SHM Converge Scientific Abstract ePoster Gallery-An Opioid Stewardship Program to Improve Opioid Prescribing Practices in the Inpatient Setting

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The document describes an inpatient opioid stewardship program at Brigham and Women’s Hospital aimed at improving opioid prescribing on a hospitalist-staffed general medicine service. The program targeted opioid-naïve patients admitted with acute, non-cancer pain. It included multidisciplinary guideline development, clinician/nurse/pharmacist/patient education, and real-time feedback when opioid orders fell outside recommended guidelines.<br /><br />The study compared a pre-intervention group (November 2019–July 2020) of 746 patients with a post-intervention group (August 2020–February 2021) of 143 patients. Outcomes were analyzed using regression models and adjusted for demographic factors such as age, race, gender, language, and insurance.<br /><br />Results showed a favorable trend toward reduced opioid use after the intervention. Mean total morphine milligram equivalents (MME) per admission decreased from 49 to 17.8, and mean MME per day decreased from 6.6 to 2.7. Intravenous opioid use also fell from 14.2 to 6.2 MME per admission. Use of opioid-sparing medications around the clock increased from 42% to 52%, though these changes were not statistically significant. Overall, opioid-sparing medication days per length of stay remained essentially unchanged.<br /><br />The authors conclude that an opioid stewardship intervention for opioid-naïve inpatients has the potential to reduce opioid and IV opioid prescribing and encourage more scheduled use of non-opioid pain medications. A key limitation was the reduced number of eligible post-intervention patients during the COVID-19 pandemic. Future efforts will focus on embedding the guidelines into an EHR safety dashboard to sustain improvements.

Asset Subtitle

Agustina Saenz

Meta Tag

Author List Agustina Saenz, Cathy Yoon, Fabiola Molina, Jeffrey L. Schnipper, Julie Fiskio, Kristin Kim, Laura E. Smith, Patricia Aylward

Category Research

Concept Inpatient Opioid Stewardship Program

Concept Opioid Prescribing

Concept Opioid-Naive Patient

Concept Morphine Milligram Equivalent

Concept Prescribing Guideline

Distinguished Non-Finalist

Presenter Organization Brigham and Women's Hospital

Presenting Author Agustina Saenz

Track Quality Improvement

Keywords

opioid stewardship

inpatient prescribing

hospitalist service

acute pain

opioid-naive patients

morphine milligram equivalents

multidisciplinary intervention

non-opioid analgesics

real-time feedback

electronic health record dashboard

Inpatient Opioid Stewardship Program

Opioid Prescribing

Opioid-Naive Patient

Morphine Milligram Equivalent

Prescribing Guideline