Varney Shawn M, Bebarta Vikhyat S, Mannina Lisa M, Ramos Rosemarie G, Ganem Victoria J, Carey Katherine R
Department of Emergency Medicine, University of Texas Health Science Center, San Antonio 78229, USA.
Department of Emergency Medicine, University of Colorado School of Medicine, Aurora 80045, USA.
World J Emerg Med. 2016;7(2):106-10. doi: 10.5847/wjem.j.1920-8642.2016.02.004.
Emergency medicine providers (EMPs) prescribe about 25% of opioids, but the effect of EMP risk perception on decisions to prescribe opioids is unknown. This study was undertaken to identify factors that influence EMP risk and opioid prescribing practices.
We distributed an anonymous questionnaire to EMPs at a military trauma and referral center. Response frequencies and distributions were assessed for independence using the Chi-square test.
Eighty-nine EMPs completed the questionnaire (100% response). Respondents were primarily younger male physicians (80%) in practice under five years (55%). Male EMPs were more likely to prescribe more opioid tablets than female ones both when and when not concerned for opioid misuse (P<0.001, P<0.007, respectively). Of the providers, 70% stated that patient age would influence their prescribing decisions. Hydrocodone and oxycodone were the opioids prescribed most frequently. About 60% of the providers reported changing their prescribing behavior would not prevent opioid misuse. Additionally, 40% of the providers believed at least 10% of patients seen at this military ED misused opioids.
Female EM providers reported prescribing fewer opioid tablets. Patient age influenced prescribing behavior, but the effect is unknown. Finally, EM providers reported that altering their prescribing behavior would not prevent prescription opioid misuse.
急诊医学从业者(EMPs)开具约25%的阿片类药物处方,但EMPs的风险认知对阿片类药物处方决策的影响尚不清楚。本研究旨在确定影响EMPs风险及阿片类药物处方行为的因素。
我们向一家军事创伤和转诊中心的EMPs发放了一份匿名问卷。使用卡方检验评估应答频率和分布的独立性。
89名EMPs完成了问卷(应答率100%)。应答者主要是从业年限不到5年(55%)的年轻男性医生(80%)。无论是在担心阿片类药物滥用还是不担心的情况下,男性EMPs开具的阿片类药片都比女性更多(分别为P<0.001,P<0.007)。在这些从业者中,70%表示患者年龄会影响他们的处方决策。氢可酮和羟考酮是最常开具的阿片类药物。约60%的从业者报告称,改变他们的处方行为并不能预防阿片类药物滥用。此外,40%的从业者认为,在这家军事急诊室就诊的患者中至少有10%滥用阿片类药物。
女性急诊医学从业者报告开具的阿片类药片较少。患者年龄影响处方行为,但影响尚不清楚。最后,急诊医学从业者报告称,改变他们的处方行为并不能预防处方阿片类药物的滥用。