Abstract
Objectives
This study aimed to audit opioid prescribing practices at hospital discharge for elective surgical patients and assess alignment with contemporary best-practice recommendations.
Methods
A retrospective audit of adult elective surgical inpatients at a tertiary surgical and rehabilitation centre (1 October 2024–1 January 2025) examined discharge opioid prescribing, in oral morphine equivalent daily dose (oMEDD), against inpatient opioid use. A supplementary theatre register was used to compare patients discharged with and without an opioid.
Results
Of 580 patients screened, 576 were eligible; 47.6% (n = 274) were discharged with an opioid, most often oxycodone IR (54.8%) or tapentadol (41.2%), typically as a fixed quantity of 10 (52.2%) or five (27.4%) tablets. Discharge oMEDD (median 75 mg, interquartile range (IQR) 75–150) correlated moderately with inpatient oMEDD in the preceding 24 h (r = 0.57, P
Conclusions
Discharge opioid prescribing was reasonably individualised by patient and procedure, but quantity was frequently standardised rather than tailored, and a minority of patients received an opioid despite no recent inpatient need. Strengthening quantity individualisation, discharge simple analgesia, and patient education around cessation would further align prescribing with opioid stewardship principles.