Reducing Overprescription Practices for Opioid Use Post Anterior Cervical Surgery: The Impact of a Standardized Prescription Protocol.

Abstract

This study aimed to evaluate the impact of implementing a standardized opioid prescription protocol on prescription practices post-elective ACS surgery at a large academic institute. A prospective cohort study with a retrospective control group was conducted following institutional review board approval. A standardized protocol was created and implemented which specified opioid prescriptions post-surgery. Data on opioid doses, total and daily Morphine Milligram Equivalents requirements, and the need for refills were collected and compared between both cohorts. The study included 83 patients in the post-protocol cohort compared with 315 age- and sex-matched patients in the pre-protocol cohort. The postprotocol cohort received markedly lower daily and total doses at discharge compared with the preprotocol group (P < 0.01). No increase was observed in prescription refills before the initial follow-up in the postprotocol cohort (P = 0.35). At 12 weeks postsurgery, fewer patients in the postprotocol group remained on opioids compared with the preprotocol group (P = 0.14). Standardizing opioid prescriptions post-ACS surgery effectively reduces opioid doses prescribed without increasing refill rates. The findings support the efficacy of procedure-specific opioid prescription guidelines in reducing unnecessary opioid use and associated health and economic burdens.