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  • 22 Aug 2019 5:25 PM | Anonymous

    Esha Afreen, MS2; Zachary Colvin, DO; Anna Palatnik, MD; Erika Peterson, MD

    Opioid-related deaths have been steadily rising to alarming levels in the United States over the past twenty years. In fact, deaths resulting from opioid overdose accounted for 68% of all drug overdose deaths in 20171. The dangers of overprescribing opioids for pain management include chronic opioid dependence, pill diversion, and accidental ingestion by children due to storage in unsecured locations, further fueling the worsening opioid epidemic2,3.
    Cesarean sections are one of the most common surgical procedures performed. Current data reflects that following cesarean delivery, opioids are often prescribed in excess of the amount necessary for sufficient analgesia3,4. Furthermore, recent studies have accentuated a lack of standardization of opioid prescribing practices for postpartum women, which calls for increased efforts to educate providers on safe prescribing practices2.

    One of the efforts made by the state of Wisconsin to combat opioid overprescribing is a new state law, Wisconsin Act 266, which went into effect April 1, 2017. This law was intended to discourage providers from overprescribing opioids by mandating a search of the prescription drug monitoring program (PDMP) database if prescribing opioids for greater than three days duration. The objectives of our study were to examine whether opioid prescribing patterns and postpartum health care utilization were changed after this new law was enacted.

    We hypothesized that Wisconsin Act 266 decreased opioid prescribing without compromising effective post-Cesarean pain control through two aims:

    1. Determining whether there was a decrease in the total amount of opioids prescribed at discharge following Cesarean delivery after the law was enacted, and
    2. Determining whether there was a significant difference in postpartum encounters for pain after the law was enacted.

    A total of 1,316 women met criteria for analysis. There were no statistically significant differences in characteristics between patients in two study periods. There was a significant decrease in number and total amount of opioids prescribed at discharge in the year after the provisions were enacted. A multivariate linear regression was performed controlling for race, labor, previous cesarean deliveries, prior opioid use, and body mass index. Both outcomes remained statistically significant. There was no difference in percentage of patients who had additional encounters for postpartum pain control, or additional opioid prescriptions.

    The study concluded that the amount of opioids prescribed decreased in the year following enactment of Wisconsin Act 266 compared to the year prior, while postpartum encounters for pain did not increase. This demonstrates that opioids were previously being overprescribed and that the law has been effective at reducing opioid prescribing without compromising postoperative pain control after discharge. Future mandates such as this should be considered in other states to decrease opioid overprescribing on a national level.

    Acknowledgments:

    The student would like to thank Dr. Erika Peterson, Dr. Zachary Colvin, DO, and Dr. Anna Palatnik, MD for their continued mentorship and support for this project, as well as the Waukesha County Medical Society for their generosity in funding the fellowship that made this project possible.

    References:

    1.           Scholl L, Seth P, Kariisa M, Wilson N, Baldwin G. Drug and Opioid-Involved Overdose Deaths — United States, 2013–2017. MMWR Morb Mortal Wkly Rep. 2018;67(5152). doi:10.15585/mmwr.mm6751521e1

    2.           Badreldin N, Grobman WA, Chang KT, Yee LM. Opioid prescribing patterns among postpartum women. Am J Obstet Gynecol. 2018;219(1):103.e1-103.e8. doi:10.1016/j.ajog.2018.04.003

    3.           Osmundson SS, Schornack LA, Grasch JL, Zuckerwise LC, Young JL, Richardson MG. Postdischarge opioid use after cesarean delivery. Obstet Gynecol. 2017;130(1):36-41. doi:10.1097/AOG.0000000000002095

    4.           Bateman BT, Cole NM, Maeda A, et al. Patterns of opioid prescription and use after cesarean delivery. Obstet Gynecol. 2017;130(1):29-35. doi:10.1097/AOG.0000000000002093

  • 12 Aug 2019 12:49 PM | Anonymous

    The Wisconsin Medical Society continues to lead the conversation on well-being and empowerment for physicians and health care teams with this follow-up to last year’s successful event. Designed to energize collaborative efforts to advance proven solutions for increasing clinician empowerment, retention and satisfaction – come be a part of this critical conversation.

    More information about this event can be found here

    You can find the direct link to register here.

  • 1 Aug 2019 1:05 PM | Anonymous

    August 1, Wisconsin Medical Society

    The Wisconsin Medical Society is excited to launch WisMed Voice, a new digital advocacy tool to connect physicians with their lawmakers. 

    Read more

  • 25 Jul 2019 1:02 PM | Anonymous

    July 25, Wisconsin Medical Society 

    The Wisconsin Department of Health Services (DHS) is investigating cases of severe lung disease among teens who have reported vaping. All eight cases were reported in the counties of Milwaukee, Waukesha and Winnebago and presented with respiratory symptoms including cough, shortness of breath, and fatigue.

    Read more

  • 11 Jul 2019 1:00 PM | Anonymous

    July 11, Wisconsin Medical Society

    Governor Tony Evers signed into law Tuesday in Janesville a Wisconsin Medical Society-supported bill designed to clarify health insurance industry procedures related to “step therapy.”

    Read more

  • 13 Jun 2019 12:58 PM | Anonymous

    June 13, Wisconsin Medical Society

    Floods can happen almost anywhere and can arise quickly. Being prepared and knowing how to keep you and your family safe in a flood will make a dangerous and stressful situation more manageable.

    Read more

  • 2 May 2019 12:33 PM | Anonymous

    May 2, Wisconsin Medical Society

    Doctor Day 2019 brought more than 300 physicians and medical students from across the state to Madison to meet with legislators and their staffs yesterday.

    Read more

  • 18 Apr 2019 12:38 PM | Anonymous

    April 18, Wisconsin Medical Society

    A bill clarifying health insurance company procedures related to “step therapy” and another bill related to supervised pharmacy students being allowed to administer prescribed vaccinations garnered Society support on Wednesday in the State Capitol at a rare joint public hearing of the State Assembly and Senate health care committees.

    Read more

  • 5 Mar 2019 11:45 AM | Anonymous

    Summer is only a few months away, and the Wisconsin Medical Society has teamed up with the Medical College of Wisconsin (MCW) and the University of Wisconsin School of Medicine and Public Health (UWSMPH) to make sure your health care team is prepared.

    From Asthma to Zika: A Physician's Guide to Summer is being held April 5-6 in Madison. Focusing on emerging health trends in infectious disease, environmental health and trauma, the new two-day education conference features a full lineup of speakers from MCW and UWSMPH, plus the opportunity to fulfill opioid education required by the Medical Examining Board and plenty of time to network with colleagues from across the state.

    Click here for details including session descriptions, speaker bios and registration information. The conference has been approved for AMA PRA Category 1 Credit™. Application for CME credit with the American Academy of Family Physicians is pending.

    Contact Stephanie Taylor at 608.442.3796 or stephanie.taylor@wismed.org if you have questions.


  • 11 Jan 2019 4:50 PM | Anonymous

    January 9, Wisconsin Health News

    ProHealth Care and UW Health are expanding their clinical partnership to include heart and vascular care, the two health systems announced Tuesday.

    Under a clinical co-management agreement, the health systems will work to improve heart and vascular services in Waukesha County and the surrounding area.

    “Working with UW Health, we will take our program to a new level of excellence,” said Susan Edwards, ProHealth Care CEO.

    UW Health will provide medical and administrative oversight, and the newly opened heart and vascular center at ProHealth Waukesha Memorial Hospital will be named UW Health Heart & Vascular Center at ProHealth Care.

    “We share with ProHealth Care an intense focus on improving the quality of care, and we are excited to begin this new partnership,” said Dr. Alan Kaplan, UW Health CEO.

    UW Health and ProHealth Care have a similar partnership on cancer care, launching the UW Cancer Center at ProHealth Care in 2015.

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