Clinical Guideline for Prescribing Opioids on Discharge
PDF 283 KB
Designed to promote the safe, effective and appropriate prescribing of opioids at hospital discharge
SA Health is committed to ensuring the quality use of opioids for the treatment of acute pain to promote optimal patient outcomes. A resource kit has been developed to support healthcare professionals in the provision of effective and safe analgesia to patients with acute pain. These resources aim to guide best clinical practice, enhance the knowledge of both staff and patients in relation to opioids and assist health services in accreditation under the The National Safety and Quality Health Service (NSQHS) Standards (Medication Safety Standard).
Resources that have been endorsed for SA Health statewide use are provided below and additional resources will be added as they become available. The previous work undertaken by the Royal Adelaide Hospital Opioid Working Party that contributed to the initial development of many of the resources is acknowledged.
The SA Health resources below have been endorsed by the SA Medicines Advisory Committee (SAMAC) for statewide use following stakeholder consultation. Modifications should not be made without appropriate authorisation.
Early effective management of acute pain is critical to reducing morbidity and preventing the development of chronic pain, particularly in the post-operative period and immediately following discharge from hospital. Immediate-release (IR) opioids such as oxycodone are commonly used in this situation and recommended in preference to slow-release opioid formulations.
Whilst being highly effective, many medicines used for the management of pain, particularly opioids have a high risk of side-effects when not used appropriately (for example dependence or respiratory depression). Opioids are consistently found to be one of the top ten high-risk medicines identified worldwide and one of the top three high-risk medicines identified in the SA Health Safety Learning System (SLS).
SA Health has implemented a statewide guideline on Opioids: Prescribing on Discharge (PDF 245KB) to promote the safe, effective and appropriate prescribing of opioids. The guideline will apply to all South Australian hospitals and health services where patients are discharged with medications and includes the following considerations:
SA Health recommends that this patient information sheet is provided to all patients discharged from hospital with immediate release oxycodone for acute pain as an adjunct to counselling by a qualified healthcare professional.
The Oxycodone for short-term management of acute pain (PDF 156KB) consumer fact sheet contains information to improve patient understanding of oxycodone in acute pain management; particularly:
SA Health recommends that this consumer factsheet is provided to all patients discharged from hospital after administration of sedative and/or opioid medications as an adjunct to counselling by a qualified healthcare professional.
The Going home after having been given a medicine that can make you sleepy (PDF 192KB) consumer factsheet contains information on the effects of opioids and sedatives and provides precautions regarding activities that should be avoided in the 24 hour period following discharge.
Other fact sheets about the short-term treatment of acute pain include:
Information for paediatric patients, and their carers, given opioids for short-term treatment of acute pain (PDF 140KB).
SA Health recommends that the an oxycodone Consumer Medicine Information (CMI) leaflet be made available to all patients prescribed oxycodone on discharge, in association with appropriate counselling.
CMIs contain reliable information on the safe and effective use of prescription and pharmacist-only medicines. Therapeutic Goods Administration (TGA) regulations require that the CMI be made available to patients either in the pack or in another manner that will enable the information to be given to the person to whom the medicines are administered or otherwise dispensed.
This section is now under review and should be considered with other current evidence resources, May 2021.
The following references are recommended reading for healthcare professionals involved in the prescribing, supply, or administration of opioids to enhance knowledge and understanding regarding opioids for acute pain management, prescribing patterns and current issues: