Opioid Prescribing and Use After Pediatric Umbilical Hernia Repair

Abstract

Background: Opioid overuse is a concern in adult and pediatric populations. Physician education may improve appropriate opioid prescribing and patient instruction for use. Prescribing and use of opioid for pain control after pediatric umbilical hernia repair (UH) before and after surgeon education was evaluated. This is a substudy of a multi-institutional study assessing prescribing practice before and after surgeon education. This study further assessed patient prescription filling pattern and parent report of pain control.

Methods: A retrospective study was performed evaluating children who underwent UH 6 months before and after an educational presentation on opioid use. Prescriptions, prescription fills, patient medication use, and pain control effectiveness were assessed. Adverse events were collected.

Results: There were 78 subjects in the pre- and 99 in the posteducation group. Opioid prescribed changed from 98.7% to 61.6% (P < .0001), and nonopioid prescriptions increased following education (P = .0063). The number of opioid prescriptions filled decreased (P = .0296). There were limited data on opioid doses used and quality of pain control, but the posteducation group showed good pain control. There was no difference in adverse events.

Discussion: Surgeon education on current opioid epidemic and strategies for opioid stewardship improves opioid prescribing and use without adversely impacting pain control or clinical outcome.