Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
J Surg Oncol. 2020 Nov;122(6):1066-1073. doi: 10.1002/jso.26106. Epub 2020 Jul 6.
The objective of this study was to assess current perceptions surrounding opioid prescribing in surgical oncology to inform perioperative quality improvement initiatives.
After the Society of Surgical Oncology (SSO) approval, a survey was distributed to its membership. Five sample procedures were used to assess provider perceptions and prescribing habits. Data were summarized and compared by self-reported demographics.
One hundred and seventy-five participants completed the survey: 149 (85%) faculty, 24 (14%) trainees, and 2 (1%) advanced practice providers. Most participants (76%) practiced in academic programs and 21% practiced in non-US locations. Few differences were identified based on clinical role, academic rank, or practice years. Compared with non-US providers, US providers expected higher pain scores at discharge, recommended greater opioid prescriptions, and estimated more days of opioid use for almost every procedure. More non-US providers believed discharge opioids should not be distributed to patients who are opioid-free in their last 24 inpatient hours (80% vs 50%, P = .001). All providers ranked education as "very important" for reducing opioid prescriptions.
Compared with their international counterparts, US surgical oncology providers expected greater opioid needs and recommended higher prescription numbers. Educating providers on multimodal opioid-sparing bundles, accelerated weaning protocols, and standardized discharge prescribing habits could have a positive impact the US opioid epidemic.
本研究旨在评估外科肿瘤学中阿片类药物处方的现状,以为围手术期质量改进举措提供信息。
在获得外科肿瘤学会(SSO)批准后,向其会员分发了一份调查问卷。使用了五个示例程序来评估提供者的看法和处方习惯。根据自我报告的人口统计学数据对数据进行了总结和比较。
有 175 名参与者完成了调查:149 名(85%)教员,24 名(14%)学员和 2 名(1%)高级实践提供者。大多数参与者(76%)在学术项目中执业,21%在非美国地点执业。根据临床角色、学术地位或实践年限,几乎没有发现差异。与非美国提供者相比,美国提供者预计出院时疼痛评分更高,建议开出更多的阿片类药物处方,并估计几乎每一种程序的阿片类药物使用天数都更多。更多的非美国提供者认为,在最后 24 小时住院期间没有使用阿片类药物的患者不应发放出院阿片类药物(80%比 50%,P = .001)。所有提供者都将教育列为减少阿片类药物处方的“非常重要”。
与国际同行相比,美国外科肿瘤学提供者预计阿片类药物需求更大,建议开出更高的处方数量。对提供者进行多模式阿片类药物节约包、加速减药方案和标准化出院处方习惯的教育可能会对美国阿片类药物流行产生积极影响。