Retrospective Review on the Pain Management Prescribing Practices for Amputee Patients in an Inpatient Rehabilitiation Hospital

Abstract

Specific Aims: To assess if opioid prescriptions prescribed at discharge are reflective of the patient’s actual opioid usage, as an inpatient, to determine if a future pharmacist intervention is needed to improve the opioid renewal process at this facility. We will review the opioid renewal process and describe the current pain management prescribing practices within this rehabilitation hospital by comparing the average daily Morphine Milligram Equivalents (MMEs) prescribed 7 days prior to discharge and the daily MMEs prescribed at discharge. Subjects: Adults ranging from 18-90 years old, with a post-op amputation diagnosis, who had amputation surgery within the last 30 days of their admission. Methods: A retrospective chart review of the average daily MME used by the patient in the 7 days prior to discharge and the daily MME prescribed at discharge in an inpatient rehabilitation facility. Patients were included if they were prescribed at least one short-acting oral opioid medication as an inpatient, staying for more than 7 days between January 01, 2019 and August 01, 2020. Main Results: A chart review of 84 patients were completed, including 52 men and 33 women (mean age= 62; SD 13.6; 69% white). 32% of participants were opioid naive, while 68% had used opioids in the past. Overall the amount of MME prescribed at discharge was significantly higher than the average daily MMEs used in the 7 days prior to discharge (p= 0.0347). The average days supply prescribed at discharge was 3.3 days (SD 2.8). Conclusions: Opioid prescriptions prescribed at discharge were not reflective of the patient’s actual opioid usage as an inpatient. Pharmacist interventions may be warranted.