CPSS Pharmacist Manager, Saskatoon
Project: Reducing Post- Operative Orthopedic Opioid Prescribing for Patients who are Opioid-naive
Opioid overprescribing after elective surgery can lead to chronic opioid use and studies have shown that
around 80% of patients who used heroin reported an introduction to opioids via prescription1. Up to 80% of opioids remain unused after elective surgery, leading to potential diversion and misuse1.
Patients who are opioid-naïve should require no more than 60 opioid-containing tablets on discharge from total knee arthroplasty. In analyzing drug claim data, around 50% of patients who are opioid-naïve post-TKA receive ≥60 opioid-containing tablets in some Saskatchewan centres. Overreliance on post-surgical opioids is problematic for Saskatchewan physicians to manage as only 32% self-reported “very” or “extremely” confident in planning/carrying out opioid deprescribing and 72% reported concerns with managing difficult patients behaviours related to opioids.
Upon surveying Regina’s orthopedic surgeons, most surgeons elected for a department prescribing presentation. Although challenges associated with COIVD-related surgical backlog persist, by October 2022, a presentation will be provided by a local addiction medicine physician, followed by post-intervention claim analysis to measure prescribing changes (aiming to reduce previously identified over prescribing by a minimum of 25%).