Brian Corry, Laura J Cremer, Christopher Donnelly, Wesley M Sargent, Jamie Mells, Rodd Kelly, Joshua Reynolds, Leonard D Young
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引用次数: 0
摘要
目的 在本研究中,我们探讨了马萨诸塞州众多医疗机构的临床医生在处方药监控计划(PDMP)和电子病历(EHR)数据整合后与处方药监控计划相关的主要结果。方法 结果包括阿片类药物处方量、吗啡毫克当量(MMEs)处方量和 PDMP 查询量的 7 天滚动平均值。我们采用了纵向研究设计来分析 15 个月研究期间的 PDMP 数据,这样就有了围绕两个月整合期的六个半月的整合前和整合后观察。我们使用纵向混合效应模型来研究电子病历整合对各项关键结果的影响。结果 EHR 整合后,通过基于网络的门户网站进行的 PDMP 查询次数和总查询次数均有所增加(0.037,[95% CI = 0.017,0.057] 和 0.056,[95% CI = 0.035,0.077])。在整个研究期间,临床医生开具阿片类药物处方的两项指标均有所下降;但在整合电子病历后,未观察到明显效果。当我们对仅包括 PDMP 连续用户的子集进行分析时,这些结果是一致的。结论 我们的研究结果表明,电子病历整合有助于临床医生利用 PDMP,但不支持阿片类药物处方行为的改变。
Changes in opioid prescribing and prescription drug monitoring program utilization following electronic health record integration—Massachusetts, 2018
Objective In this study we explored key prescription drug monitoring program-related outcomes among clinicians from a broad cohort of Massachusetts healthcare facilities following prescription drug monitoring program (PDMP) and electronic health record (EHR) data integration. Methods Outcomes included 7-day rolling averages of opioids prescribed, morphine milligram equivalents (MMEs) prescribed, and PDMP queries. We employed a longitudinal study design to analyze PDMP data over a 15-month study period which allowed for six and a half months of pre- and post-integration observations surrounding a two-month integration period. We used longitudinal mixed effects models to examine the effect of EHR integration on each of the key outcomes. Results Following EHR integration, PDMP queries increased both through the web-based portal and in total (0.037, [95% CI = 0.017, 0.057] and 0.056, [95% CI = 0.035, 0.077]). Both measures of clinician opioid prescribing declined throughout the study period; however no significant effect following EHR integration was observed. These results were consistent when our analysis was applied to a subset consisting only of continuous PDMP users. Conclusions Our results support EHR integration contributing to PDMP utilization by clinicians but do not support changes in opioid prescribing behavior.
期刊介绍:
Pain Medicine is a multi-disciplinary journal dedicated to pain clinicians, educators and researchers with an interest in pain from various medical specialties such as pain medicine, anaesthesiology, family practice, internal medicine, neurology, neurological surgery, orthopaedic spine surgery, psychiatry, and rehabilitation medicine as well as related health disciplines such as psychology, neuroscience, nursing, nurse practitioner, physical therapy, and integrative health.