Straubhar Alli M, Stroup Cynthia, de Bear Olivia, Dalton Liam, Rolston Aimee, McCool Kevin, Reynolds R Kevin, McLean Karen, Siedel Jean H, Uppal Shitanshu
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Michigan Medicine, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Michigan Medicine, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA.
Gynecol Oncol. 2023 Mar;170:229-233. doi: 10.1016/j.ygyno.2023.01.018. Epub 2023 Jan 28.
To evaluate the impact a tailored opioid prescription calculator has on meeting individual patient opioid needs while avoiding opioid over prescriptions.
Our group previously developed and published an opioid prescribing calculator incorporating patient risk factors (history of depression, anxiety, chronic opioid use, substance abuse disorder, and/or chronic pain) and type of surgery (laparotomy or laparoscopy). This calculator was implemented on 1/1/2021 and its impact on opioid prescriptions was evaluated until 12/31/21. The primary outcome of the present study is to determine prescriber compliance with the calculator (defined as not overprescribing from the number of pills indicated by the calculator). The secondary outcome is to determine the excess prescription rate (defined as proportion of patients reporting more than 3 pills remaining at 30 days post-surgery). Refill rates and pain related patient phone calls were collected. Descriptive statistics were used to summarize the cohort.
Of the 355 patients included, 54.7% (N = 194) underwent laparoscopy and 45.4% (N = 161) underwent laparotomy. One hundred and forty-two patients (40%) had at least one risk factor for opioid usage. The median number of opioid pills prescribed following laparoscopy was 3 (range 0-15) and 6 (0-20) after laparotomy. The prescriber compliance was 88.2% and the excess prescription rate was 25.1% (N = 89 patients).
Our tailored opioid calculator has a high prescriber compliance. Implementation of this calculator led to a standardization of tailored opioid prescribing, while limiting the number of over prescriptions. A free web version of the calculator can be easily accessed at www.opioidcalculator.org.
评估定制的阿片类药物处方计算器在满足患者个体阿片类药物需求的同时避免阿片类药物过度处方的影响。
我们的团队此前开发并发表了一种阿片类药物处方计算器，该计算器纳入了患者风险因素（抑郁症、焦虑症、长期使用阿片类药物、药物滥用障碍和/或慢性疼痛病史）以及手术类型（剖腹手术或腹腔镜手术）。该计算器于2021年1月1日开始使用，并对其截至2021年12月31日对阿片类药物处方的影响进行了评估。本研究的主要结果是确定开处方者对计算器的依从性（定义为未超过计算器指示的药丸数量进行过度处方）。次要结果是确定过量处方率（定义为报告术后30天剩余超过3粒药丸的患者比例）。收集了再填充率和与疼痛相关的患者电话。使用描述性统计来总结该队列。
在纳入的355名患者中，54.7%（N = 194）接受了腹腔镜手术，45.4%（N = 161）接受了剖腹手术。142名患者（40%）至少有一个阿片类药物使用风险因素。腹腔镜手术后开具的阿片类药丸中位数为3（范围0 - 15），剖腹手术后为6（0 - 20）。开处方者的依从性为88.2%，过量处方率为25.1%（N = 89名患者）。
我们定制的阿片类药物计算器具有较高的开处方者依从性。该计算器的使用导致了定制阿片类药物处方的标准化，同时限制了过度处方的数量。可通过www.opioidcalculator.org轻松访问该计算器的免费网络版。
