PMID- 37653689
OWN - NLM
STAT- MEDLINE
DCOM- 20240221
LR  - 20240221
IS  - 1096-9098 (Electronic)
IS  - 0022-4790 (Print)
IS  - 0022-4790 (Linking)
VI  - 128
IP  - 8
DP  - 2023 Dec
TI  - Reducing opioid prescribing after ambulatory breast reconstruction surgery.
PG  - 1235-1242
LID - 10.1002/jso.27427 [doi]
AB  - BACKGROUND: The lack of evidence-based guidelines for postoperative opioid 
      prescriptions following breast reconstruction contributes to a wide variation in 
      prescribing practices and increases potential for misuse and abuse. METHODS: 
      Between August and December 2019, women who underwent outpatient breast 
      reconstruction were surveyed 7-10 days before (n = 97) and after (n = 101) 
      implementing a standardized opioid prescription reduction initiative. We compared 
      postoperative opioid use, pain control, and refills in both groups. Patient 
      reported outcomes were compared using the BREAST-Q physical wellbeing of the 
      chest domain and a novel symptom Recovery Tracker. RESULTS: Before changes in 
      prescriptions, patients were prescribed a median of 30 pills and consumed three 
      pills (interquartile range [IQR: 1,9]). After standardization, patients were 
      prescribed eight pills and consumed three pills (IQR: 1,6). There was no evidence 
      of a difference in the proportion of patients experiencing moderate to very 
      severe pain on the Recovery Tracker or in the early BREAST-Q physical wellbeing 
      of the chest scores (p = 0.8 and 0.3, respectively). CONCLUSION: Standardizing 
      and reducing opioid prescriptions for patients undergoing reconstructive breast 
      surgery is feasible and can significantly decrease the number of excess pills 
      prescribed. The was no adverse impact on early physical wellbeing, although 
      larger studies are needed to obtain further data.
CI  - (c) 2023 Wiley Periodicals LLC.
FAU - Fearon, Nkechi J
AU  - Fearon NJ
AD  - Josie Robertson Surgical Center, Memorial Sloan Kettering Cancer Center, New 
      York, New York, USA.
AD  - Department of Anesthesiology & Critical Care Medicine, Memorial Sloan Kettering 
      Cancer Center, New York, New York, USA.
FAU - Kurtzman, Joey
AU  - Kurtzman J
AUID- ORCID: 0000-0003-4692-0120
AD  - Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan 
      Kettering Cancer Center, New York, New York, USA.
FAU - Benfante, Nicole
AU  - Benfante N
AD  - Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan 
      Kettering Cancer Center, New York, New York, USA.
FAU - Assel, Melissa
AU  - Assel M
AD  - Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer 
      Center, New York, New York, USA.
FAU - Vickers, Andrew
AU  - Vickers A
AD  - Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer 
      Center, New York, New York, USA.
FAU - Carlsson, Sigrid
AU  - Carlsson S
AD  - Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer 
      Center, New York, New York, USA.
AD  - Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 
      New York, New York, USA.
AD  - Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at 
      Gothenburg University, Sweden.
FAU - Laudone, Vincent P
AU  - Laudone VP
AD  - Josie Robertson Surgical Center, Memorial Sloan Kettering Cancer Center, New 
      York, New York, USA.
AD  - Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 
      New York, New York, USA.
FAU - Levine, Marcia
AU  - Levine M
AD  - Josie Robertson Surgical Center, Memorial Sloan Kettering Cancer Center, New 
      York, New York, USA.
AD  - Department of Nursing, Memorial Sloan Kettering Cancer Center, New York, New 
      York, USA.
FAU - Simon, Brett A
AU  - Simon BA
AD  - Josie Robertson Surgical Center, Memorial Sloan Kettering Cancer Center, New 
      York, New York, USA.
AD  - Department of Anesthesiology & Critical Care Medicine, Memorial Sloan Kettering 
      Cancer Center, New York, New York, USA.
FAU - Mehrara, Babak J
AU  - Mehrara BJ
AD  - Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan 
      Kettering Cancer Center, New York, New York, USA.
FAU - Nelson, Jonas A
AU  - Nelson JA
AUID- ORCID: 0000-0003-0329-4422
AD  - Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan 
      Kettering Cancer Center, New York, New York, USA.
LA  - eng
GR  - P30 CA008748/CA/NCI NIH HHS/United States
PT  - Journal Article
DEP - 20230831
PL  - United States
TA  - J Surg Oncol
JT  - Journal of surgical oncology
JID - 0222643
RN  - 0 (Analgesics, Opioid)
SB  - IM
MH  - Female
MH  - Humans
MH  - *Analgesics, Opioid/administration & dosage/adverse effects
MH  - *Mammaplasty/adverse effects
MH  - *Pain, Postoperative/drug therapy/prevention & control/diagnosis
MH  - *Plastic Surgery Procedures/adverse effects
MH  - Practice Patterns, Physicians'
MH  - Drug Prescriptions/standards/statistics & numerical data
PMC - PMC10841230
MID - NIHMS1926266
OTO - NOTNLM
OT  - breast reconstruction
OT  - opioids
OT  - ostoperative pain
OT  - quality improvement
EDAT- 2023/09/01 06:43
MHDA- 2023/11/15 06:43
PMCR- 2024/12/01
CRDT- 2023/09/01 01:03
PHST- 2023/08/03 00:00 [revised]
PHST- 2023/05/21 00:00 [received]
PHST- 2023/08/15 00:00 [accepted]
PHST- 2024/12/01 00:00 [pmc-release]
PHST- 2023/11/15 06:43 [medline]
PHST- 2023/09/01 06:43 [pubmed]
PHST- 2023/09/01 01:03 [entrez]
AID - 10.1002/jso.27427 [doi]
PST - ppublish
SO  - J Surg Oncol. 2023 Dec;128(8):1235-1242. doi: 10.1002/jso.27427. Epub 2023 Aug 
      31.