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Opioid Use After Thyroid and Parathyroid Surgeries
NA trial testing Quality improvement bundle in Thyroidectomy in 240 participants. Completed in 31 December 2021.
| Lead sponsor | The Methodist Hospital Research Institute |
|---|---|
| Phase | NA |
| Status | Completed |
| Study type | INTERVENTIONAL |
| Allocation | non randomized |
| Design | sequential |
| Masking | none |
| Primary purpose | health services research |
| Enrollment | 240 |
| Start date | 14 June 2021 |
| Primary completion | 31 December 2021 |
| Estimated completion | 31 December 2021 |
| Sites | 1 location across United States |
The Methodist Hospital Research Institute
18 and older, any sex, with Thyroidectomy or Parathyroidectomy. Patients with the condition only — healthy volunteers not accepted.
Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.
Proportion of patients who receive new opioid discharge prescriptions at discharge following a thyroidectomy or parathyroidectomy procedure. This outcome excludes continuation of previous, chronic opioid therapy.
| Group | Value | 95% CI |
|---|---|---|
| Historical Control Group | 128 | |
| Post-implementation Group | 28 |
Proportion of thyroidectomy and parathyroidectomy postoperative patients with opioid discharge prescriptions exceeding the recommended dose of 112.5 oral MMEs
| Group | Value | 95% CI |
|---|---|---|
| Historical Control Group | 52 | |
| Post-implementation Group | 8 |
Proportion of thyroidectomy and parathyroidectomy postoperative patients with opioid discharge prescriptions exceeding 5 days of therapy
| Group | Value | 95% CI |
|---|---|---|
| Historical Control Group | 27 | |
| Post-implementation Group | 5 |
Proportion of thyroidectomy and parathyroidectomy postoperative patients who receive new opioid prescriptions from the surgeon's office within 7 days of surgery including discharge prescriptions. This outcome excludes continuation of previous, chronic opioid therapy.
| Group | Value | 95% CI |
|---|---|---|
| Historical Control Group | 0 | |
| Post-implementation Group | 0 |
Proportion of thyroidectomy and parathyroidectomy postoperative patients with opioid prescriptions exceeding 50 oral MMEs/day when new, postoperative discharge prescriptions are added to existing opioid therapy
| Group | Value | 95% CI |
|---|---|---|
| Historical Control Group | 9 | |
| Post-implementation Group | 0 |
Unnecessary opioid prescriptions for postoperative pain can increase the risk for new, persistent opioid use and dependence. Published literature suggests that most patients undergoing thyroid or parathyroid surgery can have their pain effectively managed without opioids following hospital discharge. The purpose of this quasi-experimental, quality improvement study is to develop, implement, and measure the impact of a quality improvement bundle that consists of (1) patient education, (2) provider education, and (3) electronic health record (EHR) enhancements. The proportion of patients who receive new opioid discharge prescriptions for pain management following thyroid or parathyroid surgery at Houston Methodist Hospital for up to 6 months following bundle implementation will be compared to a historical control group.
1 peer-reviewed publication reference this trial (live from Europe PMC):
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