Evaluation of Acute Care Providers' Opioid Prescribing Practices in Chronic Non-Cancer Pain

More than 760,000 people have died from an opioid overdose since 1999. The opioid epidemic claimed more than 70,000 lives with over 1.6 million having an opioid use disorder in 2019. Literature suggests an association between increased opioid prescribing and increased opioid addiction and by limiting the number of opioid prescriptions written may reduce opioid addiction. There is variation in opioid prescribing practices among acute care providers and opioid prescribing education has been proven to be an effective strategy to optimize prescribing in the acute care setting. This quality improvement project sought to minimize the use of opioids for chronic non-cancer pain by adhering to the Centers for Disease Control Guideline for Prescribing Opioids for Chronic Pain.
Twenty-five acute-care providers including medical doctors, nurse practitioners, and physician assistants participated. This project included a pre-test to measure providers baseline pain management knowledge, an educational module, and then a post-test. Retrospective chart audits were performed on records of patients discharged from the acute care setting from July 2020 to August 2020 with an opioid for chronic non-cancer pain prior to implementation of educational intervention and again January 2021 to February 2021 post-implementation.
Comparison of the pre-and-post-test surveys revealed learning in several areas. Though not statistically significant, (Pre: 40.4; Post: 41.3, p=.276), efficacy of the educational session was evident by improved test scores, pre-test (M = 40.4, SD = 3.5) and post-test (M = 41.3, SD = 4.7). The average number of opioid prescriptions by provider decreased significantly in the post-intervention period (Pre: 3.4; Post: .24, p<.000). Results suggest that implementing opioid-prescribing guidelines can reduce sub-optimal opioid prescribing in the acute care setting, therefore reducing the number of available opioids in the community for diversion and abuse.