Leas Daniel, Seymour Rachel B, Wally Meghan K, Hsu Joseph R
1Department of Orthopedic Surgery, Carolinas Trauma Network Research Center of Excellence, Carolinas HealthCare System, 1000 Blythe Boulevard, Charlotte, NC 28203 USA.
Charlotte, NC USA.
HSS J. 2019 Feb;15(1):51-56. doi: 10.1007/s11420-018-9633-5. Epub 2018 Oct 17.
Drug overdoses are the leading cause of death due to injury in the USA. Currently, 49 states have prescription drug-monitoring programs (PDMPs) available to prescribers.
QUESTIONS/PURPOSES: We aimed to assess knowledge and practice of two groups of acute-care prescribers regarding controlled substances.
A 16-question survey was distributed to a list of surgical and emergency medicine prescribers at our institution. The survey asked about prescriber demographics, previous experiences with a PDMP, and opinions about patient risk factors available within an electronic medical record (EMR).
We received 60 responses (27.1% response rate). All prescribers recognized a growing problem with opioids, both in general and in their own practices, with an average rating of 8.3/10 and 7.9/10, respectively. Although 95% were aware a PDMP was available, only 60% were registered users. Emergency medicine prescribers were significantly more likely to have registered and used the database; 52% said the PDMP was too time-consuming and 23% said the information was not easy to use. All respondents who reported PDMP use indicated it carried some clinical utility, with 87% reporting it to be "somewhat" or "very" useful. Emergency medicine prescribers were more likely to use the PDMP regularly, with 73% selecting "somewhat frequently" or higher, while only 9% of surgery prescribers indicated the same. Of all respondents, 97% agreed that an integrated alert in the existing EMR would be helpful.
Acute-care prescribers at our institution are universally aware of the opioid epidemic, but efficient and useful tools for identifying at-risk patients are lacking. Our prescribers desired an alert system integrated into the EMR to highlight targeted risk factors.
药物过量是美国伤害致死的首要原因。目前,49个州为开处方者提供了处方药监测项目(PDMPs)。
问题/目的:我们旨在评估两组急性护理开处方者在管制药品方面的知识和实践情况。
向我们机构的外科和急诊医学开处方者名单发放了一份包含16个问题的调查问卷。该问卷询问了开处方者的人口统计学信息、之前使用PDMP的经历以及对电子病历(EMR)中患者风险因素的看法。
我们收到了60份回复(回复率为27.1%)。所有开处方者都认识到阿片类药物问题日益严重,无论是总体情况还是在他们自己的实践中,平均评分分别为8.3/10和7.9/10。尽管95%的人知道有PDMP可用,但只有60%是注册用户。急诊医学开处方者注册并使用该数据库的可能性显著更高;52%的人表示使用PDMP太耗时,23%的人表示信息不易使用。所有报告使用过PDMP的受访者都表示它具有一定的临床实用性,87%的人报告说它“有点”或“非常”有用。急诊医学开处方者更有可能经常使用PDMP,73%的人选择“有点频繁”或更高频率,而只有9%的外科开处方者表示同样情况。在所有受访者中,97%的人同意在现有的EMR中设置综合警报会有帮助。
我们机构的急性护理开处方者普遍意识到阿片类药物流行问题,但缺乏识别高危患者的高效且有用的工具。我们的开处方者希望在EMR中集成一个警报系统,以突出针对性的风险因素。