Improvement needed in ob-gyn opioid prescribing practices
Annetta M. Madsen, M.D., from Brown University in Providence, R.I., and colleagues conducted a cross-sectional survey of a national sample of American College of Obstetricians and Gynecologists fellows and junior fellows; 179 of 300 sampled members responded. Data were obtained on opioid knowledge and typical prescribing practices, including adherence to four recommended practices.
The researchers found that across all indications combined, respondents reported prescribing a median of 26 pills per patient, with variation by indication for the prescription. Ninety-eight percent prescribed opioids after surgery; 22, 30, 24, and 18 percent, respectively, prescribed opioids for vaginal birth, ovarian cysts, endometriosis, and chronic pelvic pain of unknown cause. Nineteen percent of respondents reported adherence to three or more of the four recommended practices. No significant difference was seen in the median number of pills prescribed for those who reported adherence to at least one recommended practice versus no adherence (25 versus 28; P = 0.58). Eighty-one percent of respondents incorrectly identified the main source of misused opioids, which was via diversion from a friend or family member. Forty-four percent did not know how to dispose of unused prescription opioids correctly.
"This study highlights an urgent need for increased efforts to improve ob-gyns' knowledge of opioid use, misuse, disposal, and best prescribing practices," the authors write.
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