378 Improving Opioid Stewardship in General Surgical Practice

Abstract Aim The last 30 years has demonstrated a steady increase in drug-related deaths, with opioids implicated at least 2,219 deaths 2021 England and Wales1. Inpatient opioid prescribing surgery been to correlate long term use post-discharge2. We aim improve stewardship our DGH reduce ‘opioid-load’ the community, thereby reducing likelihood of long-term post-operative use. Method Intervention included teaching for junior doctors, audit meeting presentation posters designed collaboratively acute pain team. Prospective data collected 92 patients discharged from general October 2022 compared previous pre-intervention June 2020. Opioid prescriptions were converted Milligrams Morphine Equivalence (MMgEq) analysis. Results Following intervention, max average 58.64 MMgEq/day 85.88 previously. Max PRN prescription now 49.77 57.18 MMgEq/day. Increased involvement team (15.9% 20%) improved multimodal analgesia (PCA - 3% 13%, NSAIDS 2% 16.5%, rectus sheath blocks – 1% 4.2%). Discharge also improved; only 57.6% opioids, 89% had documented plan GP 49% specific duration. Conclusions Our results demonstrate marked improvement surgical prescribing. There is potential further including introduction misuse risk calculator formalising opiate guidelines surgery.