Effectiveness of an Opioid Stewardship Guideline in Renal Transplant Recipients Post-Discharge

Abstract

Previous literature suggests that kidney transplant recipients (KTRs) do not use the majority of opioid tablets prescribed after transplant surgery. This study analyzed the effectiveness of a new pain management guidance in KTRs after discharge from transplant surgery at a renal transplant center. The single center pre-, post- study compared the number of opioid refill requests, patient-reported pain control, multimodal analgesic agents, and opioid tablets prescribed at discharge in both pre- and post- cohorts. A total of 127 patients were included. Data was collected through standardized patient interviews and chart review from electronic medical records. The pre-guidance and post-guidance cohorts had no detectable difference in refill requests (p = 0.365) nor pain control (p = 0.324) post-discharge. The post-group had a significant reduction in opioid tablets prescribed at discharge (22 tablets ± 10 vs 10 tablets ± 2, p = <0.0001) with a significant increase in acetaminophen (p = 0.005) and lidocaine patches (p = <0.0001) prescribed at discharge. Both groups used a mean of three opioid tablets within the first week after discharge. The guidance resulted in 700 fewer opioid tablets in the community during the study time frame, with no difference in pain control nor refill requests after discharge.

Keywords:

• Opioid use
• pain management
• renal transplant
• multimodal analgesia

Acknowledgements

We would like to thank Dahlia Zuidema, PharmD, BC-ADM, CDCES, Hollie Porras, PharmD, BCPS, Denise Roach, PharmD, BCGP, and Stephanos Gozali, PharmD for contributing to the development of this project.

Declaration of interest

The author reports no conflict of interest. The author alone is responsible for the content and writing of the article.

Funding

The author(s) reported there is no funding associated with the work featured in this article.