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ASSESSMENT OF NARCOTIC PRESCRIBING PRACTICES IN A BREAST SURGICAL PRACTICE
Frederick H Millham, *Suniti Nimbkar, *Catherine Z Calvillo, *Leslie Leveille, *Dana Dowd
South Shore Hospital, Weymouth, MA

Objective: We wanted to understand the opioid tablet (OP) prescribing and consumption patterns among patients undergoing breast cancer surgery at our center. Our aim was to determine an optimal standard postoperative opioid prescription (OP) practice that meets patients’ needs without over prescribing. Design: This is a descriptive retrospective cohort study. As part of an ongoing continuous improvement program we recorded the total number of OP prescribed by our surgeons from January 15, 2016 through March 4, 2016, and the number of OP actually consumed during the post op period. Also recorded were covariates including the type of surgical procedure performed, patient’s age, narcotic use history and NCCN pain score before and after surgery. We then compared patterns of prescribing and consumption using univariate and multivariate statistical methods to derive an appropriate formula. Setting: Accredited community based comprehensive breast center with academic affiliation. Patients: We used a convenience sample of 80 consecutive women with breast cancer ranging in age from 19 to 85 who required breast surgery. Women with immediate breast reconstruction were excluded. Main Outcome: OP prescribed and OP consumed. Results: Pt were prescribed between 0 and 30 OP. 91% of patients consumed 5 or fewer OP, 46% consumed none. Of 1218 OP prescribed only 165 OP(13.5%) were taken. Median consumption was ZERO OP, IQR 0 - 1 OP. Accounting for age, pain score and narcotic history, patients requiring mastectomy consumed more OP (p<0.001). Conclusions: Following breast surgery, women required many fewer OP than were prescribed. These data support drastically reducing the standard post-operative OP prescription to no more than 5.

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Back to 2016 Annual Meeting Posters