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仅限制阿片类药物处方长度的立法对矫形创伤中的处方开具影响极小。

Legislation Only Limiting Opioid Prescription Length Has Minimal Impact on Prescribing in Orthopaedic Trauma.

机构信息

Duke University Medical Center, Department of Orthopaedic Surgery, Durham, North Carolina.

Duke University School of Medicine, Durham, North Carolina.

出版信息

J Surg Orthop Adv. 2021 Summer;30(2):101-107.

Abstract

This study evaluates the efficacy of North Carolina's Strengthen Opioid Misuse Prevention (STOP) Act in reducing the volume and rate of 90-day perioperative opioid prescribing to patients ages 18 and older after orthopaedic trauma surgery. Patients undergoing fracture surgery from January 2017 to June 2017 (pre-STOP) were compared with patients undergoing fracture surgery from January 2018 to June 2018 (post-STOP). Adjusted analyses demonstrated that patients undergoing surgery after the STOP Act (n = 730) were prescribed significantly lower volume of opioids in the discharge to 2-week time frame and at the first postoperative prescription (7.3 and 5.8 fewer oxycodone, respectively). Otherwise, there were no significant differences between the two cohorts in adjusted volume or rates of 90-day opioid prescribing. The STOP act has had only a minor impact on early post-discharge opioid prescribing in patients undergoing fracture surgery. These findings question the efficacy of this type of legislation in combating opioid overprescribing in orthopaedic trauma. (Journal of Surgical Orthopaedic Advances 30(2):101-107, 2021).

摘要

本研究评估了北卡罗来纳州强化阿片类药物滥用预防(STOP)法案在减少骨科创伤手术后 18 岁及以上患者术后 90 天内阿片类药物开方量和开方率方面的效果。比较了 2017 年 1 月至 2017 年 6 月(STOP 前)接受骨折手术的患者与 2018 年 1 月至 2018 年 6 月(STOP 后)接受骨折手术的患者。调整分析表明,在 STOP 法案实施后接受手术的患者(n = 730)在出院后至 2 周的时间内和首次术后处方时的阿片类药物开方量明显较低(分别减少了 7.3 和 5.8 个羟考酮)。否则,两个队列在调整后的 90 天阿片类药物开方量或开方率方面没有显著差异。STOP 法案对接受骨折手术的患者出院后早期阿片类药物开方的影响较小。这些发现质疑了这种类型的立法在对抗骨科创伤中阿片类药物过度开方方面的效果。(《外科矫形进展杂志》30(2):101-107,2021)。

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