{"title":"在急诊室接触静脉注射类阿片六个月后持续使用类阿片的频率。前瞻性队列研究","authors":"","doi":"10.1016/j.jemermed.2024.03.018","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>As rates of opioid use disorder in the general population have increased, some have questioned whether IV opioids should be used routinely for treatment of acute severe pain in the emergency department (ED).</p></div><div><h3>Objectives</h3><p>We determined the incidence of persistent opioid use among opioid-naïve patients exposed to IV opioids in the ED.</p></div><div><h3>Methods</h3><p>This was a prospective observational cohort study conducted in two EDs in the Bronx, NY. Opioid-naïve adults with severe pain who received IV opioids in the ED were followed-up 6 months later by telephone interview and review of the state opioid prescription database. We defined persistent opioid use as filling 6 or more prescriptions for opioids in the 6 months following the ED visit or an average of one prescription per month.</p></div><div><h3>Results</h3><p><span>We screened 1555 patients. Of these, 506 patients met entry criteria and provided analyzable data. Morphine was the IV opioid most frequently administered in the ED (478, 94%), followed by hydromorphone<span> (20, 4%). Of the 506, 8 (2%) received both IV morphine and hydromorphone and 63 (12%) participants were prescribed an opioid for use after the ED visit. One patient/506 (0%) met our </span></span><em>apriori</em> criteria for persistent opioid use within 6 months.</p></div><div><h3>Conclusion</h3><p>Among 506 opioid naïve ED patients administered IV opioids for acute severe pain, only one used opioids persistently during the subsequent 6 months.</p></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Frequency of Persistent Opioid Use 6 Months After Exposure to IV Opioids in the Emergency Department: A Prospective Cohort Study\",\"authors\":\"\",\"doi\":\"10.1016/j.jemermed.2024.03.018\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>As rates of opioid use disorder in the general population have increased, some have questioned whether IV opioids should be used routinely for treatment of acute severe pain in the emergency department (ED).</p></div><div><h3>Objectives</h3><p>We determined the incidence of persistent opioid use among opioid-naïve patients exposed to IV opioids in the ED.</p></div><div><h3>Methods</h3><p>This was a prospective observational cohort study conducted in two EDs in the Bronx, NY. Opioid-naïve adults with severe pain who received IV opioids in the ED were followed-up 6 months later by telephone interview and review of the state opioid prescription database. We defined persistent opioid use as filling 6 or more prescriptions for opioids in the 6 months following the ED visit or an average of one prescription per month.</p></div><div><h3>Results</h3><p><span>We screened 1555 patients. Of these, 506 patients met entry criteria and provided analyzable data. Morphine was the IV opioid most frequently administered in the ED (478, 94%), followed by hydromorphone<span> (20, 4%). Of the 506, 8 (2%) received both IV morphine and hydromorphone and 63 (12%) participants were prescribed an opioid for use after the ED visit. One patient/506 (0%) met our </span></span><em>apriori</em> criteria for persistent opioid use within 6 months.</p></div><div><h3>Conclusion</h3><p>Among 506 opioid naïve ED patients administered IV opioids for acute severe pain, only one used opioids persistently during the subsequent 6 months.</p></div>\",\"PeriodicalId\":16085,\"journal\":{\"name\":\"Journal of Emergency Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Emergency Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0736467924000805\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"EMERGENCY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Emergency Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0736467924000805","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
Frequency of Persistent Opioid Use 6 Months After Exposure to IV Opioids in the Emergency Department: A Prospective Cohort Study
Background
As rates of opioid use disorder in the general population have increased, some have questioned whether IV opioids should be used routinely for treatment of acute severe pain in the emergency department (ED).
Objectives
We determined the incidence of persistent opioid use among opioid-naïve patients exposed to IV opioids in the ED.
Methods
This was a prospective observational cohort study conducted in two EDs in the Bronx, NY. Opioid-naïve adults with severe pain who received IV opioids in the ED were followed-up 6 months later by telephone interview and review of the state opioid prescription database. We defined persistent opioid use as filling 6 or more prescriptions for opioids in the 6 months following the ED visit or an average of one prescription per month.
Results
We screened 1555 patients. Of these, 506 patients met entry criteria and provided analyzable data. Morphine was the IV opioid most frequently administered in the ED (478, 94%), followed by hydromorphone (20, 4%). Of the 506, 8 (2%) received both IV morphine and hydromorphone and 63 (12%) participants were prescribed an opioid for use after the ED visit. One patient/506 (0%) met our apriori criteria for persistent opioid use within 6 months.
Conclusion
Among 506 opioid naïve ED patients administered IV opioids for acute severe pain, only one used opioids persistently during the subsequent 6 months.
期刊介绍:
The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections:
• Original Contributions
• Clinical Communications: Pediatric, Adult, OB/GYN
• Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care
• Techniques and Procedures
• Technical Tips
• Clinical Laboratory in Emergency Medicine
• Pharmacology in Emergency Medicine
• Case Presentations of the Harvard Emergency Medicine Residency
• Visual Diagnosis in Emergency Medicine
• Medical Classics
• Emergency Forum
• Editorial(s)
• Letters to the Editor
• Education
• Administration of Emergency Medicine
• International Emergency Medicine
• Computers in Emergency Medicine
• Violence: Recognition, Management, and Prevention
• Ethics
• Humanities and Medicine
• American Academy of Emergency Medicine
• AAEM Medical Student Forum
• Book and Other Media Reviews
• Calendar of Events
• Abstracts
• Trauma Reports
• Ultrasound in Emergency Medicine