4CPS-218 Opioid prescribing for acute non-cancer pain, post-operative pain and post-procedure pain by surgical teams at a tertiary hospital: 1-day audit

Background and Importance In Ireland, numbers of prescribed opioids are increasing yearly, out of proportion to population increase1. Acute hospitals are a major source of initial opioid prescriptions into communities 2. The Health Service Executive (HSE) has published opioid prescribing guidelines for the management of acute non-cancer pain, post-operative pain and post-procedure pain, specifically addressing the use of slow-release opioids, duration of prescription and avoidance of diversion following discharge 3. At our hospital, there is no standardised approach to opioid prescribing in this population. A baseline point prevalence survey (PPS) of opioid prescribing in this population by surgical teams was conducted. Aim and Objectives • To characterise opioid prescribing for acute non-cancer pain, post-operative pain and post-procedure pain in a tertiary healthcare setting • To inform local policy development on appropriate opioid use. Material and Methods The PPS took place on a single day in May 2023. Approval to conduct the survey was sought from the hospital Quality and Patient Safety Dept. All adult patients admitted to our hospital under a surgical team were included. The inpatient medication prescription record and medical notes for each patient were reviewed by a clinical pharmacist. Opioid prescription details were recorded on a data collection form hosted on Microsoft Forms. Results 72% of study population (n=205) were prescribed an opioid; total of 224 opioid prescriptions Most common indication, 43%, was acute postoperative pain (97/224) 27% (61/224) of prescriptions were for slow-release formulations 30% (67/224) of opioid prescriptions were prescribed for > 1 week 97% (218/224) of opioid prescriptions were commenced during the current admission Figures 1 & 2 respectively, summarise the opioid agent and formulation prescribed. Conclusion and Relevance This 1-day snapshot audit has presented several areas for improvement at our hospital, specifically the use of slow-release opioids, treatment duration and discharge prescription. Several quality improvement initiatives are being initiated as part of a wider opioid stewardship programme in line with the HSE National Clinical Programme for Anaesthesia. References and/or Acknowledgements 1. HSE PCRS Data Sources. Annual reports. https://www.sspcrs.ie/portal/annual-reporting 2. US National Survey on Drug Use and Health. https://www.samhsa.gov/data/sites/default/files/cbhsqreports/NSDUHMethodsSummDefs2018/NSDUHMethodsSummDefs2018.htm 3. HSE National Clinical Programme for Anaesthesia. Guidance for Opioid Prescribing for Acute Non-cancer Pain, Post-operative Pain and Post-procedure Pain, 2022. Conflict of Interest No conflict of interest.