Standard Protocol Cuts Opioid Rx After Pediatric Appendectomy

Quality improvement intervention used to reduce opioid prescribing at discharge for children undergoing an appendectomy

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WEDNESDAY, Feb. 23, 2022 (HealthDay News) -- A standardized prescribing protocol can minimize opioid prescriptions at the time of discharge for pediatric appendectomy patients, according to a study published in the March issue of the Journal of the American College of Surgeons.

Lorraine I. Kelley-Quon, M.D., from Children's Hospital Los Angeles, and colleagues evaluated a quality improvement (QI) program to minimize opioid prescribing at time of discharge for children undergoing appendectomy. The analysis included 1,524 children (aged 18 years or younger) who underwent appendectomy in 2019 at one of 10 children's hospitals within the Western Pediatric Surgery Research Consortium.

The researchers found that after the QI intervention, overall opioid prescribing decreased from 18.2 to 4.0 percent, with significant decreases in the five hospitals that did not routinely prescribe opioids after appendectomy before the intervention (2.7 versus 0.8 percent) and at the five hospitals that lacked a prescribing protocol before the intervention (37.9 versus 8.8 percent). There was no change observed in the proportion of 30-day emergency room visits after the QI intervention.

"Future efforts to optimize opioid prescribing should emphasize stakeholder engagement and harness information technology infrastructure to facilitate evidence-based pain management strategies for children who receive surgery," the authors write.

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