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为下肢医疗服务提供者减轻阿片类药物危机的阿片类药物管理计划。

Mitigating the opioid crisis for the lower extremity provider opioid stewardship programs.

作者信息

Smith Robert G

机构信息

Shoe String Podiatry, 723 Lucerne Circle, Ormond Beach, Florida 32174, USA.

出版信息

Foot (Edinb). 2020 Dec;45:101708. doi: 10.1016/j.foot.2020.101708. Epub 2020 Jun 22.

Abstract

Opioids are an effective form of analgesia for pain treatment. Over prescribing of opioids agents have becom;1;e detrimental to the United States' public health. One of the most difficult challenges for any prescriber is to balance the potential benefits versus the potential risks of opioid prescribing. Addressing the opioid crisis requires an interprofessional team approach. The utilization of an opioid stewardship program provides the necessary frame work to identify gaps in the in quality and development in the implementation of a change of long standing opioid culture and practice. These programs address opioid prescribing, treatment for opioid use disorder, educational initiatives, and the use of information technology. A few acronyms have been created to assist providers to guide them when prescribing opioids. The purpose of this article is to explore the central theme of responsible opioid pain management. It will introduce, define, and defend with clinical base evidence a proposed acronym "MORPHINE" to assist and help shape prescription opioid strategies used for lower extremity pain. Implications for practicing lower extremity providers need to acknowledge the potential harm that prescribing opioids may cause to their patients. Opioid stewardship principles should become a priority in podiatric medicine and podiatric surgery.

摘要

阿片类药物是疼痛治疗中一种有效的镇痛形式。阿片类药物的过度处方已对美国公众健康造成危害。对于任何开处方者而言,最困难的挑战之一是平衡阿片类药物处方的潜在益处与潜在风险。应对阿片类药物危机需要跨专业团队的方法。阿片类药物管理计划的运用提供了必要的框架,以识别长期存在的阿片类药物文化和实践变革实施过程中的质量和发展差距。这些计划涉及阿片类药物处方、阿片类药物使用障碍治疗、教育举措以及信息技术的使用。已经创建了一些首字母缩略词来帮助医疗服务提供者在开具阿片类药物处方时进行指导。本文的目的是探讨负责任的阿片类药物疼痛管理的核心主题。它将引入、定义并以临床基础证据捍卫一个提议的首字母缩略词“MORPHINE”,以协助并塑造用于治疗下肢疼痛的阿片类药物处方策略。下肢医疗服务提供者在实践中需要认识到开具阿片类药物可能对其患者造成的潜在危害。阿片类药物管理原则应成为足病医学和足病外科的优先事项。

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