Factors that influence discharge opioid prescribing among bariatric surgeons across Michigan. Am J Surg 2023 Jan;225(1):184-190
Date
08/07/2022Pubmed ID
35933183DOI
10.1016/j.amjsurg.2022.07.023Scopus ID
2-s2.0-85135566491 (requires institutional sign-in at Scopus site)Abstract
BACKGROUND: Opioid prescribing following bariatric surgery has been a focus due to its association with new persistent opioid use (NPOU) and worse outcomes. Guidelines have led to a reduction in opioids prescribed, but there remains variation in prescribing practices.
METHODS: We conducted interviews with 20 bariatric surgeons across Michigan. Transcripts were analyzed using descriptive content analysis.
RESULTS: At the patient level, surgeons described the role of surgical history and pain tolerance. At the provider level, surgeons discussed patient dissatisfaction, reputation, and workload. At the institution level, surgeons discussed colleagues, resources, and administration. At a collaborative level, surgeons described the role of evidence and performance measures. There was lack of consensus on whether NPOU is a problem facing patients undergoing bariatric surgery.
CONCLUSION: Despite efforts aimed at addressing opioid prescribing, variability exists in prescribing practices. Understanding determinants that impact stakeholder alignment is critical to increasing adherence to guideline-concordant care.
Author List
Vitous CA, Carlin AM, Waljee J, Stricklen A, Ross R, Ghaferi A, Ehlers APAuthor
Amir Ghaferi MD President, Phys Enterprise & SAD Clinical Affairs in the Medical College Physicians Administration department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Analgesics, OpioidBariatric Surgery
Humans
Michigan
Opioid-Related Disorders
Pain, Postoperative
Patient Discharge
Practice Patterns, Physicians'
Surgeons