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Introduction

The Council of State Neurosurgical Societies (CSNS), the socioeconomic arm of the American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS), and the Joint Pain Section are conducting a nationwide survey of current neurosurgical physicians and residents identifying practice patterns of opioid utilization. 

The Opioid Epidemic continues to garner interest from both the medical community and the general public. We hope through the study of our current practice we can pinpoint actionable improvement strategies. All answers and respondents are de-identified (anonymous) and will remain strictly confidential.

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* 1. In which state do you practice?

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* 2. What best describes your practice level?

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* 3. How would you describe your employment setting?

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* 4. Have you completed a fellowship in spine surgery?

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* 5. Have you ever done any specialized training in pain management?

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* 6. Have you been required to complete CME in pain management as part of hospital or state rules?

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* 7. Does your practice utilize pre-operative opioid contracts that may include time limits, urine testing, dosage and/or supply counts?

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* 8. How often do you ask about the duration of pre-operative narcotic use?

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* 9. Do you have access to a dedicated pain management team at your institution or in your practice?

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* 10. What percentage of patients do you believe are chronically using opioids prior to surgery in your practice?

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* 11. Does your practice/hospital have or is it developing protocols or initiatives to reduce opioid use?

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* 12. What percentage of your patients require referral to pain management post-operatively for persistent refractory postoperative pain?

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* 13. What interventions do you utilize pre-operatively to improve post-operative pain control?

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* 14. Does your practice routinely prescribe opioids in the pre-operative time frame?

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* 15. What is your or your hospital’s IV opioid of choice for breakthrough pain in the inpatient setting?

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* 16. Do you routinely utilize (>50%) a PCA device in inpatient post-op pain management?

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* 17. What is your post-operative time frame after which you refer a patient with refractory pain to a pain management specialist?

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* 18. For how long do you typically agree to prescribe post-operative opioids for a patient who was not on opioids pre-operatively?

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* 19. For how long do you typically agree to prescribe post-operative opioids for a patient who was on chronic opioids pre-operatively?

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* 20. If a patient continues to require post-operative opioids after your typical prescribing period, from where do you recommend the patient continue to obtain these medications?

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* 21. Who is the majority prescribing provider for post-op opioids in your practice?

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* 22. How has your opioid prescribing pattern changed over your career?

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* 23. Does your practice/institution have a policy/protocol for screening patients for high risk of opioid abuse?

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* 24. Does your practice/institution have a policy/protocol for education/management of patients who are at high risk for opioid abuse?

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* 25. Has your state set lawful limits for opioid prescribing for opioid NAÏVE patients?

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* 26. Has your state set lawful limits for opioid prescribing for CHRONIC opioid patients?

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* 27. If you state has set lawful limits for opioid prescribing how has this impacted your practice? (Select all that apply)

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* 28. How has your state Prescription Drug Monitoring Program (PDMP) impacted your practice? (Select all that apply)

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* 29. Do you think that general prescribing guidelines (with suggested doses and duration) for post-operative pain management for routine neurosurgical procedures would be useful to your practice?

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* 30. For CRANIOTOMY PATIENTS - What oral opioid do you routinely use for inpatient post-op pain control?

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* 31. For  CRANIOTOMY PATIENTS - What additional NONOPIOID therapies do you utilize for inpatient post-op pain control (select all that apply)?

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* 32. For CRANIOTOMY PATIENTS - How many days’ supply of opioids does your practice typically provide?

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* 33. For CRANIOTOMY PATIENTS - What percentage of your patients stop all opioid use upon discharge from your practice?

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* 34. For NONINSTRUMENTED SPINE SURGERY and ACDF patients-  What oral opioid do you routinely use for inpatient post-op pain control?

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* 35. For NONINSTRUMENTED SPINE SURGERY and ACDF patients - What additional NONOPIOID therapies do you utilize for inpatient post-op pain control (select all that apply)?

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* 36. For NONINSTRUMENTED SPINE SURGERY and ACDF patients - How many days’ supply of opioids does your practice typically provide?

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* 37. For NONINSTRUMENTED SPINE SURGERY and ACDF patients - What percentage of your patients stop all opioid use upon discharge from your practice?

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* 38. For INSTRUMENTED SPINE SURGERY patients (C/T/L spine) - What oral opioid do you routinely use for inpatient post-op pain control?

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* 39. For INSTRUMENTED SPINE SURGERY patients (C/T/L spine) - What additional NONOPIOID therapies do you utilize for inpatient post-op pain control (select all that apply)?

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* 40. For INSTRUMENTED SPINE SURGERY patients (C/T/L spine) - How many days’ supply of opioids does your practice typically provide?

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* 41. For INSTRUMENTED SPINE SURGERY patients (C/T/L spine) - What percentage of your patients stop all opioid use upon discharge from your practice?

0 of 41 answered
 

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