Hospital Discharge Opioid Prescribing Trends in a Multistate Institution Following the Introduction of Opioid Prescribing Guidelines and Key Metrics Dashboard

Abstract

Background Despite the introduction of the Centers for Disease Control and Prevention's opioid prescribing guidelines, studies indicate that a significant proportion of opioids prescribed at hospital discharge remains unused. Little is known if improved provider awareness of guidelines and metrics would facilitate rightsizing opioid prescriptions at hospital discharge. Our institution created opioid prescribing guidelines and a key metrics dashboard and subsequently disseminated these tools to our institution's leadership and prescribers. We aim to evaluate the effectiveness of these efforts in reducing hospital discharge opioid prescriptions, especially those for acute pain exceeding 100 morphine milligram equivalents (MME). Methods Following the development of practice-specific opioid prescribing guidelines in 2017, a key metrics dashboard was created in 2021 to display the percentage of hospital discharges with opioids prescribed and the percentage of discharges with opioids prescribed for acute pain exceeding 100 MME. These metrics were broken down into calendar years between 2018 and 2022, and by the 7 major practice regions across our institution spanning 5 U.S. States. Results From 2018 to 2022, all regions showed a decline in the percentage of hospital discharges with opioids prescribed (range 2.7%-9.4%). In the same period, 5 of 7 regions showed a decline in discharge opioid prescriptions exceeding 100 MME for acute pain (range 8.8%-23.2%). Two sites showed an increase of 2.4% and 2.7%. Conclusion Downward trends in hospital discharge opioid prescriptions were observed for most practice regions following the introduction of our institution's opioid prescribing guidelines and key metrics dashboard.