• Beata Stanley, Amanda F Norman, Lisa J Collins, George A Zographos, David M Lloyd-Jones, Anthony Bonomo, and Yvonne A Bonomo.
• Department of Addiction Medicine, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
• ANZ J Surg. 2018 Nov 1; 88 (11): 1187-1192.

BackgroundTo understand patterns of opioid prescribing on discharge in the orthopaedic and neurosurgical wards of a tertiary metropolitan hospital.MethodsA retrospective audit of medical records and discharge summaries for all orthopaedic and neurosurgical patients admitted for at least 2 days on two surgical wards over a 6-month period between 1 January and 30 June 2017.ResultsA combined total of 355 patients (281 orthopaedic and 74 neurosurgical patients) were included in the audit. Approximately 82% were discharged on opioids. Of patients discharged on opioids, 71.4% of the orthopaedic group and 73.8% of the neurosurgical group were discharged on combinations of two or more opioids (immediate release together with slow release). Around 65% of the sample discharged on opioids was opioid naïve on admission. About 32.5% of the orthopaedic patients and 68.9% of the neurosurgical patients were discharged on a combination of opioid and other pharmacotherapy that could potentiate the central nervous system depressant effect of the opioids. Only 6.9% of orthopaedic patients and 11.5% of the neurosurgical patients had discharge summaries that included any reference to opioid management after discharge.ConclusionOrthopaedic and neurosurgical units had high opioid prescribing rates on discharge from hospital. This highlights the need for clear communication of the intended medication management plan post-discharge in order to minimize inappropriate and ongoing use of opioids post-surgery.© 2018 Royal Australasian College of Surgeons.

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