Provider compliance with a tailored opioid prescribing calculator in gynecologic surgery

Objective. To evaluate the impact a tailored opioid prescription calculator has on meeting individual patient opioid needs while avoiding opioid over prescriptions.Methods. Our group previously developed and published an opioid prescribing calculator incorporating pa -tient risk factors (history of depression, anxiety, chronic opioid use, substance abuse disorder, and/oer chronic pain) and type of surgery (laparotomy or laparoscopy). This calculator was implemented on 1/1/2021 and its im-pact on opioid prescriptions was evaluated until 12/31/21. The primary outcome of the present study is to deter-mine prescriber compliance with the calculator (defined as not overprescribing from the number of pills indicated by the calculator). The secondary outcome is to determine the excess prescription rate (defined as pro-portion of patients reporting more than 3 pills remaining at 30 days post-surgery). Refill rates and pain related patient phone calls were collected. Descriptive statistics were used to summarize the cohort.Results. Of the 355 patients included, 54.7% (N = 194) underwent laparoscopy and 45.4% (N = 161) under-went laparotomy. One hundred and forty-two patients (40%) had at least one risk factor for opioid usage. The me-dian number of opioid pills prescribed following laparoscopy was 3 (range 0-15) and 6 (0-20) after laparotomy. The prescriber compliance was 88.2% and the excess prescription rate was 25.1% (N = 89 patients).Conclusions. Our tailored opioid calculator has a high prescriber compliance. Implementation of this calculator led to a standardization of tailored opioid prescribing, while limiting the number of over prescriptions. A free web version of the calculator can be easily accessed at http://www.opioidcalcutor.org/.Published by Elsevier Inc.