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显微外科手术后的阿片类药物处方模式:一项随访回顾性图表审查。

Opioid Prescribing Patterns After Micrographic Surgery: A Follow-up Retrospective Chart Review.

作者信息

Donigan Jessica M, Franco Abigail I, Stoddard Gregory J, Hedderman Amanda, Tristani-Firouzi Payam, Bowen Glen M, Millican Eric A, Duffy Keith L

机构信息

School of Medicine, University of Utah, Salt Lake City, Utah.

Department of Family Medicine, St. Joseph's Hospital Health Center, Syracuse, New York.

出版信息

Dermatol Surg. 2019 Apr;45(4):508-513. doi: 10.1097/DSS.0000000000001725.

DOI:10.1097/DSS.0000000000001725
PMID:30570517
Abstract

BACKGROUND

The abuse of opioids has reached epidemic proportions in the United States, and leftover medications are a primary source for nonmedical pain relievers. A past study at the University of Utah showed that micrographic surgeons were likely overprescribing opioids, with 35% of patients receiving a postoperative prescription.

OBJECTIVE

To examine the current opioid prescribing habits of the micrographic surgeons at the University of Utah compared with those in 2010.

METHODS

Retrospective chart review of the patient records of 4 micrographic surgeons between February and May 2017.

RESULTS

Four hundred patient visits were reviewed. An opioid prescription was provided after 12% of encounters, 23% lower than in 2010 (p = .004). Younger patient age, increased number of stages and defect size, repair of the defect, and particular surgeons predicted opioid prescription.

CONCLUSION

The percentage of patients who received an opioid prescription after undergoing micrographic surgery at the University of Utah decreased from 35% in 2010 to 12% in 2017. Reports of the minimal need of opioids after micrographic surgery, the authors' past study showing an institutional tendency to overprescribe, and reports of the national opioid epidemic likely all contributed to the decrease in opioid prescriptions at the authors' institution.

摘要

背景

在美国,阿片类药物的滥用已达到流行程度,剩余药物是非医疗用止痛药的主要来源。犹他大学过去的一项研究表明,显微外科医生可能存在阿片类药物处方过量的情况,35%的患者术后收到了处方。

目的

与2010年相比,研究犹他大学显微外科医生目前的阿片类药物处方习惯。

方法

对2017年2月至5月间4位显微外科医生的患者记录进行回顾性图表审查。

结果

共审查了400次患者就诊情况。12%的就诊后开具了阿片类药物处方,比2010年低23%(p = .004)。患者年龄较小、手术阶段数量和缺损大小增加、缺损修复以及特定的外科医生可预测阿片类药物处方情况。

结论

在犹他大学接受显微外科手术后开具阿片类药物处方的患者比例从2010年的35%降至2017年的12%。显微外科手术后对阿片类药物需求极小的报告、作者过去关于机构存在处方过量倾向的研究以及全国阿片类药物流行的报告可能都导致了作者所在机构阿片类药物处方量的减少。

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