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大型三级医疗学术中心的阿片类药物知识与处方习惯

Opioid Knowledge and Prescribing Habits at a Large Tertiary Care Academic Center.

作者信息

Prempreet Bajaj, Brennan Megan, Grigoropoulos Gregory, Hintz Adam, Parikh Satyum, Shah Neha, Wozniak Amy

机构信息

Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, USA.

Physical Medicine & Rehabilitation, Loyola University Chicago Stritch School of Medicine, Maywood, USA.

出版信息

Cureus. 2022 Aug 10;14(8):e27843. doi: 10.7759/cureus.27843. eCollection 2022 Aug.

Abstract

BACKGROUND

Opioids are commonly prescribed medications for pain management with high risks associated with chronic use. The inherent risk associated with opioids is worsened by variable prescribing practices used by prescribers. In the midst of the "opioid epidemic," perceptions of opioid prescription among healthcare practitioners have not been widely investigated.

OBJECTIVE

This study aimed to explore the opinions, experiences, and habits of prescribers as well as other healthcare personnel involved in the administration of opioids at an academic medical center.

METHODS

Questions were shared through an online survey format, answerable in Likert scale scores from 1 to 5 and categorized into three domains; prescribing habits/management, education, and risk stratification.

RESULTS

A total of 638 survey responses were collected comprising 130 physicians (21%), 44 residents and fellows (6.9%), 53 physician assistants and nurse practitioners (8.31%), 18 pharmacists (2.82%), 85 medical students (13.32%), and 308 nurses (48.28%). Collected responses revealed a weak consensus on prescribing practices and a lack of evidence-based opioid management such as low utilization of multidisciplinary clinics and unfamiliarity with the WHO analgesic ladder across all specialties. The survey also indicated a lack of education regarding the prescribing of opioids across all specialties although pharmacists reported obtaining the most. Lastly, the use of risk stratification tools such as prescription drug monitoring programs and urine drug testing were underutilized amongst practitioners.

CONCLUSION

Strengthening practitioners' opioid management abilities with evidence-based interventions for each aforementioned domain may aid in the fight against the opioid epidemic.

摘要

背景

阿片类药物是常用于疼痛管理的处方药,长期使用存在高风险。开具处方者使用的不同处方习惯加剧了阿片类药物固有的风险。在“阿片类药物流行”期间,医疗从业者对阿片类药物处方的看法尚未得到广泛调查。

目的

本研究旨在探讨一所学术医疗中心开具处方者以及其他参与阿片类药物管理的医护人员的意见、经验和习惯。

方法

通过在线调查的形式提出问题,答案采用1至5分的李克特量表评分,并分为三个领域;处方习惯/管理、教育和风险分层。

结果

共收集到638份调查回复,其中包括130名医生(21%)、44名住院医师和研究员(6.9%)、53名医师助理和执业护士(8.31%)、18名药剂师(2.82%)、85名医科学生(13.32%)和308名护士(48.28%)。收集到的回复显示,在处方习惯方面存在微弱的共识,并且缺乏基于证据的阿片类药物管理,例如多学科诊所利用率低以及所有专业对世界卫生组织镇痛阶梯不熟悉。调查还表明,所有专业在阿片类药物处方方面都缺乏教育,尽管药剂师报告获得的教育最多。最后,从业者对诸如处方药监测程序和尿液药物检测等风险分层工具的使用不足。

结论

通过针对上述每个领域的循证干预措施来增强从业者的阿片类药物管理能力,可能有助于对抗阿片类药物流行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0359/9460958/46145ebba667/cureus-0014-00000027843-i01.jpg

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