照料者报告的教育程度与儿童手术后处方类阿片药物的上锁储存和处置之间的关联。
Association of caregiver-reported education with locked storage and disposal of prescription opioids after children's surgery.
机构信息
Michigan Opioid Prescribing Engagement Network, University of Michigan, Ann Arbor, MI.
Michigan Opioid Prescribing Engagement Network, University of Michigan, Ann Arbor, MI; Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI.
出版信息
J Pediatr Surg. 2020 Nov;55(11):2442-2447. doi: 10.1016/j.jpedsurg.2020.04.022. Epub 2020 May 11.
PURPOSE
This study aimed to assess whether caregiver-reported storage and disposal education were associated with locked opioid storage and disposal of leftover opioids after children's surgery.
METHODS
Caregivers of children <18 years who were prescribed an opioid were surveyed 7-21 days after surgery at an academic children's hospital (4/1/2018-3/31/2019) on opioid-related education and management practices (54% response rate). Multivariable logistic regression models were estimated for locked storage and disposal of leftover opioids as functions of storage and disposal education, adjusting for demographics, procedure, prescription characteristics, and postoperative day at time of survey.
MAIN FINDINGS
Among 606 respondents, storage education was reported by 366 (60.4%) and locked storage by 111 caregivers (18.3%). Caregivers who reported verbal storage education (aOR 3.01 (95% CI 1.52-5.94); p = 0.001) or both written and verbal storage education (aOR 2.18 (95% CI 1.30-3.68); p = 0.003) were more likely to lock opioids in storage. Among 451 caregivers with leftover opioids, disposal education was reported by 226 (50.1%) and disposal by 111 caregivers (24.6%). There was no association between verbal and/or written disposal education with disposal.
CONCLUSION
Caregivers infrequently reported education, locked storage, and disposal of leftover opioids after children's surgery. Education may improve locked opioid storage, but additional strategies are needed to increase disposal.
TYPE OF STUDY
Treatment.
LEVEL OF EVIDENCE
Level III.
目的
本研究旨在评估照顾者报告的储存和处置教育是否与儿童手术后锁存阿片类药物储存和剩余阿片类药物的处置有关。
方法
在一家学术儿童医院（2018 年 4 月 1 日至 2019 年 3 月 31 日），对接受阿片类药物治疗的 <18 岁儿童的照顾者进行了术后 7-21 天的调查，调查内容包括与阿片类药物相关的教育和管理实践（54%的应答率）。使用多变量逻辑回归模型，将锁定储存和处置剩余阿片类药物作为储存和处置教育的函数进行估计，调整了人口统计学、手术程序、处方特征和调查时的术后天数。
主要发现
在 606 名受访者中，有 366 名（60.4%）报告了储存教育，有 111 名（18.3%）照顾者报告了锁存储存。报告口头储存教育的照顾者（OR 3.01（95%CI 1.52-5.94）；p=0.001）或书面和口头储存教育均报告的照顾者（OR 2.18（95%CI 1.30-3.68）；p=0.003）更有可能将阿片类药物锁存储存。在 451 名有剩余阿片类药物的照顾者中，有 226 名（50.1%）报告了处置教育，有 111 名（24.6%）报告了处置。口头和/或书面处置教育与处置之间没有关联。
结论
儿童手术后，照顾者很少报告教育、锁定储存和处置剩余阿片类药物。教育可能会改善锁存阿片类药物的储存，但需要采取其他策略来增加处置。
研究类型
治疗。
证据水平
三级。
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