@article{19633e632fa04169968080478cf9cf64,
title = "A prospective feasibility study evaluating the 5x-multiplier to standardize discharge prescriptions in cancer surgery patients",
abstract = "Background: We designed a prospective feasibility study to assess the 5x-multiplier (5x) calculation (eg, 3 pills in last 24 hours × 5 = 15) to standardize discharge opioid prescriptions compared to usual care. Methods: Faculty-based surgical teams volunteered for either 5x or usual care arms. Patients undergoing inpatient (≥ 48 hours) surgery and discharged by surgical teams were included. The primary end point was discharge oral morphine equivalents. Secondary end points were opioid-free discharges and 30-day refill rates. Results: Median last 24-hour oral morphine equivalents was similar between arms (7.5 mg 5x vs 10 mg usual care, P = .830). Median discharge oral morphine equivalents were less in the 5x arm (50 mg 5x vs 75 mg usual care, P < .001). Opioid-free discharges included 33.5% 5x vs 18.0% usual care arm patients (P < .001). Thirty-day refill rates were similar (15.3% 5x vs 16.5% usual care, P = .742). Conclusion: The 5x-multiplier was associated with reduced opioid prescriptions without increased refills and can be feasibly implemented across a diverse surgical practice.",
author = "{for the PROMOTE Consortium} and DiPeri, {Timothy P.} and Newhook, {Timothy E.} and Day, {Ryan W.} and Chiang, {Yi Ju} and Dewhurst, {Whitney L.} and Arvide, {Elsa M.} and Bruno, {Morgan L.} and Scally, {Christopher P.} and Roland, {Christina L.} and Katz, {Matthew H.G.} and Vauthey, {Jean Nicolas} and Chang, {George J.} and Badgwell, {Brian D.} and Perrier, {Nancy D.} and Grubbs, {Elizabeth G.} and Lee, {Jeffrey E.} and Tzeng, {Ching Wei D.} and Bednarski, {Brian K.} and Chen, {Iris B.} and Comeaux, {Ryan J.} and Cox, {Dana M.} and Feig, {Barry W.} and Fisher, {Sarah B.} and Fournier, {Keith F.} and Ghebremichael, {Semhar J.} and Gibson, {Heather M.} and Gourmelon, {Nicole C.} and Graham, {Paul H.} and Shannon Hancher and Hunt, {Kelly K.} and Naruhiko Ikoma and {Ivey MPAS}, {Shanae L.} and Keung, {Emily Z.} and Ledet, {Celia R.} and Limmer, {Angela R.} and Mansfield, {Paul F.} and Mayon, {Lauren K.} and Messick, {Craig A.} and Popat, {Keyuri U.} and {Rajkot MPAS}, {Nikita F.} and {Robinson MPAS}, {Justine L.} and Rodriguez-Bigas, {Miguel A.} and Santos, {David A.} and Skibber, {John M.} and Speer, {B. Bryce} and Jose Soliz and Tillman, {Matthew M.} and Torres, {Keila E.} and {van Meter}, Antoinette and Williams, {Uduak Ursula}",
note = "Funding Information: TPD is supported by the National Institutes of Health T32 CA 009599 and the MD Anderson Cancer Center support grant (P30 CA016672). CDT is supported by the University Cancer Foundation and the Duncan Family Institute for Cancer Prevention and Risk Assessment via a Cancer Survivorship Research Seed Money Grant at the University of Texas MD Anderson Cancer Center and an Andrew Sabin Family Fellowship. Funding Information: TPD is supported by the National Institutes of Health T32 CA 009599 and the MD Anderson Cancer Center support grant (P30 CA016672). CDT is supported by the University Cancer Foundation and the Duncan Family Institute for Cancer Prevention and Risk Assessment via a Cancer Survivorship Research Seed Money Grant at the University of Texas MD Anderson Cancer Center and an Andrew Sabin Family Fellowship. CDT reports research funding/consultant fees to the institution from PanTher Therapeutics. CLR reports research funding to institution from Bristol Myers Squibb. Funding Information: We would like to thank our Complex General Surgical Oncology, Surgical Endocrinology, Colorectal, and Hepatopancreatobiliary fellows for their outstanding patient care and participation in this QI project. We would like to thank the multidisciplinary partners within our “Perioperative Reduction in Opioids through Multidisciplinary Options, Trials, and Education” (PROMOTE) Consortium. Publisher Copyright: {\textcopyright} 2022 The Authors",
year = "2022",
month = jul,
doi = "10.1016/j.sopen.2022.04.004",
language = "English (US)",
volume = "9",
pages = "51--57",
journal = "Surgery Open Science",
issn = "2589-8450",
publisher = "Elsevier BV",
}