Accepted for/Published in: JMIR Formative Research
Date Submitted: Aug 5, 2025
Date Accepted: May 30, 2026
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Use of Electronic Patient Record Systems for Rapid Response to an MHRA Public Assessment Report 
ABSTRACT
Objectives To use existing digital infrastructure to identify patterns of modified-release opioid use after elective surgery, as a rapid response to a UK Medicines & Healthcare products Regulatory Agency report. Methods Adult patients undergoing elective surgery between 2019 and 2025 were extracted from a standardised reporting pipeline within four weeks of report publication. Patients were screened for modified-release opioid prescriptions in the postoperative period and at hospital discharge. Proportions of patients prescribed these medications were evaluated across the study period. Surgical procedure codes were screened to identify high use specialties and procedures. Results Of 127,215 elective surgeries screened, 103,400 met eligibility criteria. 7,148 (6.9%) patients received a new modified-release opioid prescription postoperatively, with 2431(2.4%) receiving one at hospital discharge. Prescribing of modified-release opioids has declined since 2020, but use persists in thoracic, neuro, and orthopaedic surgical specialties. Discussion Mature digital and analytical infrastructure within healthcare institutions can swiftly evaluate local practices in the context of national medication safety alerts. This can shorten response times and improve patient care, but requires close collaboration between clinicians and healthcare informaticians.
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