Purpose: To develop and evaluate a tool for resident education around post-operative opioid prescribing practices.
Background: Opioid abuse is a growing public health crisis. Resident physicians within OB/GYN routinely prescribe opioids following a variety of common operative procedures. However, formalized curriculum regarding appropriate post-operative opioid prescribing practices is limited. Consequently, prescribing practices of residents are influenced by multiple factors, including hospital culture or program type, with a lack of standardization or best practice guidelines.
Methods: OB/GYN residents, PGY 1-4, within a single institution were invited to complete a baseline survey assessment of their opioid knowledge and prescribing habits. A one-hour lecture was then given as part of the program’s standard didactic curriculum, with an emphasis on areas of educational weakness identified by participants in the pre-survey, as well as best practice guidelines from literature review and leadership within the department. Residents were asked to complete a second survey to evaluate their knowledge and prescribing habits after the curricular intervention. Results from the two surveys were assessed and compared.
Results: A total of 19 residents completed both the pre- and post-intervention surveys. All respondents agreed that opioid prescribing education should be added to the curriculum, with most indicating a preference for a didactic lecture. A majority (76.3%) indicated that they planned to alter their prescribing habits after attending the educational session. There was a statistically significant decrease in self-reported numbers of opioid tablets prescribed after open, laparoscopic and vaginal hysterectomy, as well as after cesarean delivery. There was no change in the number of self-reported opioid tablets prescribed after hysteroscopic and other laparoscopic procedures, or after vaginal delivery. Residents also reported stronger confidence as prescribers (p< 0.02), as well as plans to increase the use of opioid risk assessment tools (p< 0.01), and trended towards more counseling on opioid disposal (p=0.083).
Discussions: Opioid focused education improves residents’ knowledge and confidence related to opioid prescribing, reduces reported opioid prescriptions, and provides standardization for prescribing practices. Obstetrics and gynecology residencies should consider adding this topic to their regular didactic curriculum.
Topics: CREOG & APGO Annual Meeting, 2021, Student, Resident, Faculty, Residency Director, Patient Care, Medical Knowledge, Systems-Based Practice & Improvement, GME, Assessment, Lecture, Quality & Safety,
Jennifer Sternberg, MD, LAC+USC Medical Center; Mary Ciotti, MD ; Christina Dancz, MD, MPH
