Variability in opioid prescribing practices among cardiac surgeons and trainees

Edward D. Percy, Sameer Hirji, Claudia Cote, Charles Laurin, Logan Atkinson, Spencer Kiehm, Alexandra Malarczyk, Morgan Harloff, Sabin J. Bozso, Ryan Buyting, Ali Fatehi Hassanabad, Ming Hao Guo, Iqbal Jaffer, Carly Lodewyks, Derrick Y. Tam, Philippe Tremblay, Jean François Légaré, Richard Cook, Tsuyoshi Kaneko, Marc P. Pelletier

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background and Aim: The opioid epidemic has become a major public health crisis in recent years. Discharge opioid prescription following cardiac surgery has been associated with opioid use disorder; however, ideal practices remain unclear. Our aim was to examine current practices in discharge opioid prescription among cardiac surgeons and trainees. Methods: A survey instrument with open- and closed-ended questions, developed through a 3-round Delphi method, was circulated to cardiac surgeons and trainees via the Canadian Society of Cardiac Surgeons. Survey questions focused on routine prescription practices including type, dosage and duration. Respondents were also asked about their perceptions of current education and guidelines surrounding opioid medication. Results: Eighty-one percent of respondents reported prescribing opioids at discharge following routine sternotomy-based procedures, however, there remained significant variability in the type and dose of medication prescribed. The median (interquartile range) number of pills prescribed was 30 (20-30) with a median total dose of 135 (113-200) Morphine Milligram Equivalents. Informal teaching was the most commonly reported primary influence on prescribing habits and a lack of formal education regarding opioid prescription was associated with a higher number of pills prescribed. A majority of respondents (91%) felt that there would be value in establishing practice guidelines for opioid prescription following cardiac surgery. Conclusions: Significant variability exists with respect to routine opioid prescription at discharge following cardiac surgery. Education has come predominantly from informal sources and there is a desire for guidelines. Standardization in this area may have a role in combatting the opioid epidemic.

Original languageEnglish
Pages (from-to)2657-2662
Number of pages6
JournalJournal of cardiac surgery
Issue number10
StatePublished - Oct 1 2020


  • analgesic
  • cardiovascular research
  • opioid prescription


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