• ANZ journal of surgery · Jun 2020

    Evaluation of communication to general practitioners when opioid-naïve post-surgical patients are discharged from hospital on opioids.

    • Tim Tran, Simone E Taylor, Johnson George, Daisy Pisasale, Adele Batrouney, Janet Ngo, Beata Stanley, and Rohan A Elliott.
    • Pharmacy Department, Austin Health, Melbourne, Victoria, Australia.
    • ANZ J Surg. 2020 Jun 1; 90 (6): 1019-1024.

    BackgroundTo address the opioid crisis, much work has focused on minimizing opioid supply to surgical patients upon hospital discharge. Research is limited regarding handover to primary care providers. The aim of this study was to evaluate the communication of post-operative opioid prescribing information provided by hospitals to general practitioners (GPs).MethodsThis study comprised two components. First, a retrospective audit of discharge summaries for opioid-naïve surgical patients supplied with an opioid on discharge was conducted to evaluate accuracy of opioid documentation and presence of an opioid management plan. Second, a survey was distributed to GPs to seek their opinions regarding adequacy of communication about hospital-initiated opioids in discharge summaries, challenges experienced in opioid management and suggestions for improvement.ResultsDischarge summaries for 285 patients were audited. Twenty-seven (9.5%) patients had no discharge summary completed. Of the remaining 258, 63 (24.4%) summaries had at least one discrepancy between the opioid(s) listed and the opioid(s) dispensed. Only 33 (12.8%) summaries contained an opioid management plan. From 57 GP-completed surveys, 41 (71.9%) GPs rarely or never received an opioid management plan from hospital surgical units and 34 (59.7%) were dissatisfied/very dissatisfied with information provided about opioid supply and management. Qualitative responses highlighted difficulties GPs experience managing opioid treatment for post-surgical patients after discharge, differing patient expectations and the need to improve communication at times of transition.ConclusionWhen opioid-naive patients are discharged from hospital on opioids, communication from hospitals to GPs is poor. Future interventions should focus on strategies to improve this.© 2020 Royal Australasian College of Surgeons.

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