Laurentian University, School of Rural and Northern Health, Sudbury, ON P3E 2C6, Canada.
Can Fam Physician. 2011 Mar;57(3):324-32.
To measure physicians' experiences with opioid-related adverse events and their perceived level of confidence in their opioid prescribing skills and practices.
Mailed survey. Setting The province of Ontario.
A total of 1000 primary care physicians randomly selected from the College of Physicians and Surgeons of Ontario registration database.
Opioid-related adverse events and concerns (eg, number of patients, type of opioid, cause of the event or concern); physicians' confidence, comfort, and satisfaction with opioid prescribing; physicians' opinions on strategies to optimize their prescribing; and physicians' perspectives of their interactions with pharmacists and nurses.
The response rate was close to 66%, for a total of 658 participants. Almost all respondents reported prescribing opioids for chronic pain in the past 3 months. Eighty-six percent of respondents reported being confident in their prescribing of opioids, but 42% of respondents indicated that at least 1 patient had experienced an adverse event related to opioids in the past year, usually involving oxycodone, and 16.3% of respondents did not know if their patients had experienced any opioid-related adverse events. The most commonly cited factors leading to adverse events were that the patient took more than prescribed, the prescribed dose was too high, or the patient took alcohol or sedating drugs with the opioids. Most physicians had concerns about the opioid use of 1 or more of their patients; concerns included running out of opioids early, minimal access to pain and addiction treatment, and addiction and overdose. The reported number of physicians' patients taking opioids was positively associated with their confidence and comfort levels in opioid prescribing and negatively associated with their belief that many patients become addicted to opioids.
Most physicians have encountered opioid-related adverse events. Comprehensive strategies are required to promote safe prescribing of opioids, including guidelines and comprehensive office-system materials.
衡量医生在阿片类药物相关不良事件方面的经验，以及他们对自身开阿片类药物处方技能和实践的信心程度。
邮寄问卷调查。
安大略省。
从安大略省医师学院注册数据库中随机抽取的共 1000 名初级保健医生。
阿片类药物相关不良事件和关注问题（如患者人数、阿片类药物类型、事件或关注问题的原因）；医生对开阿片类药物处方的信心、舒适度和满意度；医生对优化处方策略的看法；以及医生对与药剂师和护士互动的看法。
回复率接近 66%，共有 658 名参与者。几乎所有的受访者都报告在过去 3 个月内为慢性疼痛患者开具了阿片类药物。86%的受访者表示对自己开阿片类药物处方有信心，但 42%的受访者表示在过去一年中至少有 1 名患者经历过与阿片类药物相关的不良事件，通常涉及羟考酮，而 16.3%的受访者不知道自己的患者是否经历过任何与阿片类药物相关的不良事件。导致不良事件最常见的因素是患者服用的药物超过了规定剂量、规定剂量过高或患者同时服用阿片类药物和酒精或镇静药物。大多数医生对 1 名或多名患者的阿片类药物使用存在担忧；这些担忧包括阿片类药物过早用完、获得疼痛和成瘾治疗的机会有限、以及成瘾和过量用药。报告的开阿片类药物的医生患者人数与他们对阿片类药物处方的信心和舒适度水平呈正相关，与他们认为许多患者对阿片类药物成瘾的信念呈负相关。
大多数医生都遇到过阿片类药物相关的不良事件。需要采取综合策略来促进阿片类药物的安全处方，包括指南和全面的办公室系统材料。
