Addressing the Opioid Crisis One Surgical Patient at a Time: Outcomes of a Novel Perioperative Pain Program

Am J Med Qual. 2020 Jan/Feb;35(1):5-15. doi: 10.1177/1062860619851170. Epub 2019 May 25.

Abstract

Opioid prescriptions in the surgical setting have been implicated as contributors to the opioid epidemic. The authors hypothesized that a multidisciplinary approach to perioperative pain management for patients on chronic opioid therapy could decrease postoperative opioid requirements while reducing postoperative pain scores and improving functional outcomes. Therefore, a Perioperative Pain Program (PPP) for chronic opioid users was implemented. This study presents outcomes from the first 9 months of the PPP. Sixty-one patients met the inclusion criteria. Opioid consumption in morphine milligram equivalent (MME) was calculated and physical and health status of patients was assessed with the Brief Pain Inventory, Short-Form McGill Pain Questionnaire, and Short Form-12. Preliminary results showed significant reduction in MME, improved pain scores, and improved function for surgical patients on chronic opioids. PPP effectively reduced opioid usage without negatively influencing patient-reported outcomes, such as physical pain score assessment and health-related quality of life.

Keywords: chronic opioids; multimodal; opioid epidemic; pain management; perioperative.

MeSH terms

  • Analgesics, Opioid / adverse effects*
  • Analgesics, Opioid / therapeutic use
  • Female
  • Humans
  • Male
  • Middle Aged
  • Opioid Epidemic / prevention & control*
  • Opioid-Related Disorders / epidemiology
  • Opioid-Related Disorders / prevention & control*
  • Pain Management / methods
  • Pain, Postoperative / epidemiology
  • Pain, Postoperative / prevention & control*
  • Patient Care Team / standards
  • Patient-Centered Care / organization & administration*

Substances

  • Analgesics, Opioid