TY - JOUR
KW - Analgesics, Opioid/administration & dosage/adverse effects
KW - Attitude of Health Personnel
KW - Clinical Decision-Making
KW - Decision Support Techniques
KW - Education, Medical, Continuing
KW - Guideline Adherence
KW - Habits
KW - Health Knowledge, Attitudes, Practice
KW - Humans
KW - Opioid-Related Disorders/diagnosis/epidemiology/prevention & control
KW - Orthopedic Procedures/adverse effects/standards
KW - Pain, Postoperative/diagnosis/epidemiology/prevention & control
KW - Patient Education as Topic
KW - Patient Selection
KW - Practice Guidelines as Topic
KW - Practice Patterns, Physicians'/standards
KW - Prescription Drug Misuse/prevention & control
KW - Risk Assessment
KW - Risk Factors
KW - Treatment Outcome
AU - E. M. Soffin
AU - S. A. Waldman
AU - R. J. Stack
AU - G. A. Liguori
A1 - 
AB - Orthopedic surgery is associated with significant perioperative pain. Providing adequate analgesia is a critical component of patient care and opioids play a vital role in the acute postoperative setting. However, opioid prescribing for patients undergoing orthopedic procedures has recently been identified as a major contributor to the current opioid epidemic. As opioid usage and related morbidity and mortality continue to rise nationwide, opioid-prescribing practices are under increased scrutiny. Here, we update the evidence base and recommendations behind a set of interventions developed at the Hospital for Special Surgery to address the national epidemic at the local level. The main components of our program include (1) guidelines for managing patients who are opioid tolerant and/or have a substance abuse disorder; (2) education programs for patients, emphasizing the role of opioids in recovery after elective orthopedic surgery; (3) education programs for prescribers of controlled substances, including clinical and regulatory aspects; (4) the development of surgery-specific prescribing recommendations for opioid-naive patients; and (5) mechanisms to modify prescribing habits to limit unnecessary prescribing of controlled substances.
AD - From the Department of Anesthesiology, Hospital for Special Surgery, New York, New York.
BT - Anesthesia and Analgesia
C5 - Education & Workforce; Opioids & Substance Use
CP - 5
CY - United States
DO - 10.1213/ANE.0000000000002433
IS - 5
JF - Anesthesia and Analgesia
M1 - Journal Article
N2 - Orthopedic surgery is associated with significant perioperative pain. Providing adequate analgesia is a critical component of patient care and opioids play a vital role in the acute postoperative setting. However, opioid prescribing for patients undergoing orthopedic procedures has recently been identified as a major contributor to the current opioid epidemic. As opioid usage and related morbidity and mortality continue to rise nationwide, opioid-prescribing practices are under increased scrutiny. Here, we update the evidence base and recommendations behind a set of interventions developed at the Hospital for Special Surgery to address the national epidemic at the local level. The main components of our program include (1) guidelines for managing patients who are opioid tolerant and/or have a substance abuse disorder; (2) education programs for patients, emphasizing the role of opioids in recovery after elective orthopedic surgery; (3) education programs for prescribers of controlled substances, including clinical and regulatory aspects; (4) the development of surgery-specific prescribing recommendations for opioid-naive patients; and (5) mechanisms to modify prescribing habits to limit unnecessary prescribing of controlled substances.
PP - United States
PY - 2017
SN - 1526-7598; 0003-2999
SP - 1704
EP - 1713
EP - 
T1 - An Evidence-Based Approach to the Prescription Opioid Epidemic in Orthopedic Surgery
T2 - Anesthesia and Analgesia
TI - An Evidence-Based Approach to the Prescription Opioid Epidemic in Orthopedic Surgery
U1 - Education & Workforce; Opioids & Substance Use
U2 - 29049115
U3 - 10.1213/ANE.0000000000002433
VL - 125
VO - 1526-7598; 0003-2999
Y1 - 2017
Y2 - Nov
ER -