Prostate Cancer Clinical Trial
Official title:
Post-Discharge Opioid Reduction Intervention for Open, Laparoscopic, and Endoscopic Surgery (ORIOLES): A Quality Improvement Study of Prescribing Habits and Patient Education
ORIOLES is a non-randomized, pre-post intervention study designed to improve quality of opioid prescribing and use after discharge for patients undergoing urologic surgery. The study will initially focus on a pre-defined cohort of patients undergoing radical prostatectomy. After the predefined study period for the pre-intervention arm, a three-part intervention is employed to assess the effect on opioid prescribing and use in the post-intervention arm. Pending results, the intervention may be applied to all surgeries in the department for routine clinical care.
The goal of the study is to reduce the amount of opioid analgesia prescribed after urologic
surgery in the Department of Urology at Johns Hopkins. The initiative focuses on patients
undergoing surgery for prostate cancer with radical prostatectomy including patients enrolled
in IRB00123618/NCT03006562. The pre-intervention arm will consist of patients enrolled August
2017 to January 2018. The intervention arm will consist of patient enrolled January 2018 to
completion of the study.
The intervention consists of a information discharge sheet, a standardized prescribing
guideline at discharge, and nurses providing improved education for patients at discharge
about appropriate use of opioid medication, routes for disposal, and potential side effects.
Data on prescriptions written (amount and type of mediation) and use of opioid and other pain
medication after surgery will be compared before and after the quality improvement initiative
is started. Outcomes are assessed via 30-day phone call follow-up with data on perioperative
outcomes, postoperative medication use, and symptoms already assessed in
IRB00123618/NCT03006562. At the completion of the pre-intervention arm, providers in the
urology department are informed about the average and distribution of usage of post-discharge
opioids. Education and standardized prescribing (allowing for provider judgment) may help
reduce/personalize the amount of opioids prescribed at discharge to reduce wasted medication
entering circulation. The initiative may then be expanded to encompass all surgeries in the
department to reduce opioid prescribing and use for routine clinical care.
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