INTRODUCTION: Enhanced Recovery After Surgery (ERAS) protocols, Restricted Opioid Prescribing Protocols (ROPPs), and opioid calculators reduce and standardize opioid prescribing. This project will evaluate the effects of an ERAS protocol and a quality improvement (QI) intervention incorporating ROPPs and an opioid calculator on demographic disparities in opioid prescribing post-hysterectomy. METHODS: This retrospective cohort study evaluated patients after hysterectomy across three time periods: Pre-ERAS (February to August 2020), Post-ERAS (May to November 2023), and Post-QI (July 2024 to January 2025) (IRB: STUDY00160958). Associations between opioids prescribed and race, ethnicity, rurality, type of medical insurance, and having a primary care provider were examined. Independent t-tests and analysis of variance were used for statistical analysis (significance at P <.05). RESULTS: A total of 673 patients were included. No difference in mean morphine milligram equivalents (MME) by race was found in Pre-ERAS. Post-ERAS, White patients had higher mean MME than Black patients or patients of other non-White races (134.3, 112.0, 101.1; P <.05). Pre-ERAS, Hispanic patients had higher mean MME than non-Hispanic patients (142.1, 116.4; P <.05). Post-ERAS Hispanic patients had lower mean MME than non-Hispanic patients (96.2, 130.0; P <.05). No difference in mean MME was found Post-QI by ethnicity or race. No differences were found by rurality, insurance type, or primary care provider. CONCLUSIONS/IMPLICATIONS: Racial and ethnic disparities in opioid prescribing at discharge were present after implementing ERAS protocols but improved with adding the QI intervention. Further research will involve multivariable analysis, including known risk factors for increased opioid use, to assess for potential confounders.
D'Agostino et al. (Thu,) studied this question.