If you want to limit the amount of opioids you prescribe in your practice, you’ve come to the right place.
Our goal with this initiative is to reduce the number of opioids that are prescribed to patients during and after surgery. Below, you’ll find tools to empower you as you have conversations with your patients about the role opioids play in their care.
Physicians in partnership with the OrthoCarolina Research Institute (OCRI) were faced with the challenge to rethink the need for opioids during and after orthopedic surgery and we challenge you to do the same. We are here to help you make adjustments and incorporate opioid free surgery, where applicable, in your own medical practices.
We know every patient won’t be a good fit for opioid-free surgery like the one we used in our research, but that doesn’t mean there aren’t other alternatives for you to explore with your patients.
We found the benefits to an opioid free surgical protocol had a number of advantages for patients pain and comfort levels post surgery including but not limited to:
As you’ll see in the above video, Dr. Brian Curtin of OrthoCarolina’s Hip & Knee Center admits he was hesitant about performing opioid free hip replacement surgery on his patients as part of OCRI’s research study. However, once he saw how patients were responding to the pain medication and had conversations with patients, he was fully on board.
He estimates that 80-90% of patients were interested in the opioid reduced pathway after he had a conversation with is patients that covered the following topics:
If you cover those points in a short conversation, you can arm patients with valuable information and empowers patients to play an active role in choosing medications that have a better safety profile for them specifically. We know all patients will not be a good candidate for opioid free surgery based on their individual sensitives and allergies to medication.
We know each practice, clinic, surgery center, and hospital has their own systems and procedures when it comes to surgery orders, prescribing practices, and other general administrative tasks. So, this process will look different for each surgeon.
When OCRI embarked on opioid free surgery research, we identified champions and key players along the way by involving the following healthcare departments in executing our research protocol:
To read more about OCRI’s study protocol implementation strategy via our article published in BMC Musculoskeletal Disorders.
The concept behind opioid minimizing surgery is that we are treating a patient’s pain from an inflammatory standpoint, a nerve standpoint, and from a pain standpoint all while avoiding the opioid containing medication before, during, and after surgery. Collectively, they work together, as OCRI’s research shows, to treat patients’ pain just as effectively as an opioid would.
It was important to our opioid reduction effort that all medications used were well established and easily stocked in most hospitals and surgery centers.
DISCLAIMER: The medications listed below may or may not apply to your surgery. The medications listed here are ones that were used as part of an opioid free surgery research study, and the exact medications and dosages used for each patient varied depending on the type of surgery that was conducted. This list is not intended to be an all-encompassing list of potential medications that can be used for reducing opioids in your treatment. It is nothing more than an example or guideline of potential opioid-reducing options. The following lists are not medical advice.
Here are a few things to consider as you decide if a patient might be a successful candidate for opioid reduced surgery:
First, it’s important that you as the healthcare practitioner find your own voice and reasoning for why a patient is a strong candidate for opioid reduced surgery.
After speaking to well over 100 patients about reduced opioid surgery options, OrthoCarolina’s Dr. Nady Hamid walks patients through their pain medication options for before, during, and after an upcoming surgery. He’s found that when he talks about common side effects as they relate to prescription opioids, it helps patients make a more informed decision.
“It’s not only that opioid medications are highly addictive,” he reminds patients. “They carry side effects that make patients feel crumby as they are taking them.”
Some of the side effects he mentions are:
By educating our patients, they are invited into making an informed decisions with you about their care including options to reduce the use of opioids in their treatment plan.
Some patients will hear “opioid free surgery” and assume that means no pain killers and/ or anesthesia will be used during their surgery, which could not be further from the truth. They may even ask staff in your clinic about opioid free surgery. Here are some key points for clinical staff to know about opioid reduced or opioid free surgery.
OrthoCarolina used EPIC to manage their Electronic Health Records. So, it was important that our communication to patients was integrated with EPIC and their patient interface called, “MyChart.”
The EPIC EHR currently reports hospitals that use its software held medical records of 54% of patients in the US and 2.5% worldwide. With EPIC’s vast reach, building a patient outreach tool allows OCRI’s opioid reduction efforts to scale nationally.
Our team’s EPIC build consisted three goals:
CLICK HERE to see how OrthoCarolina is using EPIC to spark a conversation about opioid prescriptions with their patients.
By visiting the EPIC Community Library, healthcare systems who also use the EPIC EHR will be able to utilize the MyChart and BPA Storyboard tools OCRI and OrthoCarolina built as part of their ongoing practice-changing opioid reduction efforts.
Unidentified breakthroughs in combatting the opioid epidemic are just waiting to be discovered, but we can’t do it without the support of generous people like you.
