34th AM (2023) - Poster Session-Balancing Pain and OUD Management in the Peri-Operative Period

Balancing Pain and OUD Management in the Peri-Operative Period - A Mixed-Methods Study

Pdf Summary

A recent survey conducted at UW Hospital has found that patients receiving medication for opioid use disorder (MOUD) are more likely to have their medication interrupted during the perioperative period. The survey revealed that 40% of patients on buprenorphine had their medication interrupted, compared to only 13% of patients on methadone. Interestingly, the survey also found that the type of MOUD or dose did not appear to be a primary consideration for providers when managing post-surgical pain.<br /><br />The survey results also highlighted the collaborative effort between providers, patients, and their primary care physicians in managing postoperative pain in patients with MOUD. The most commonly reported essential practice when prescribing opioids at discharge was following up with the patient's primary care provider.<br /><br />In addition to the survey, the study also included a review of electronic medical records at UW Hospital and qualitative interviews with survey respondents. The EMR review found that 31% of surgical cases involved MOUD interruption, with buprenorphine experiencing higher interruption rates compared to methadone.<br /><br />Overall, the study suggests that providers typically do not withhold MOUD following surgery, but when they do, there is no improvement in pain management. The study also suggests that communication with primary care providers is critical to successful peri/postoperative pain management.<br /><br />The study acknowledges several limitations, including its exploratory nature and the need for a larger sample size to fully understand the extent of MOUD interruptions and the effectiveness of pain management in patients with MOUD. The study suggests that future research should include randomized controlled trials to test the effects of interrupting vs maintaining MOUD on patient outcomes.<br /><br />It is important to note that the study sample was predominantly white and limited to a single hospital, so the findings may not be generalizable to all populations. Further research is needed to ensure adequate representation of all demographics and to validate the study findings across different populations.

Keywords

opioid use disorder

medication interruption

perioperative period

buprenorphine

methadone

post-surgical pain

primary care provider

pain management

interrupting MOUD

patient outcomes

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