{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T05:26:43Z","timestamp":1730870803293,"version":"3.28.0"},"reference-count":9,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003This study aims to determine if adoption of a user-friendly algorithm for individualized opioid prescribing at discharge would decrease the number of opioids prescribed after cesarean delivery.<\/jats:p><jats:p>\n            Study Design\u2003As part of a quality initiative, we developed and implemented an algorithm for opioid prescribing at discharge for patients after cesarean delivery. The intervention group comprised patients delivering by cesarean in the 6 months following initiation of the intervention. The intervention group was divided into three groups based on inpatient opioid needs 24 to 48\u2009hours after delivery. Oxycodone tablets were prescribed at discharge based on inpatient group. The control group comprised patients delivering at the same institution in the 6 months prior to initiation of the intervention. The primary outcome was number of oxycodone tablets prescribed at discharge. The secondary outcome was the proportion of patients with a pain-related encounter or additional oxycodone prescription up to 6 weeks after delivery.<\/jats:p><jats:p>\n            Results\u2003From July to December 2020, a total of 382 subjects met criteria for the intervention. The comparison group consisted of 391 subjects discharged from January to June 30, 2020, after cesarean. Baseline characteristics and inpatient opioid use 24 to 48\u2009hours after delivery did not differ between the groups. Compared with the control group, subjects in the intervention group had fewer oxycodone tablets prescribed at discharge (11.1 vs. 15.8, p\u2009&lt;\u20090.001). The number of pain-related encounters within 6 weeks of delivery did not differ between the intervention and comparison groups (10.5 vs. 10.3%, p\u2009=\u20090.82). There was no increase in the additional number of oxycodone prescriptions after discharge (4.7% in the intervention group vs. 4.3% in the control group, p\u2009=\u20090.81).<\/jats:p><jats:p>\n            Conclusion\u2003Discharge opioid prescribing based on inpatient use after cesarean reduces the number of opioids prescribed without increasing the number of pain-related encounters after discharge. A simple algorithm may ensure compliance from prescribers.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-2185-2741","type":"journal-article","created":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T22:39:25Z","timestamp":1696372765000},"page":"e3025-e3029","source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Postdischarge Opioid Prescription after Cesarean: A Quality Improvement Initiative"],"prefix":"10.1055","volume":"41","author":[{"given":"Katherine T.","family":"Pellino","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Kershner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erika L.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,11,30]]},"reference":[{"issue":"11","key":"ref1","doi-asserted-by":"crossref","first-page":"290","DOI":"10.15585\/mmwr.mm6911a4","article-title":"Drug and opioid-involved overdose deaths - United States, 2017-2018","volume":"69","author":"N Wilson","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"volume-title":"Most Frequent Procedures Performed in U.S. Hospitals, 2010.","author":"A Pfuntner","key":"ref2"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1097\/AOG.0000000000004517","article-title":"Pharmacologic Stepwise Multimodal Approach for Postpartum Pain Management: ACOG Clinical Consensus No. 1","volume":"138","author":"American College of Obstetricians and Gynecologists","year":"2021","journal-title":"Obstet Gynecol"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"247.e1","DOI":"10.1016\/j.ajog.2019.04.012","article-title":"Guidelines for postoperative care in cesarean delivery: Enhanced Recovery After Surgery (ERAS) Society recommendations (part 3)","volume":"221","author":"G A Macones","year":"2019","journal-title":"Am J Obstet Gynecol"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1097\/AOG.0000000000002095","article-title":"Postdischarge opioid use after cesarean delivery","volume":"130","author":"S S Osmundson","year":"2017","journal-title":"Obstet Gynecol"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1097\/AOG.0000000000002093","article-title":"Patterns of opioid prescription and use after cesarean delivery","volume":"130","author":"B T Bateman","year":"2017","journal-title":"Obstet Gynecol"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1370\/afm.2493","article-title":"Predicting opioid use following discharge after cesarean delivery","volume":"18","author":"J A Carrico","year":"2020","journal-title":"Ann Fam Med"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1097\/AOG.0000000000002782","article-title":"Individualized compared with standard postdischarge oxycodone prescribing after cesarean birth: a randomized controlled trial","volume":"132","author":"S S Osmundson","year":"2018","journal-title":"Obstet Gynecol"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1097\/AOG.0000000000002094","article-title":"A shared decision-making intervention to guide opioid prescribing after cesarean delivery","volume":"130","author":"M Prabhu","year":"2017","journal-title":"Obstet Gynecol"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2185-2741.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T13:46:05Z","timestamp":1730814365000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2185-2741"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,3]]},"references-count":9,"journal-issue":{"issue":"S 01","published-online":{"date-parts":[[2024,5,13]]},"published-print":{"date-parts":[[2024,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2185-2741","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"type":"print","value":"0735-1631"},{"type":"electronic","value":"1098-8785"}],"subject":[],"published-other":{"date-parts":[[2023,10,3]]},"published":{"date-parts":[[2023,10,3]]}}}