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急诊科阿片类药物的使用与处方:一项回顾性研究。

Administration and Prescription of Opioids in Emergency Departments: A Retrospective Study.

作者信息

McNeil Casey L, Habib Alma, Okut Hayrettin, Hassouneh Stephanie, Ablah Elizabeth, Beard Sheryl

机构信息

Smoky Hill Family Practice Residency, Salina, KS.

University of Minnesota, Department of Medicine, Minneapolis, MN.

出版信息

Kans J Med. 2021 Jan 21;14(1):1-4. doi: 10.17161/kjm.vol1413368. eCollection 2021.

Abstract

INTRODUCTION

Opioid overdose caused 47,600 deaths in 2017 in the United States. Emergency departments (EDs) are one source of opioids that could be abused or diverted for non-medical use. Bills to reduce opioid use in EDs have been passed in multiple states; however, Kansas does not have a bill regulating opioid administration. This study sought to identify characteristics that influence opioid administration and prescription at EDs in Wichita, Kansas.

METHODS

This was a retrospective chart review analyzing patient encounters from EDs of three hospitals in Wichita, Kansas during May 2018. Information collected from charts included demographic and insurance information, as well as pain evaluation, diagnosis, disposition, provider education, and provider documentation of efforts to limit opioid abuse.

RESULTS

Of the 1,444 encounters included in the analysis, providers administered opioids in the ED during 17.4% of visits and prescribed opioids for outpatient treatment for 10.6% of ED patient encounters. Subjective pain rating and provider credentials were associated significantly with opioid prescription.

CONCLUSION

The prevalence of opioid administration and prescription in participating emergency departments is roughly equivalent to current best-practice data from hospitals utilizing strong opioid-reduction protocols.

摘要

引言

2017年,阿片类药物过量在美国导致47,600人死亡。急诊科是阿片类药物的一个来源,这些药物可能会被滥用或转用于非医疗用途。多个州已通过减少急诊科阿片类药物使用的法案;然而,堪萨斯州没有一项规范阿片类药物管理的法案。本研究旨在确定影响堪萨斯州威奇托市急诊科阿片类药物管理和处方的特征。

方法

这是一项回顾性病历审查,分析了2018年5月期间堪萨斯州威奇托市三家医院急诊科的患者就诊情况。从病历中收集的信息包括人口统计学和保险信息,以及疼痛评估、诊断、处置、提供者教育和提供者关于限制阿片类药物滥用努力的记录。

结果

在纳入分析的1444次就诊中,提供者在17.4%的就诊中在急诊科使用了阿片类药物,并为10.6%的急诊科患者就诊开具了门诊治疗的阿片类药物处方。主观疼痛评分和提供者资质与阿片类药物处方显著相关。

结论

参与研究的急诊科中阿片类药物管理和处方的发生率大致相当于采用强有力的阿片类药物减少方案的医院的当前最佳实践数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14c5/7833981/7a707c1974db/14-1f1.jpg

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