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. Author manuscript; available in PMC: 2020 Dec 1.
Published in final edited form as: Ann Surg. 2020 Jan;271(1):86–93. doi: 10.1097/SLA.0000000000003434

TABLE 4.

Framework for an Evidence-based Postoperative Opioid-prescribing Pathway.

Pathway Element Description/Examples
Choose procedure or patient cohort to pilot initiative Elective, low variability, uncomplicated patients
Collect data on prescribing practices Retrospective chart review, Prescription Drug Monitoring Programs
Collect data on patient-reported opioid use Prospective patient surveys (medication use, pain scores, satisfaction)
Generate evidence-based prescribing recommendations Using patient-reported medication use, identify potential prescribing cut-points (such as by percentile treated)
Stakeholder education Engaging all providers involved in patient care (pre-op, peri-op, post-op residents, faculty, nurses, PAs, NPs)
Patient and caregiver education Counseling patients and caregivers regarding safe postoperative opioid use, pain control, disposal
Continual assessment and update of recommendations Prospective chart review to analyze impact of recommendations, patient surveys to analyze medication use and pain scores