| Title |
The Impact of Education and Prescribing Guidelines on Opioid Prescribing for Breast and Melanoma Procedures
|
|---|---|
| Published in |
Annals of Surgical Oncology, September 2018
|
| DOI | 10.1245/s10434-018-6772-3 |
| Pubmed ID | |
| Authors |
Jay S. Lee, Ryan A. Howard, Michael P. Klueh, Michael J. Englesbe, Jennifer F. Waljee, Chad M. Brummett, Michael S. Sabel, Lesly A. Dossett |
| Abstract |
Excessive opioid prescribing is common in surgical oncology, with 72% of prescribed opioids going unused after curative-intent surgery. In this study, we sought to reduce opioid prescribing after breast and melanoma procedures by designing and implementing an intervention focused on education and prescribing guidelines, and then evaluating the impact of this intervention. In this single-institution study, we designed and implemented an intervention targeting key factors identified in qualitative interviews. This included mandatory education for prescribers, evidence-based prescribing guidelines, and standardized patient instructions. After the intervention, interrupted time-series analysis was used to compare the mean quantity of opioid prescribed before and after the intervention (July 2016-September 2017). We also evaluated the frequency of opioid prescription refills. During the study, 847 patients underwent breast or melanoma procedures and received an opioid prescription. For mastectomy or wide local excision for melanoma, the mean quantity of opioid prescribed immediately decreased by 37% after the intervention (p = 0.03), equivalent to 13 tablets of oxycodone 5 mg. For lumpectomy or breast biopsy, the mean quantity of opioid prescribed decreased by 42%, or 12 tablets of oxycodone 5 mg (p = 0.07). Furthermore, opioid prescription refills did not significantly change for mastectomy/wide local excision (13% vs. 14%, p = 0.8), or lumpectomy/breast biopsy (4% vs. 5%, p = 0.7). Education and prescribing guidelines reduced opioid prescribing for breast and melanoma procedures without increasing the need for refills. This suggests further reductions in opioid prescribing may be possible, and provides rationale for implementing similar interventions for other procedures and practice settings. |
X Demographics
The data shown below were collected from the profiles of 9 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 6 | 67% |
| Unknown | 3 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 5 | 56% |
| Members of the public | 4 | 44% |
Mendeley readers
The data shown below were compiled from readership statistics for 86 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 86 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Doctoral Student | 11 | 13% |
| Other | 8 | 9% |
| Researcher | 8 | 9% |
| Student > Bachelor | 8 | 9% |
| Professor > Associate Professor | 7 | 8% |
| Other | 19 | 22% |
| Unknown | 25 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 32 | 37% |
| Nursing and Health Professions | 6 | 7% |
| Pharmacology, Toxicology and Pharmaceutical Science | 5 | 6% |
| Business, Management and Accounting | 3 | 3% |
| Social Sciences | 2 | 2% |
| Other | 6 | 7% |
| Unknown | 32 | 37% |
Attention Score in Context
This research output has an Altmetric Attention Score of 23. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 26 October 2018.
All research outputs
#1,381,616
of 22,790,780 outputs
Outputs from Annals of Surgical Oncology
#222
of 6,462 outputs
Outputs of similar age
#32,039
of 341,262 outputs
Outputs of similar age from Annals of Surgical Oncology
#10
of 126 outputs
Altmetric has tracked 22,790,780 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 93rd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,462 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.4. This one has done particularly well, scoring higher than 96% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 341,262 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 90% of its contemporaries.
We're also able to compare this research output to 126 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 92% of its contemporaries.