1452 Development of a Postoperative Opioid Prescription Practice Algorithm for Benign Gynecologic Surgery (POPP Algorithm)

Study Objective To determine if gynecologic surgery patients have satisfactory postoperative pain control when the POPP algorithm is used to guide the quantity of opioid medication prescribed. The secondary aim is to see if this algorithm leads to less opioid tablets prescribed after gynecologic surgery compared to past opioid prescription records. Design Prospective observational study, with a secondary comparison to a de-identified, retrospective dataset Setting A large military medical center Patients or Participants Women ≥18 years-old undergoing benign gynecologic surgery Interventions Using existing data on opioid use after gynecologic surgery, we developed a simple algorithm to guide physicians in their opioid prescribing practices. Using the algorithm, the physician prescribes a set quantity of opioids, accounting for the type of surgery performed and the presence of certain patient characteristics. Patient demographic and background information are collected, both from a brief survey and the medical record. The researcher contacts patients 2 weeks post-operatively to conduct a brief survey to determine postoperative pain satisfaction and the quantity of opioid tablets remaining. Measurements and Main Results Upon study completion, data analysis will determine if the algorithm provided patients with adequate opioid medication by looking at the number of patients that required refills, the median number of tablets consumed after each procedure type, correlation of opioid use with other factors, and patient perception of pain control. We will compare quantity of opioids prescribed using the POPP algorithm to the quantity prescribed to a retrospective cohort of similar patients. We will adjust generalized linear models using patient and surgical co-variates to identify if algorithm prescribing is significantly lower than non-algorithm prescribing. Conclusion Preliminary data demonstrates the POPP algorithm, when used for patients undergoing benign gynecologic surgery, results in satisfactory postoperative pain control, an adequate quantity of opioid medication for most patients, and less excess opioids dispensed.