IMPACT OF A HOSPITAL PAIN THERAPY UNIT ON OPIOID PRESCRIPTION APPROPRIATENESS AND CONSUMPTION REDUCTION: A RETROSPECTIVE ANALYSIS

P. Buonavolontà¹, V. Donatiello², M. Alfieri¹, A. Scalvenzi², A. Frangiosa², G.M. Casillo³, A. Altiero³, R. Mercogliano³, G. Guglielmi³ | ¹Pain Therapy Center, "A. Cardarelli" Hospital, Napoli; ²Dept. of Elective Anesthesiological Activities, "A. Cardarelli" Hospital, Napoli; ³Dept. of Pharmacology, "A. Cardarelli" Hospital, Napoli

INTRODUCTION
The inappropriate use of opioids for pain management has become a significant concern in hospital settings, contributing to adverse drug reactions, dependency, and increased healthcare costs. In this context, the activation of specialized Pain Therapy Units represents a pivotal strategy to promote multimodal analgesia, optimize prescription practices, and reduce reliance on opioids. This study evaluates the impact of establishing a Pain Therapy Unit within AORN Antonio Cardarelli Hospital on opioid prescription trends and appropriateness.
METHODS
A retrospective observational study was conducted by analyzing electronic medical records and pharmaceutical consumption data from January 2023 to December 2024. The investigation focused on the period before and after the implementation of the Pain Therapy Unit, which became operational in May 2024. Data collection included the frequency and dosage of opioid prescriptions, stratified by active substance (fentanyl, tapentadol, tramadol, oxycodone), patient demographics, clinical indications, and prescribing departments. Statistical comparisons were performed to assess changes in prescribing behavior and drug utilization patterns.
RESULTS
Following the activation of the Pain Therapy Unit in May 2024, a significant reduction in opioid prescriptions was observed across all monitored substances. Notably, fentanyl, tapentadol, tramadol, and oxycodone prescriptions decreased by over 50% in terms of defined daily doses (DDD) and total units dispensed. The reduction was most evident in non-oncological settings, particularly in surgical and internal medicine departments. Concurrently, an increase in consultations with the Pain Therapy Unit and adoption of non-opioid analgesic protocols were recorded. Preliminary analyses suggest an improvement in prescription appropriateness, with fewer off-label opioid uses and better alignment with clinical guidelines.
CONCLUSIONS
The introduction of a dedicated Pain Therapy Unit at AORN Antonio Cardarelli markedly contributed to a more rational and conservative approach to opioid use. The findings highlight the effectiveness of multidisciplinary pain management strategies in reducing opioid consumption and improving prescription quality. These results support the broader integration of Pain Therapy Units in hospital systems to enhance patient safety and optimize pharmacological stewardship.