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Opioid-Free Ureteroscopy: Are Academic Urologists Lagging Behind Private Practice? | LitMetric

AI Article Synopsis

  • The study aimed to assess trends in opioid prescribing following ureteroscopy and compare practices between private and academic hospitals from 2016 to 2019.
  • A retrospective review of 555 patients showed a significant decline in opioid prescriptions over time, particularly in private hospitals which reached zero median prescriptions by 2017.
  • The results indicated that while both settings reduced opioid use, private practitioners responded more quickly than academic institutions, with no observed spillover effects from other opioid-reduction initiatives.

Article Abstract

Objective: To examine overall trends in opioid prescribing after ureteroscopy and compared opioid use between private and academic practice settings. We also analyzed the potential for spillover effect from an unrelated opioid-reduction initiative for major oncologic surgery.

Methods: We conducted a retrospective chart review of all ureteroscopies performed within our system at four distinct time points from 2016-2019. We recorded the type and number of opioid pills prescribed and calculated oral morphine equivalents. Analysis included comparison between community and academic hospitals as well as pre- and post-initiative.

Results: 555 patients undergoing ureteroscopy and 29 attending surgeons were included in the analysis. The median prescription size per ureteroscopy decreased throughout the study period in both the private and academic settings. From 2016-2017, median oral morphine equivalents (OMEs) decreased from 60 to 0 in the private setting and remained at 0 for the duration of the study period. Opioid reduction in the academic setting lagged behind private practitioners but median OMEs did steadily decrease to 0 in 2019. No significant spillover effect was observed.

Conclusion: Since 2016, opioid prescribing following ureteroscopy has decreased in both the private and academic practice settings. Notably, private practice urologists achieved a median of 0 opioids 2 years prior to academic urologists. These data suggest that, in some circumstances, academic institutions may have been slower to respond to the opioid epidemic.

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Source
http://dx.doi.org/10.1016/j.urology.2022.06.021DOI Listing

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