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在术后阿片类药物使用方面对外科肿瘤学提供者进行教育:干预后 1 年的部门调查。

Educating surgical oncology providers on perioperative opioid use: A departmental survey 1 year after the intervention.

机构信息

Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.

Department of Surgery, Vanderbilt University, Nashville, Tennessee.

出版信息

J Surg Oncol. 2020 Sep;122(3):547-554. doi: 10.1002/jso.25983. Epub 2020 May 23.

Abstract

BACKGROUND AND OBJECTIVES

A department-wide opioid reduction education program resulted in a 1-month change in perceptions of opioid needs and prescribing recommendations for surgical oncology patients. This study's aim was to re-evaluate if early trends were retained 1 year later.

METHODS

Surgical Oncology attendings, fellows, and advanced practice providers at a Comprehensive Cancer Center were surveyed 1-year after an August 2018 opioid reduction education program, to compare departmental and individual opioid prescribing habits.

RESULTS

The September 2019 response rate was 54/93 (58%), with 41 completing both the post-education and 1-year follow-up surveys. The departmental and matched cohort continued to recommend a lower quantity of discharge opioids for all five index operations (by >50%) and expected less postoperative days to zero opioid needs, when compared to pre-education perceptions. Providers continued to agree that discharge opioid prescriptions should be based on a patient's last 24 hours of inpatient opioid use. There was universal agreement that each respondent's opioid administration had decreased in the past year.

CONCLUSIONS

The initial 1-month improvements in perioperative opioid prescribing perceptions were retained 1 year later by Surgical Oncology providers who recommended fewer discharge opioids, faster weaning to zero opioids, and standardized patient-specific discharge opioid volume calculations.

摘要

背景与目的

一项全部门阿片类药物减少教育计划导致外科肿瘤患者对阿片类药物需求的看法和处方建议在 1 个月内发生变化。本研究旨在评估 1 年后是否保留了早期趋势。

方法

在 2018 年 8 月进行阿片类药物减少教育计划 1 年后,对综合癌症中心的外科肿瘤主治医生、住院医师和高级执业医师进行了调查,以比较部门和个人阿片类药物处方习惯。

结果

2019 年 9 月的回复率为 54/93(58%),其中 41 人完成了教育后和 1 年随访调查。与教育前的看法相比,该部门和匹配队列继续建议所有 5 种索引手术的出院阿片类药物数量减少(减少 50%以上),并期望术后天数减少到零阿片类药物需求。提供者继续认为,出院阿片类药物处方应基于患者住院期间最后 24 小时的阿片类药物使用情况。每位受访者的阿片类药物管理在过去一年中减少了,这一点得到了普遍认同。

结论

外科肿瘤学提供者在过去一年中保留了最初 1 个月内围手术期阿片类药物处方认知的改善,他们建议减少出院阿片类药物、更快地减少到零阿片类药物以及标准化基于患者个体的出院阿片类药物剂量计算。

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