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4CPS-218 Opioid prescribing for acute non-cancer pain, post-operative pain and post-procedure pain by surgical teams at a tertiary hospital: 1-day audit
  1. EM Byrne
  1. Cork University Hospital, Pharmacy, Cork, Ireland Rep.


Background and Importance In Ireland, numbers of prescribed opioids are increasing yearly, out of proportion to population increase1. Acute hospitals are a major source of initial opioid prescriptions into communities 2. The Health Service Executive (HSE) has published opioid prescribing guidelines for the management of acute non-cancer pain, post-operative pain and post-procedure pain, specifically addressing the use of slow-release opioids, duration of prescription and avoidance of diversion following discharge 3.

At our hospital, there is no standardised approach to opioid prescribing in this population. A baseline point prevalence survey (PPS) of opioid prescribing in this population by surgical teams was conducted.

Aim and Objectives • To characterise opioid prescribing for acute non-cancer pain, post-operative pain and post-procedure pain in a tertiary healthcare setting

• To inform local policy development on appropriate opioid use.

Material and Methods The PPS took place on a single day in May 2023. Approval to conduct the survey was sought from the hospital Quality and Patient Safety Dept. All adult patients admitted to our hospital under a surgical team were included. The inpatient medication prescription record and medical notes for each patient were reviewed by a clinical pharmacist. Opioid prescription details were recorded on a data collection form hosted on Microsoft Forms.


  • 72% of study population (n=205) were prescribed an opioid; total of 224 opioid prescriptions

  • Most common indication, 43%, was acute postoperative pain (97/224)

  • 27% (61/224) of prescriptions were for slow-release formulations

  • 30% (67/224) of opioid prescriptions were prescribed for > 1 week

  • 97% (218/224) of opioid prescriptions were commenced during the current admission

  • Figures 1 & 2 respectively, summarise the opioid agent and formulation prescribed.

Conclusion and Relevance This 1-day snapshot audit has presented several areas for improvement at our hospital, specifically the use of slow-release opioids, treatment duration and discharge prescription. Several quality improvement initiatives are being initiated as part of a wider opioid stewardship programme in line with the HSE National Clinical Programme for Anaesthesia.

References and/or Acknowledgements 1. HSE PCRS Data Sources. Annual reports.

2. US National Survey on Drug Use and Health.

3. HSE National Clinical Programme for Anaesthesia. Guidance for Opioid Prescribing for Acute Non-cancer Pain, Post-operative Pain and Post-procedure Pain, 2022.

Conflict of Interest No conflict of interest.

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