# Reducing Unused Prescribed Opioids After Cesarean Birth

> **NIH NIH K23** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2022 · $169,665

## Abstract

PROJECT SUMMARY/ABSTRACT
Over the past 15 years, the United States has seen the emergence of an opioid epidemic with drug overdose
ranking as the most common cause for accidental death. The rise in drug overdose deaths mirrors the rise in
legal opioid prescribing. Unfortunately, most persons using opioids for non-medical purposes obtain them from
a family member or friend who was legitimately prescribed opioids. While significant attention has been
devoted to prescribing recommendations for individuals with chronic pain and for acute post-surgical pain,
much less attention has been given to post-surgical opioid prescribing after hospital discharge. As the most
common abdominal surgery in the United States, cesarean birth is the ideal setting to examine methods to
reduce unused prescribed opioids. My preliminary work demonstrates that most women have unused opioids
after cesarean birth, however a significant proportion of women use all opioids and have unmet pain needs. In
addition, current opioid prescribing practices appear to be largely based on prescriber habits rather than
patient need. This body of work endeavors to 1) characterize post-discharge opioid use patterns and identify
demographic and obstetric variables associated with differential use 2) create and validate a clinical decision
support tool that predicts customized post-discharge opioid need and 3) conduct a pilot randomized clinical trial
comparing prescribing guided by the CDS tool to standard care to test whether this tool reduces unused
opioids without increasing unmet pain after cesarean birth. The overarching objective of this mentored career
development experience is to emerge as an independent clinical investigator leading a multidisciplinary
research program to improve opioid prescribing after hospital discharge. To accomplish this goal, I will
augment my prior research training with advanced coursework and skills development in predictive modeling
and conducting clinical trials as well as leadership training focused on opioid prescribing and maternal and
infant public health systems. Throughout the award period, the I will work closely with a multidisciplinary team
of mentors and advisors—including experts in obstetrics and gynecology, biostatistics, anesthesiology, public
health, and epidemiology—to carry out my stated career objectives and specific aims.

## Key facts

- **NIH application ID:** 10448490
- **Project number:** 5K23DA047476-04
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Sarah Scheiderich Osmundson
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $169,665
- **Award type:** 5
- **Project period:** 2019-08-01 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10448490

## Citation

> US National Institutes of Health, RePORTER application 10448490, Reducing Unused Prescribed Opioids After Cesarean Birth (5K23DA047476-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10448490. Licensed CC0.

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