Each year, approximately 1.8 million women will have a cesarean delivery or hysterectomy. While opioids are the mainstay treatment for acute pain after these surgeries, most women use only a fraction of the opioids prescribed and do not properly dispose of unused drugs.
Researchers at Women & Infants Hospital of Rhode Island, a Care New England hospital, and Brown University seek to address this problem and have received a 2018 Seed Award from the Brown Office of the Vice President for Research for their project, "'Right-sizing' opioid prescription post-cesarean delivery and hysterectomy: Balancing excess medication and patient pain control." Principal Investigator is Patricia Risica, DrPH, associate professor of behavioral and social sciences and associate professor of epidemiology at the Brown University School of Public Health; and co-principal investigator is Kristen A. Matteson, MD, MPH, director of the Division of Research for the Department of Obstetrics and Gynecology at The Warren Alpert Medical School of Brown University and Women & Infants Hospital and associate professor of obstetrics and gynecology. Dr. Matteson is a member of the Care New England Medical Group.
The specific aims of this project are: to conduct formative research with prescribing physicians, nurses, and patients; to use this information to create two web-based interventions - one for prescribers encouraging right-sized opioid prescribing and one for cesarean delivery and hysterectomy patients to encourage appropriate use and excess medication disposal; to pilot test these new interventions and estimate their efficacy by comparing the amount of opioids prescribed, those not consumed, pain scores, and appropriate disposal of excess medications.
"Dr. Risica and I look forward to working together on this project to develop an effective intervention to promote adherence to best practices for opioid prescribing that is informed by the experiences of the potential consumers of the intervention: patients and health care providers," stated Dr. Matteson.
"An effective intervention to promote 'right-sized' opioid prescriptions after cesarean delivery and hysterectomy has the potential for extrapolation to other surgical settings to widely address optimal opioid prescribing post-operatively, which would advance Brown University's position as a center of excellence in addressing the opioid epidemic," said the researchers in their application.
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About Women & Infants Hospital
Women & Infants Hospital of Rhode Island, a Care New England hospital, is one of the nation's leading specialty hospitals for women and newborns. A major teaching affiliate of The Warren Alpert Medical School of Brown University for obstetrics, gynecology and newborn pediatrics, as well as a number of specialized programs in women's medicine, Women & Infants is the ninth largest stand-alone obstetrical service in the country and the largest in New England with approximately 8,500 deliveries per year. A Designated Baby-Friendly® USA hospital, U.S.News & World Report 2014-15 Best Children's Hospital in Neonatology and a 2014 Leapfrog Top Hospital, in 2009 Women & Infants opened what was at the time the country's largest, single-family room neonatal intensive care unit.
Women & Infants and Brown offer fellowship programs in gynecologic oncology, maternal-fetal medicine, urogynecology and reconstructive pelvic surgery, neonatal-perinatal medicine, pediatric and perinatal pathology, gynecologic pathology and cytopathology, and reproductive endocrinology and infertility. It is home to the nation's first mother-baby perinatal psychiatric partial hospital, as well as the nation's only fellowship program in obstetric medicine.
Women & Infants has been designated as a Breast Imaging Center of Excellence by the American College of Radiography; a Center of Excellence in Minimally Invasive Gynecology; a Center of Biomedical Research Excellence by the National Institutes of Health (NIH); and a Neonatal Resource Services Center of Excellence. It is one of the largest and most prestigious research facilities in high risk and normal obstetrics, gynecology and newborn pediatrics in the nation, and is a member of the National Cancer Institute's Gynecologic Oncology Group and the Pelvic Floor Disorders Network.