Scientific Poster Session II: Students Research-in-Progress

Abstract

Patients frequently require opioids for analgosedation in the intensive care unit (ICU). Studies evaluating prescribing suggest that ICU patients are often prescribed unnecessary opioids at ICU and hospital discharge. This can lead to dependence, misuse, and even death. Studies have not evaluated the impact of ICU pharmacists to mitigate this problem.

Research Question or Hypothesis:

To determine if a pharmacist-driven opioid stewardship program reduces prescribing of oral opioids across transitions of care in previously opioid-naive ICU patients.

Study Design:

Single-center, retrospective, observational cohort study.

Methods:

This is a before-and-after intervention study at an urban academic medical center. A pharmacist-driven opioid stewardship program was implemented in March 2021 to decrease unnecessary opioid prescriptions at transitions of care. Opioid-naïve patients admitted between April 1, 2020 through February 28, 2021 (pre-intervention) will be compared with patients admitted between April 1, 2021 through February 28, 2022 (post-intervention). Inclusion criteria is an active oral opioid order in the ICU =72 hours. Exclusion criteria include opioid prescriptions prior to admission, medical marijuana use prior to admission, transition to comfort care/hospice, death prior to discharge, pain service consultation, and admission during both time periods. Data will be collected on patient characteristics, inpatient opioid utilization, and opioid prescribing at ICU and hospital discharge. A sample size of 786 patients total is needed to detect a difference in proportions of 0.1 using a power of 80% and a two-sided p-value of 0.05. A logistic regression model will be applied to control the independent variables for multivariate analysis. The comparison of secondary outcomes between groups will be analyzed using a chi-square test, Fisher’s exact test, t-test, or Mann-Whitney U test as required.

Results:

Data collection is in progress.

Conclusion: