Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston, Massachusetts, USA.
Division of Otolaryngology-Head and Neck Surgery, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA.
Otolaryngol Head Neck Surg. 2021 Apr;164(4):781-787. doi: 10.1177/0194599820987454. Epub 2021 Feb 16.
Determine whether opioid prescriber patterns have changed for tonsillectomy, parotidectomy, and thyroidectomy after implementation of the Massachusetts Prescription Awareness Tool (MassPAT).
Retrospective cohort study.
Single-center tertiary care hospital.
Patients were included if they received tonsillectomy, parotidectomy, or thyroid surgery at Lahey Hospital and Medical Center (Burlington, Massachusetts) between October 1, 2015, and October 1, 2019. Prescribing patterns were compared prior to implementation of MassPAT, October 1, 2015, to October 14, 2016, to postimplementation of MassPAT, October 15, 2016, to October 1, 2019. Quantity of opioids prescribed was described using total morphine milligram equivalents (MME). Data were analyzed using univariate analysis, multivariate analysis, and trend line using line of best fit.
A total of 737 subjects were included in the study. There was a downward trend in the quantity of opioids prescribed for all 3 surgeries during the study period. There was a significant difference in the quantity of opioids prescribed pre- and postimplementation of MassPAT for tonsillectomy (647.70 ± 218.50 MME vs 474.60 ± 185.90 MME, < .001), parotidectomy (241.20 ± 57.66 MME vs 156.70 ± 72.99 MME, < .001), and thyroidectomy (171.20 ± 93.77 MME vs 108.50 ± 63.84 MME, < .001). There was also a decrease in the number of patients who did not receive opioids for thyroidectomy pre- and post-MassPAT (7.56% vs 24.14%).
We have demonstrated that there is an association with state drug monitoring programs and decrease in the amount of opioids prescribed for acute postoperative pain control for common otolaryngology surgeries.
在马萨诸塞州处方意识工具（MassPAT）实施后，确定扁桃体切除术、腮腺切除术和甲状腺切除术的阿片类药物处方模式是否发生了变化。
回顾性队列研究。
单中心三级保健医院。
如果患者在 2015 年 10 月 1 日至 2019 年 10 月 1 日期间在莱希医院和医疗中心（马萨诸塞州伯灵顿）接受扁桃体切除术、腮腺切除术或甲状腺手术，则将其纳入研究。在 MassPAT 实施之前（2015 年 10 月 1 日至 2016 年 10 月 14 日）、MassPAT 实施之后（2016 年 10 月 15 日至 2019 年 10 月 1 日）比较了处方模式。使用总吗啡毫克当量（MME）描述开具的阿片类药物数量。使用单变量分析、多变量分析和最佳拟合线的趋势线进行数据分析。
共有 737 名患者纳入本研究。在研究期间，所有 3 种手术的阿片类药物处方数量均呈下降趋势。扁桃体切除术（647.70 ± 218.50 MME 比 474.60 ± 185.90 MME， <.001）、腮腺切除术（241.20 ± 57.66 MME 比 156.70 ± 72.99 MME， <.001）和甲状腺切除术（171.20 ± 93.77 MME 比 108.50 ± 63.84 MME， <.001）在 MassPAT 实施前后开具的阿片类药物数量存在显著差异。甲状腺切除术也有更多的患者术前和术后未接受阿片类药物治疗（7.56%比 24.14%）。
我们已经证明，与州药物监测计划有关，并与常见耳鼻喉科手术急性术后疼痛控制阿片类药物用量减少有关。
