Evaluation of an opioid restrictive pain management initiative in adult kidney transplant recipients. Issue 7 (25th April 2021)

• Record Type: Journal Article
• Authors: Dualeh, Shukri H. A.; McMurry, Katie; Herman, Alexandra E.; Maryan, Samantha; Pacurar, Lavinia A.; Waits, Seth A.; Tischer, Sarah
• Is Part Of: Clinical transplantation. Volume 35:Issue 7(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-04-25
• Subjects: kidney -- opioid -- pain -- transplant; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.14313
• Languages: English
• ISSNs: 0902-0063

Abstract

Abstract: Purpose: Evidence to guide opioid utilization following kidney transplantation is lacking. The purpose of this study is to evaluate the implementation of an opioid restrictive post‐operative pain management protocol in adult kidney transplant recipients. Methods: We analyzed patients who underwent kidney transplant between 1/1/2017 to 8/15/2018. A standardized, opioid restrictive pain management protocol was implemented in February 2018. The primary outcome was quantity of opioid tablets prescribed at discharge. Secondary outcomes included amount of opioid prescribed within first 30 days, number of patient calls for pain, and opioid prescription in electronic medical record (EMR) at 90 days and 1 year. Results: After implementation, significantly fewer opioid tablets were prescribed at discharge (4 vs. 60 tablets, p < .001) and less oral morphine milligram equivalence (OME) were prescribed within 30 days of transplant (38 vs. 300, p < .001). In cohort 2, fewer patients received more than one opioid prescription, more patients received truncal block and only 5 patients received patient controlled analgesia compared to all in cohort 1. Conclusion: A standardized, patient‐centered pain management strategy after kidney transplantation reduced opioid prescribing without increasing readmissions or clinic calls. This data may be used to inform guidelines for appropriate OME prescribing at discharge after kidney transplantation.