Shared Decision Making: How Does it Effect Opioid Prescribing?

In a study presented at AAGL Virtual 2020, researchers sought to determine the impact of shared decision making on postsurgical opioid prescribing in women undergoing minimally invasive hysterectomy.

Overall, the patient-directed arm of the study used a greater percentage of oxycodone (38.4%) than did the patients in the standard treatment group (26.7%). No difference was observed in the total number of oxycodone used in the standard (mean 7.9±9.8 tablets) and patient-directed arms (mean 8.4±10.2 tablets, p=0.5).Five patients in the patient-directed arm were prescribed additional narcotics following preoperative visits compared with none of those in the standard arm, and there were no differences in rates of unexpected office and emergency room visits for pain.

“Shared decision making significantly increased percent of oxycodone utilization but did not decrease the total number of oxycodone used. Patients used on average 20 tablets less than the standard 30 tablets prescribed, and gynecologic surgeons should consider prescribing less opioids after MIS hysterectomy.”

—Michael Potts

Reference:

Delara RMM, Islam MR, Thomas N, et al. Shared decision making in opioid prescribing in gynecologic surgery: a prospective randomized controlled trial. Presented at AAGL Virtual 2020. November 6-14. https://aagl.confex.com/aagl/2020/meetingapp.cgi/Paper/4328