St. Paul’s Hospital’s Opioid Stewardship Program (OSP) continued to build momentum in its second year of operation, according to its two-year progress report recently released.

Findings contained in this latest ​report cover the period from January to December 2021 of SPH’s OSP.

This report indicates that over 2000 recommendations were made to improve opioid prescribing among 645 patient encounters.

The program began in January 2020 to improve opioid prescribing at SPH, lower the number of adverse events and reduce the risk for long-term dependence and future opioid misuse/addiction.

Canada is the second-highest opioid consumer in the world after the United States. Rates of prescription opioid use have tripled in the past decade, leading to greater opioid misuse, addiction and deaths.

The program at SPH is working to reach its goals while maintaining or improving pain management for patients receiving opioids during their acute admission.

The hospital’s is the first OSP within Providence Health Care (PHC) and Vancouver Coastal Health’s (VCH) geographical areas, and the third OSP in BC.

The second year of the program shows a 26-per-cent increase from the number of recommendations offered in its first.

​The most common recommendations include:

  • Patient education (19 per cent),
  • Adding or increasing a non-opioid analgesic (16 per cent), and
  • Stopping as-needed opioids when no longer clinically indicated (15 per cent).

Almost all (96 per cent) of the over 2000 recommendations offered were accepted and integrated into clinical practice (an increase from 93% in the program’s first year).

In addition to the program’s clinical activities, a number of educational initiatives were undertaken in 2021. More specifically, the OSP team successfully delivered presentations at 19 educational events to increase awareness of the program and disseminate results on its effectiveness. Such events were hospital-based (e.g., medicine resident teaching, orthopedic surgery fellow training, general surgery nursing rounds, hospital grand rounds), regional (e.g., obstetrics and gynecology regional rounds), and national (e.g., Western Canada Pain Rounds and the British Columbia Centre on Substance Use Conference).

In addition, the OSP team has been actively participating in research and quality improvement initiatives such as:

  • Patient and health care provider OSP satisfaction surveys,
  • Educational infographic development for the BC Controlled Prescription Program, and
  • Evaluation of opioid use following discharge from general surgery.

Finally, the SPH Opioid Stewardship Advisory Committee, a group of interdisciplinary health care providers at SPH, convened six times in 2021 to review system-level changes that may be required to optimize opioid prescribing in the hospital setting.

To date, the OSP has demonstrated tremendous success at improving patient care and safety around opioid prescribing in the hospital setting.