As part of the National Institute on Drug Abuse’s HEALing Communities study, Boston Medical Center’s goal is to decrease opioid-related deaths by 40% over three years in Massachusetts through a range of treatment interventions. One area of focus is post-surgical opioid prescribing, where BMC has reduced opioid prescribing by 24% for orthopaedics.
When clinicians prescribe opioids for patients being discharged from orthopaedic surgery, they see a suggested dose calculated in Epic that is automatically tapered leading up to the patient’s discharge. This taper schedule, with dosing based on the pain the patient experiences, is shared with the patient on the visit summary as part of a personalized post-op treatment plan. The patient then tracks the pills needed on the visit summary and shares this information at a two-week follow-up appointment.
“We’re New England’s largest safety net hospital, and our patients struggle with the day-to-day impact of the opioid epidemic,” said Dr. Daniel Newman, associate CMIO at BMC. “With post-op opioid tapering and our other diagnostic, treatment, and prevention strategies, we hope to reduce opioid use and addiction in the future while still helping patients safely manage pain.”
In addition to reducing orthopaedic-specific prescribing, the post-op tapering approach also helped BMC decrease overall variation in opioid prescribing. Patients surveyed said that the opioids they were prescribed effectively managed their pain.
Learn more about BMC’s efforts to fight opioid addiction, and read about their post-op opioid prescribing program in The Journal of the American Academy of Orthopaedic Surgeons.