Some Tennessee hospitals have almost entirely stopped prescribing opioids after women give birth, while others are still giving addictive narcotics to nearly every new mother as they go home.
The findings are part of a study presented at the Society of Maternal-Fetal Medicine annual conference based on TennCare patients. There are known regional variations on prescribing pain medication to new mothers, and Tennessee is on the high end. But less is known about hospital-to-hospital differences.
Researchers found at some Tennessee hospitals, as many as nine-in-10 new moms are receiving a supply opioids, even as others have virtually stopped altogether. And there’s not much explanation for the discrepancy other than perhaps the culture of the particular hospital, says co-author Sarah Osmundson, a professor and OB-GYN at Vanderbilt University Medical Center.
“Opioid prescribing and a lot of prescribing practices in general are not things you’re taught exactly how to do in medical school and residency, and so you tend to just learn from your colleagues,” she says. “That was my experience.”
Osmundson says she was surprised when she moved to Nashville from the West Coast five years ago just how freely physicians were still prescribing opioids to new mothers, often 30 oxycodone pills even for women who didn’t have complicated deliveries.
The one correlation researchers found was that the more TennCare patients a hospital saw, the less likely it was to prescribe opioids. Those with a higher rate of commercially-insured patients tended to prescribe pain medication more freely.
“Which could indicate that hospitals with a large proportion of births covered by private payors place a higher priority on patient satisfaction with regards to pain control and management through prescription opioids,” the study says.
Researchers do not identify the high-prescribers, but they say a next step is focusing on promoting more judicious opioid use at those hospitals.