The over-prescribing of opioids following hospital surgery is increasing the risk of long-term misuse and addiction among patients, according to a new report.
The report found more than 70% of public and private hospitals regularly supplied opioids for patients to take home “just in case” even when they did not need them in the 48 hours prior to discharge.
Key recommendations include establishing a National Opioid Utilisation Surveillance Program so hospitals can monitor usage, shifting from the term ‘painkillers’ to ‘medicines for reducing pain’, and asking pharmaceutical manufacturers to produce a greater variety of pack sizes for opioids.
Undertaken by Society of Hospital Pharmacists of Australia (SHPA) President Professor Michael Dooley, the Reducing opioid-related harm: A hospital pharmacy landscape paper is the first Australian study to examine hospital pharmacy practices surrounding the prescription and supply of opioids to patients.
It states Australian opioid prescriptions rose 24% between 2010-11 and 2014-15, resulting in 1.1 million opioid prescriptions being dispensed, with pharmaceutical opioids accounting for more drug-related deaths than any other drug category.
Research shows the common provision of opioids post-surgery is a key factor exposing many patients to harm, it reads.
The report attributes rising harm to a range of factors including over-prescribing by doctors, unrealistic expectations of pain management and lack of evidence-based educational programs for health professions.
Professor Dooley said the report aimed to initiate the conversation about such services in hospitals and prompt an urgently needed coordinated and multidisciplinary response to minimise the risk associated with opioid medications.
“This work highlights that current practices in hospitals relating to the prescribing and dispensing of opioids at discharge are resulting in quantities in excess of patient need, which has the potential to lead to preventable harm,” Professor Dooley said.
“We found clinical pharmacy services are often unable to prioritise surgical patients being discharged and these patients are not having an appropriate review of their medication.”
The report collected data from 135 metropolitan, regional and rural Australian facilities and makes 33 recommendations targeted at health professionals, consumers and government stakeholders to boost strategies to improve patient care nationwide.
“The insight gathered by SHPA members adds enormous impetus to consolidate and expand efforts already underway to reduce opioid harms in six key areas – working with prescribers, engaging patients, supporting opioid stewardship, managing medication supply, supporting transitions of care between the hospital and the home and empowering pharmacists,” Professor Dooley said.