1 Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.
2 Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Otolaryngol Head Neck Surg. 2018 Jul;159(1):29-34. doi: 10.1177/0194599818765125. Epub 2018 Mar 20.
Objectives To recognize current opioid prescription patterns in otolaryngology and determine changes in rates of outpatient opioid prescribing over time. Study Design Cross-sectional analysis of national survey database. Setting Ambulatory care settings in the United States. Subjects and Methods The National Ambulatory Medical Care Survey from 2006 to 2013 was analyzed for outpatient otolaryngology visits. The rate of opioid medication prescribing was determined with patient and visit characteristics associated with an opioid prescription, including corresponding diagnoses. Calendar trends for the rate of opioid prescribing were determined and compared biennially. Results Among 19.2 ± 1.7 million otolaryngology visits annually (raw N = 11,905), there were 728,000 ± 96,000 visits with an opioid prescription (3.8% ± 0.4%). Adults were more likely than children to receive a narcotic (4.3% vs 1.9%, P < .001); there was no significant difference according to sex (3.9% female vs 3.7% male, P = .567). With respect to calendar trend, the opioid prescription rate increased significantly from 2.3% in 2006-2007 to 4.6% in 2008-2011 and then decreased to 3.5% in 2012-2013 ( P < .031). The most common visit diagnosis categories associated with opioid prescribing were as follows: postoperative care (19.7% of prescriptions), adenotonsillitis (13.9%), chronic otitis media (8.7%), otitis externa (6.2%), and nasal obstruction (5.6%). Conclusion Despite the opioid epidemic in the United States, only a small portion of otolaryngology visits were associated with opioid prescription. However, given the significant increase in prescribing from 2008 to 2011, continued surveillance of prescribing patterns is warranted.
识别耳鼻喉科当前的阿片类药物处方模式，并确定随时间推移门诊阿片类药物处方率的变化。
国家调查数据库的横断面分析。
美国的门诊护理环境。
分析了 2006 年至 2013 年的国家门诊医疗保健调查，以获取耳鼻喉科门诊就诊情况。根据与阿片类药物处方相关的患者和就诊特征（包括相应的诊断），确定阿片类药物药物的处方率。确定并比较了阿片类药物处方率的日历趋势。
每年有 1920 万±170 万次耳鼻喉科就诊（原始 N=1190.5 次），其中有 72.8 万±9.6 万次就诊开具了阿片类药物处方（3.8%±0.4%）。与儿童相比，成年人更有可能接受麻醉性药物（4.3%比 1.9%，P<.001）；但根据性别没有显著差异（女性 3.9%，男性 3.7%，P=0.567）。关于日历趋势，阿片类药物处方率从 2006-2007 年的 2.3%显著增加到 2008-2011 年的 4.6%，然后在 2012-2013 年降至 3.5%（P<.031）。与开具阿片类药物处方相关的最常见就诊诊断类别如下：术后护理（19.7%的处方）、腺样体扁桃体炎（13.9%）、慢性中耳炎（8.7%）、外耳炎（6.2%）和鼻阻塞（5.6%）。
尽管美国阿片类药物泛滥，但只有一小部分耳鼻喉科就诊与阿片类药物处方相关。然而，鉴于 2008 年至 2011 年处方量显著增加，有必要继续监测处方模式。
