5x-Multiplier Versus 3-Tier Model: A Pragmatic Randomized Clinical Trial for Discharge Opioid Prescriptions After Intra-Abdominal Cancer Surgery.
Brittany C Fields, Timothy E Newhook, Heather A Lillemoe et al.
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In 30 seconds
This pragmatic single-center randomized clinical trial compared two discharge opioid prescribing models in 150 adults undergoing major abdominal cancer surgery. The 5x-multiplier model resulted in a median discharge opioid volume of 25 mg, significantly lower than the 75 mg from the 3-tier model (P <0.001). Both models showed similar post-discharge opioid consumption and patient satisfaction.
Key findings
- Median discharge opioid volume was 25 mg for the 5x-multiplier versus 75 mg for the 3-tier model (P <0.001).
- 44% of patients in the 5x-multiplier group were discharged opioid-free compared to 1% in the 3-tier group.
- Median post-discharge opioid consumption was 0 mg for the 5x-multiplier and 10 mg for the 3-tier model (P =0.496).
- Refill rates were 24% for the 5x-multiplier and 18% for the 3-tier model (P =0.426).
Why it matters
The study highlights the potential of standardized prescribing models to reduce opioid prescriptions after surgery, addressing concerns about opioid dependence and diversion. Understanding these models can help clinicians optimize pain management while minimizing risks associated with opioid use.