Analysis of Opioid Prescribing Trends Following Thyroidectomy and Parathyroidectomy Before and After the 2021 American Academy of Otolaryngology-Head and Neck Surgery Opioid Prescribing Clinical Practice Guidelines.

IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY
Otolaryngology- Head and Neck Surgery Pub Date : 2024-12-01 Epub Date: 2024-10-16 DOI:10.1002/ohn.1008
Robert E Africa, Brian J McKinnon, Orly M Coblens, Viran J Ranasinghe, Sepehr Shabani
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Abstract

Objective: To evaluate the trends in opioid and nonopioid prescribing for thyroidectomy and parathyroidectomy before and after the publication of guidelines by the American Academy of Otolaryngology-Head and Neck Surgery in April 2021.

Study design: Retrospective.

Setting: Eighty-three health care organizations in the United States that contribute to the TriNetX database.

Methods: Deidentified patient data were retrieved from the TriNetX. Patients who were prescribed either opioids or nonopioid analgesic within 1 to 5 days following thyroid surgery and parathyroidectomy were included. Evaluation of the prescription trends was performed by interrupted time series analysis in Statistical Analysis System 9.4 with significance set at P < .05 to assess trends before and after the new opioid prescription guidelines.

Results: For thyroid surgery, there was an immediate effect of the guideline change indicated by a 3.3% decrease in the opioid prescription trend (P = .03) and a significant increase in nonopioid use of overtime by 0.13% every 3 months (P < .0001). The opioid prescription trend following parathyroidectomy significantly decreased over time by 0.28% every 3 months (P < .0001), while the nonopioid prescription trend increased by 0.14% (P < .0001).

Conclusion: There was an associated immediate reduction in the opioid prescribing trend for thyroidectomy, but the change was not sustained overtime. There was an associated decrease in the opioid prescribing trend for parathyroidectomy, but not immediately after the initial publication of the prescription guidelines.

Level of evidence: Level III.

甲状腺切除术和甲状旁腺切除术后阿片类药物处方趋势分析》(Apysis of Opioid Prescribing Trends Following Thyroidectomy and Parathyroidectomy Before and After the 2021 American Academy of Otolaryngology-Head and Neck Surgery Opioid Prescribing Clinical Practice Guidelines)。
目的评估2021年4月美国耳鼻咽喉头颈外科学会发布指南前后甲状腺切除术和甲状旁腺切除术阿片类药物和非阿片类药物处方的趋势:研究设计:回顾性:研究设计:回顾性研究。研究地点:美国向TriNetX数据库提供信息的83家医疗机构:方法:从 TriNetX 数据库中检索患者身份不明的数据。纳入了甲状腺手术和甲状旁腺切除术后1至5天内被处方阿片类或非阿片类镇痛药的患者。处方趋势的评估是通过统计分析系统 9.4 中的中断时间序列分析进行的,显著性设定为 P 结果:就甲状腺手术而言,指南的改变产生了立竿见影的效果,阿片类药物的处方趋势下降了 3.3%(P = 0.03),而非阿片类药物的超时使用每 3 个月显著增加 0.13%(P 结论:甲状腺手术和甲状旁腺切除术的处方趋势与指南的改变密切相关:甲状腺切除术的阿片类药物处方量有立即减少的趋势,但随着时间的推移,这种变化不会持续。甲状旁腺切除术的阿片类药物处方呈减少趋势,但并非在处方指南首次发布后立即减少:证据等级:三级。
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来源期刊
Otolaryngology- Head and Neck Surgery
Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学
CiteScore
6.70
自引率
2.90%
发文量
250
审稿时长
2-4 weeks
期刊介绍: Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.
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