify the role and responsibility for physicians to implement direct intervention at the local hospital or department level," the authors write. "Further, any direct, locally implemented measures to reduce opioid prescription are likely to be less expensive than the implementation of regulatory mandates by health authorities."

Abstract/Full Text

Physician's Briefing