54 Improving Responsible Opioid Prescribing on Patient Discharge

Aim There has been a 15-fold increase in opioid prescribing between 1992-2012. Interestingly, the duration of the first opioid prescription, rather than the strength, is more likely to be associated with misuse in post-operative patients. GPs are unaware on discharge, of the quantity of opioids dispensed (in Australia). We undertook an audit of current opioid prescribing habits on patient discharge (in a regional Australian hospital), with the aim to increase the number of GPs that receive details of the quantity of opioids prescribed, by including this in the discharge letter. Method We completed a closed-loop 3-cycle audit. The first cycle involved auditing the discharge letters from the ward for 3 consecutive weeks, in order to determine how many of these included the opioid quantity prescribed on discharge. Following this, we instigated change, by publishing a weekly reminder to the team. We then re-audited the discharge letters for another three consecutive weeks. The third cycle of the audit, included putting a poster in the doctor’s office, followed by re-auditing another three consecutive weeks. Results Initially, 3% of discharge letters included the opioid quantity that the patient was discharged with. In the second cycle, this increased to 27%, and in the third cycle this improved again to 53%. Conclusions This audit has shown an improvement with each audit cycle, resulting in more responsible opioid prescribing. This will contribute to reducing opioid-related harm in the community, whilst providing community doctors with information that they can use to continue responsible opioid prescribing.