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Variability in opioid prescribing practices among cardiac surgeons and trainees
Author(s) -
Percy Edward D.,
Hirji Sameer,
Cote Claudia,
Laurin Charles,
Atkinson Logan,
Kiehm Spencer,
Malarczyk Alexandra,
Harloff Morgan,
Bozso Sabin J.,
Buyting Ryan,
Fatehi Hassanabad Ali,
Guo Ming Hao,
Jaffer Iqbal,
Lodewyks Carly,
Tam Derrick Y.,
Tremblay Philippe,
Légaré JeanFrançois,
Cook Richard,
Kaneko Tsuyoshi,
Pelletier Marc P.
Publication year - 2020
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.14885
Subject(s) - medicine , medical prescription , pill , opioid , interquartile range , family medicine , anesthesia , emergency medicine , nursing , receptor
Background and Aim The opioid epidemic has become a major public health crisis in recent years. Discharge opioid prescription following cardiac surgery has been associated with opioid use disorder; however, ideal practices remain unclear. Our aim was to examine current practices in discharge opioid prescription among cardiac surgeons and trainees. Methods A survey instrument with open‐ and closed‐ended questions, developed through a 3‐round Delphi method, was circulated to cardiac surgeons and trainees via the Canadian Society of Cardiac Surgeons. Survey questions focused on routine prescription practices including type, dosage and duration. Respondents were also asked about their perceptions of current education and guidelines surrounding opioid medication. Results Eighty‐one percent of respondents reported prescribing opioids at discharge following routine sternotomy‐based procedures, however, there remained significant variability in the type and dose of medication prescribed. The median (interquartile range) number of pills prescribed was 30 (20‐30) with a median total dose of 135 (113‐200) Morphine Milligram Equivalents. Informal teaching was the most commonly reported primary influence on prescribing habits and a lack of formal education regarding opioid prescription was associated with a higher number of pills prescribed. A majority of respondents (91%) felt that there would be value in establishing practice guidelines for opioid prescription following cardiac surgery. Conclusions Significant variability exists with respect to routine opioid prescription at discharge following cardiac surgery. Education has come predominantly from informal sources and there is a desire for guidelines. Standardization in this area may have a role in combatting the opioid epidemic.