Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston 02114, Massachusetts, USA.
Department of Emergency Medicine, University of California, Irvine, California, USA.
Pain Res Manag. 2021 Jan 13;2021:4980170. doi: 10.1155/2021/4980170. eCollection 2021.
It is important to analyze the types of etiologies and provider demographics that drive opioid prescription in our emergency departments. Our study aimed to determine which patients in the ED are receiving opioid prescriptions, as well as their strength and quantity. Secondary outcomes included identifying difference in prescribing between provider classes.
We conducted a retrospective study at a tertiary care university-based, level-one trauma ED from November 2017 to October 2018. We identified and analyzed data from 2,259 patients who were sent home with an opioid prescription. We retrieved patient and provider demographics, diagnosis, etiologies, and prescription information.
The mean age of a patient receiving an opioid prescription was 45, and 72.7% of patients were white. The most common diagnosis groups associated with an opioid prescription were abdominal pain (18.5%), nonfracture extremity pain (18.4%), and back/neck pain (12.5%). Hydrocodone-acetaminophen 5-325 mg was the most commonly prescribed (67.4%). The median total prescribed milligram morphine equivalent (MME) was highest for extremity fracture (75.0; IQR 54.0-100.0). The median total prescribed amount of pills was highest for patients with extremity fractures (15.0; IQR 12.0-20.0).
Our study elucidates the prescribing patterns of an academic level 1 trauma center and should pave the way for future studies looking to maximize effectiveness at ways to curb ED opioid prescription.
分析导致急诊科开具阿片类药物处方的病因类型和提供者特征至关重要。我们的研究旨在确定急诊科接受阿片类药物处方的患者类型,以及他们的处方强度和数量。次要结局包括确定不同提供者类别之间的处方差异。
我们对 2017 年 11 月至 2018 年 10 月在一家三级护理大学附属一级创伤急诊科进行了一项回顾性研究。我们确定并分析了 2259 名携带阿片类药物处方回家的患者的数据。我们检索了患者和提供者的人口统计学、诊断、病因和处方信息。
接受阿片类药物处方的患者的平均年龄为 45 岁,72.7%的患者为白人。与阿片类药物处方相关的最常见诊断组是腹痛(18.5%)、非骨折肢体疼痛(18.4%)和腰背/颈部疼痛(12.5%)。氢可酮-对乙酰氨基酚 5-325mg 是最常开的处方(67.4%)。四肢骨折患者的总处方美沙酮等效剂量中位数最高(75.0;IQR 54.0-100.0)。四肢骨折患者的总处方药丸数中位数最高(15.0;IQR 12.0-20.0)。
我们的研究阐明了一家学术一级创伤中心的处方模式,应该为未来研究寻找抑制急诊科阿片类药物处方的有效性方法铺平道路。