From the Society

Journal of Hospital Medicine releases consensus statement on inpatient opioid prescribing

Bolstering prescribing practices to improve patient outcomes.


 

The Journal of Hospital Medicine, the official peer-reviewed journal of the Society of Hospital Medicine, has released a statement titled “Improving the Safety of Opioid Use for Acute Noncancer Pain in Hospitalized Adults: A Consensus Statement from the Society of Hospital Medicine” in response to the growing issue of managing opioid prescribing in the inpatient setting.

The statement offers 16 recommendations covering whether to use opioids in the hospital and how to improve the safety of opioid prescribing both during hospitalization and at discharge. The statement is available in the April 2018 issue of the journal.

Dr. Shoshana Herzig, director of hospital medicine research at Beth Israel Deaconess Medical Center, and assistant professor of medicine at Harvard Medical School
Dr. Shoshana Herzig
“Our prescribing patterns in the setting of acute pain meaningfully impact downstream outcomes and prescribing practices,” said Shoshana J. Herzig, MD, MPH, director of hospital medicine research at Beth Israel Deaconess Medical Center, assistant professor of medicine at Harvard Medical School, and lead author on the consensus statement. “The degree of importance related to this topic often is underestimated by hospitalists because we think of it as a more straightforward situation – prescribing for acute pain. In reality, there are nuances to it, and we have data to show that it’s not done well a lot of the time.”

SHM convened a working group to develop the consensus statement, intended for clinicians practicing in the inpatient setting. The development of the statement began with the working group conducting a systemic review of relevant guidelines and composing a draft based on extracted recommendations. The working group then obtained feedback from external experts in hospital-based opioid prescribing, SHM members, the SHM Patient-Family Advisory Council, other professional societies and peer reviewers.

The statement reads, “Despite a paucity of data on the comparative effectiveness of different management strategies for acute pain, several areas of expert consensus emerged across existing guidelines, which were felt to be relevant and applicable to the hospital setting. The objective of these recommendations is to provide information that can be used to inform and support opioid-related management decisions for acute pain by clinicians practicing medicine in the inpatient setting.”

“The journal is always pleased to be able to publish results of rigorous and innovative work, and the consensus document authored by Dr. Herzig and her team represents an outstanding example,” said Andrew Auerbach, MD, MPH, MHM, Professor of Medicine in Residence at the University of California, San Francisco, and editor in chief for the Journal of Hospital Medicine. “As we enter the ‘post-opioid’ era of pain management, papers like these will provide critical guidance for how to improve pain control among hospitalized patients; they are important first steps in the transition to new pain care strategies that are safer, more effective and patient-centered.”

Click here to access the consensus statement.

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