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Title: Evaluation of communication to general practitioners when opioid-naïve post-surgical patients are discharged from hospital on opioids.
Austin Authors: Tran, Tim ;Taylor, Simone E ;George, Johnson;Pisasale, Daisy ;Batrouney, Adele;Ngo, Janet;Stanley, Beata;Elliott, Rohan A 
Affiliation: Pharmacy
Department of Addiction Medicine, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia
Issue Date: Jun-2020
Date: 2020-04-27
Publication information: ANZ Journal of Surgery 2020; 90(6): 1019-1024
Abstract: To address the opioid crisis, much work has focused on minimizing opioid supply to surgical patients upon hospital discharge. Research is limited regarding handover to primary care providers. The aim of this study was to evaluate the communication of post-operative opioid prescribing information provided by hospitals to general practitioners (GPs). This study comprised two components. First, a retrospective audit of discharge summaries for opioid-naïve surgical patients supplied with an opioid on discharge was conducted to evaluate accuracy of opioid documentation and presence of an opioid management plan. Second, a survey was distributed to GPs to seek their opinions regarding adequacy of communication about hospital-initiated opioids in discharge summaries, challenges experienced in opioid management and suggestions for improvement. Discharge summaries for 285 patients were audited. Twenty-seven (9.5%) patients had no discharge summary completed. Of the remaining 258, 63 (24.4%) summaries had at least one discrepancy between the opioid(s) listed and the opioid(s) dispensed. Only 33 (12.8%) summaries contained an opioid management plan. From 57 GP-completed surveys, 41 (71.9%) GPs rarely or never received an opioid management plan from hospital surgical units and 34 (59.7%) were dissatisfied/very dissatisfied with information provided about opioid supply and management. Qualitative responses highlighted difficulties GPs experience managing opioid treatment for post-surgical patients after discharge, differing patient expectations and the need to improve communication at times of transition. When opioid-naive patients are discharged from hospital on opioids, communication from hospitals to GPs is poor. Future interventions should focus on strategies to improve this.
DOI: 10.1111/ans.15903
ORCID: 0000-0002-2924-3466
Journal: ANZ Journal of Surgery
PubMed URL: 32338817
Type: Journal Article
Subjects: communication
general practitioners
opioid analgesics
patient discharge
post-operative period
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