Impact of Education and Legislation on Opioid Prescribing Patterns Following Cesarean Delivery

Indianapolis, IN

Opioid overprescribing post-surgery, including cesarean delivery, may contribute to patients taking opioids unnecessarily or increase potential for misuse through improper storage and lack of disposal of unused pills. In an effort to control overprescribing of opioids, Indiana passed Senate Enrolled Act 226 on July 1, 2017, which prevents providers from prescribing more than a seven-day supply of opioids to adults receiving their first opioid prescription from that provider. The purpose of this study is to investigate if legislation or prescriber education will decrease the number of opioids prescribed at discharge following cesarean delivery. The study consisted of three phases based on date of discharge: pre-legislation phase (March 1, 2017-June 30, 2017), post-legislation phase (July 1, 2017-October 30, 2017), and post-education phase (February 1, 2018-May 31, 2018). Two hundred patients were included in each phase of the study. Education was provided regarding the overprescribing of opioids and methods to reduce overprescribing in January 2018 and an anonymous survey was given to assess how the providers anticipated the education to impact their prescribing practices. A retrospective chart review was conducted for the pre- and post-legislation phase patients to determine baseline morphine milligram equivalents and number of opioid pills prescribed at discharge. Preliminary results from the pre-legislation phase indicate that an average of 37.8 opioid pills, equaling 276 morphine milligram equivalents, were prescribed for each patient. A chart review will be conducted for patients discharged during the post-legislation and post-education phase.