What are the opioid prescribing practices for home pain relief in young people under 18 who have undergone surgery? A new report from the Therapeutic Medication Management Program (TMMP) provides for the first time an overall picture of the situation in Quebec university hospitals, in addition to identifying several good practices to prevent inappropriate use of these medications. Valuable recommendations for pediatric health personnel, especially in the current context of the opioid crisis.
This study is the most recent conducted by the PGTM, an initiative bringing together the five university hospitals in Quebec and which focuses on the optimal use of medications. First and foremost, the authors of the report recommend the use of pre-written prescriptions in order to standardize prescribing practices according to age and type of surgery.
“This is an effective measure that is fairly simple to implement, particularly with the introduction of electronic prescriptions,” says Élaine Pelletier, pharmacist at CHU Sainte-Justine and co-author of the report. “In addition, young people and their parents must be well informed about the expected beneficial effects of opioids and the associated risks in order to make informed decisions about the proper administration of these medications and their storage.”
When it comes to adolescents, it is recommended to systematically complete a questionnaire on risk factors for opioid misuse to ensure adequate supervision.
“When we talk about inappropriate opioid use among adolescents, it has been shown that they often use medications prescribed for other family members and stored long-term and unsafely,” says Élaine Pelletier, who is also an associate clinician at the Faculty of Pharmacy at the Université de Montréal. “Or, these are medications that were prescribed to them following surgery and were not returned to the pharmacy.”
To prevent the misuse of opioids by patients and those around them, the report also recommends planning information sessions or developing an electronic educational tool on postoperative care, pain management and the safe use of opioids before and after surgery. This would include providing details on the appropriate storage and destruction of unused opioids.
About the report
The report Descriptive analysis of opioid prescriptions issued upon discharge following pediatric surgery in Quebec university hospitals is published by the Therapeutic Medication Management Program (PGTM), an initiative of the five heads of pharmacy departments of Quebec university hospitals in place for nearly 20 years and which focuses on the optimal use of medications in adult and pediatric patients.
The retrospective study included 505 opioid prescriptions for home postoperative pain management, all those issued to people under 18 years of age between 1er April and October 31, 2021 in the four university hospitals in Quebec that perform pediatric surgeries. The clinical intervention model offers Quebec hospitals ways to implement to ensure the optimal use of opioids in pain management.
View the full report: pgtm.qc.ca/wp-content/uploads/2024/05/240419_ad_opioides_ped_pgtm.pdf
Consult the summary of recommendations and the clinical intervention model: pgtm.qc.ca/wp-content/uploads/2024/05/mic_opioides-pediatrie_20240330_final.pdf
The five member centers of the PGTM are:
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