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Standardization of Outpatient Procedure (STOP) Narcotics: A Prospective Non-Inferiority Study to Reduce Opioid Use in Outpatient General Surgical Procedures.门诊手术规范化（STOP）麻醉：一项前瞻性非劣效性研究，旨在减少门诊普通外科手术中的阿片类药物使用。
J Am Coll Surg. 2019 Jan;228(1):81-88.e1. doi: 10.1016/j.jamcollsurg.2018.09.008. Epub 2018 Oct 22.
2
Opioid Consumption After Knee Arthroscopy.膝关节镜检查后的阿片类药物消耗。
J Bone Joint Surg Am. 2018 Oct 3;100(19):1629-1636. doi: 10.2106/JBJS.18.00049.
3
Unused opioid analgesics and drug disposal following outpatient dental surgery: A randomized controlled trial.门诊牙科手术后未使用的阿片类镇痛药及药物处置：一项随机对照试验。
Drug Alcohol Depend. 2016 Nov 1;168:328-334. doi: 10.1016/j.drugalcdep.2016.08.016. Epub 2016 Sep 20.
4
Wide Variation and Excessive Dosage of Opioid Prescriptions for Common General Surgical Procedures.普通普外科手术中阿片类药物处方的广泛差异和过量用药
Ann Surg. 2017 Apr;265(4):709-714. doi: 10.1097/SLA.0000000000001993.
5
CDC Guideline for Prescribing Opioids for Chronic Pain - United States, 2016.美国 2016 年慢性疼痛阿片类药物处方指南。
MMWR Recomm Rep. 2016 Mar 18;65(1):1-49. doi: 10.15585/mmwr.rr6501e1.
6
Self-reported pain complaints among Afghanistan/Iraq era men and women veterans with comorbid posttraumatic stress disorder and major depressive disorder.患有创伤后应激障碍和重度抑郁症的阿富汗/伊拉克战争时期退伍军人的自我报告疼痛主诉。
Pain Med. 2013 Oct;14(10):1529-33. doi: 10.1111/pme.12208. Epub 2013 Aug 7.
7
The association of persistent pain with out-patient addiction treatment outcomes and service utilization.持续性疼痛与门诊成瘾治疗结果及服务利用之间的关联。
Addiction. 2008 Dec;103(12):1996-2005. doi: 10.1111/j.1360-0443.2008.02358.x. Epub 2008 Oct 8.

评估军事卫生系统中门诊疼痛护理和阿片类药物处方的质量。

Assessing the Quality of Outpatient Pain Care and Opioid Prescribing in the Military Health System.

作者信息

Hepner Kimberly A, Roth Carol P, Sherry Tisamarie B, McBain Ryan K, Ruder Teague, Engel Charles C

出版信息

Rand Health Q. 2022 Aug 31;9(4):19. eCollection 2022 Aug.

PMID:36238003
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9519116/
Abstract

Pain conditions are the leading cause of disability among active-duty service members. Given the significant implications for force readiness and service member well-being, the Military Health System (MHS) has made it a strategic priority to provide service members with the highest-quality treatment for pain conditions. RAND researchers assessed MHS outpatient care for acute and chronic pain, including opioid prescribing. The assessment involved developing a set of 14 quality measures designed to assess aspects of outpatient care for pain, including care associated with dental and ambulatory procedures, acute low back pain, chronic pain, opioid prescribing, and medication treatment for opioid use disorder. This research offers the most comprehensive examination to date of the quality and safety of pain care in the MHS and its alignment with evidence-based clinical practice guidelines. It identifies several areas of strength in pain care delivery, along with some areas for improvement, and provides recommendations to support the MHS in continuing to improve pain care for service members.

摘要

疼痛病症是现役军人致残的主要原因。鉴于其对部队战备状态和军人福祉的重大影响，军事卫生系统（MHS）已将为军人提供最高质量的疼痛病症治疗作为一项战略重点。兰德公司的研究人员评估了MHS针对急性和慢性疼痛的门诊护理，包括阿片类药物的处方开具情况。该评估涉及制定一套14项质量指标，旨在评估疼痛门诊护理的各个方面，包括与牙科和门诊手术、急性下背痛、慢性疼痛、阿片类药物处方开具以及阿片类药物使用障碍的药物治疗相关的护理。这项研究提供了迄今为止对MHS疼痛护理质量和安全性及其与循证临床实践指南一致性的最全面检查。它确定了疼痛护理提供方面的几个优势领域，以及一些需要改进的领域，并提出了建议，以支持MHS继续改善对军人的疼痛护理。