Disclosures: Matthew R. Elverman, MD: No financial relationships or conflicts of interest

Objective : After the opioid public health emergency was declared in 2017, the number of opioids prescribed on discharge was monitored. An initiative was taken to titrate opioids down during inpatient rehabilitation (IPR) stay, with the goal of prescribing less opioids, while still controlling patient’s pain. Opioids prescribed on discharge were monitored based on rehabilitation impairment categories (RIC’s) such as major trauma, amputation, etc.

Design: Retrospective cohort study

Setting : Inpatient rehabilitation hospital

Participants : 895

Interventions: During IPR stays, patients’ opioids were given based on pain scales >6/10. Providers then started implementing different plans via electronic medical record (EMR) to find different modalities to achieve pain relief. Additional medications (Tylenol, lidocaine patches, capsaicin cream, gabapentin, etc) were given based on nature of pain and for lower pain scales < 6/10. Patients were discharged on the lowest amount of opioids based on the frequency they were given to patient in IPR, while still being able to control pain. Finally, prescribers made efforts to only give 1 week of opioids on discharge. Patients were scheduled to have close follow up with primary care providers to ensure their pain was controlled. Differences in the quantity of opioids prescribed on discharge were then recorded from 2017 to current.

Main Outcome Measures: The main outcome measure was pills per patient prescribed on discharge.

Results: Using a scatterplot of the data from Nov, 2017 to current, the number opioids, specifically opioid pills per patient at IPR discharge were recorded by month. Opioids prescribed on discharge for patients suffering from fractures resulted in a 5.9% decrease; patients suffering from amputations resulted in a 39% decrease; patients suffering from major multi-traumas resulted in a 71% decrease.

Conclusions: Data collected from 2017 to current showed that the declaration of the Opioid Crisis and subsequent efforts implemented via EMR has decreased the number of opioids prescribed on discharge from the IPR setting.

Level of Evidence: Level II

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/opioid-prescription-reduction-after-2017-opioid-public-health-emergency/