眼科的阿片类药物处方和决策支持工具对减少过量用药的影响。

Opioid Prescription in Ophthalmology and the Impact of a Decision Support Tool in Reducing Excess Dosing.

机构信息

From the Case Western Reserve University School of Medicine (V.B., R.P.S., K.E.T.).

Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic (K.S., C.V., A.K., J.M., R.P.S., K.E.T.), Cleveland, Ohio, USA.

出版信息

Am J Ophthalmol. 2022 Nov;243:34-41. doi: 10.1016/j.ajo.2022.06.019. Epub 2022 Jul 6.

DOI:10.1016/j.ajo.2022.06.019

PMID:35809659

Abstract

PURPOSE

To characterize opioid prescribing in ophthalmology and to determine the impact of an alert system on opioid prescription patterns.

DESIGN

Retrospective pre- and post-implementation study.

METHODS

The study population included individuals aged ≥18 years who received opioids written by ophthalmologists within a tertiary care center between January 3, 2015, and November 3, 2021, in the context of an opioid alert system. Mean morphine equivalent daily dose (MEDD) per prescription was compared before and after implementation of the opioid alert system. Additionally, mean MEDD per prescription was compared based on patient demographics and diagnoses.

RESULTS

A total of 8014 individual patients were included in this study. The study population received a total of 9055 prescriptions, 77% of which were written for pain management related to an ophthalmic surgery. Mean MEDD per prescription decreased by 15.17 after implementation of the alert system (P < .001). A higher mean MEDD per prescription was observed among males (33.53 MEDD; P < .001). Black individuals received a higher mean MEDD per prescription (33.93 MEDD) compared with white individuals (32.80 MEDD; P = .03). Opioids written for disorders of the eyelid, lacrimal system, and orbit constituted 57.4% of total prescriptions.

CONCLUSIONS

Prescription patterns based on patient demographics and diagnoses can provide foci for opioid prescription reform in ophthalmology. The observed decrease in opioid dosage may indicate realization of the alert system.

摘要

目的

描述眼科的阿片类药物处方情况，并确定警报系统对阿片类药物处方模式的影响。

设计

回顾性实施前后研究。

方法

研究人群包括 2015 年 1 月 3 日至 2021 年 11 月 3 日期间在三级护理中心接受眼科医生开具的阿片类药物的年龄≥18 岁的个体，在阿片类药物警报系统的背景下。比较实施阿片类药物警报系统前后每张处方的平均吗啡等效日剂量（MEDD）。此外，还根据患者人口统计学和诊断比较了每张处方的平均 MEDD。

结果

本研究共纳入 8014 名个体患者。研究人群共收到 9055 张处方，其中 77%是为与眼科手术相关的疼痛管理开具的。实施警报系统后，每张处方的平均 MEDD 减少了 15.17（P<0.001）。男性每张处方的平均 MEDD 更高（33.53 MEDD；P<0.001）。与白人相比，黑人个体每张处方的平均 MEDD 更高（33.93 MEDD）（P=0.03）。用于眼睑、泪器和眼眶疾病的阿片类药物构成了总处方的 57.4%。