What are the findings of an educational investigation of postoperative opioid prescribing patterns among otolaryngological residents and attending physicians?
Explore This IssueJuly 2021
Improvement in opioid prescribing and pain management should be an essential component of otolaryngology residency education and attending continuing medical education.
BACKGROUND: Despite the ongoing opioid epidemic in the U.S., studies have demonstrated that opioids are overprescribed postoperatively, leading to mishandling and overuse. Lack of postoperative opioid prescribing guidelines has translated to a large variation in prescribing patterns. Moreover, instruction in this area has historically been overlooked within resident education.
STUDY DESIGN: Cross-sectional survey study.
SETTING: Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston.
SYNOPSIS: Researchers queried residents and attending clinical faculty members via electronic survey at a single academic institution from February through April 2020 regarding their opioid prescribing practices. Twenty-nine attending otolaryngologists and 22 residents completed the survey. Opioid prescriptions were categorized on an integer scale from 0 to 50 pills, with each pill equivalent to 5 mg of oxycodone. Among faculty, surgical cases with the most postoperatively prescribed opioids included tonsillectomy, neck dissection, brow lift, facelift, and open reduction of facial trauma. Among residents, surgical cases with the most postoperatively prescribed opioids included tonsillectomy (ages 11 years and above), neck dissection, open reduction of facial trauma, parotidectomy, and thyroid/parathyroid surgery. Residents on average prescribed fewer opioid pills per procedure than attendings. However, in general, there was agreement in opioid prescribing patterns between residents and attending physicians, suggesting that residents model attendings’ opioid prescription patterns. Authors emphasized the need for institutional and society guidelines on postoperative pain management within otolaryngology. Study limitations included the single institution cross-sectional survey study design and the broad classification of opioid prescribing.
CITATION: Mokhtari TE, Miller LE, Chen JX, et al. Opioid prescribing practices in academic otolaryngology: A single institutional survey. Am J Otolaryngol. 2021;42:103038.