Jeremy Szmerling BPharm (Hons), GradCertPharmPrac, ANZCAP-Reg (PainMgmt, Steward), Sam Maleki BPharm, MPharmPrac, FANZCAP (OncHaem, Research), Gordon Mar BA, MB, Mmed, FANZCA, Anne Goulopoulos BPharm(Hons), GradCertPharmPrac, MClinPharm, AdvPracPharm, FANZCAP (Lead&Mgmt)
{"title":"在大都市医院网络中培养最佳镇痛处方实践：评估镇痛管理计划","authors":"Jeremy Szmerling BPharm (Hons), GradCertPharmPrac, ANZCAP-Reg (PainMgmt, Steward), Sam Maleki BPharm, MPharmPrac, FANZCAP (OncHaem, Research), Gordon Mar BA, MB, Mmed, FANZCA, Anne Goulopoulos BPharm(Hons), GradCertPharmPrac, MClinPharm, AdvPracPharm, FANZCAP (Lead&Mgmt)","doi":"10.1002/jppr.1914","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The increasing incidence of opioid-related harm associated with inappropriate opioid prescription underscores the need for effective interventions directed at enhancing analgesic prescribing practices. Analgesic stewardship (AGS) programs have emerged to facilitate appropriate analgesic use, reducing analgesic-related harm and optimising patient outcomes.</p>\n </section>\n \n <section>\n \n <h3> Aim</h3>\n \n <p>This study aimed to assess the impact of an AGS program on the appropriateness of opioid analgesia prescribing for adult inpatients within a metropolitan health network during the initial two months following program implementation.</p>\n </section>\n \n <section>\n \n <h3> Method</h3>\n \n <p>This retrospective audit examined de-identified aggregate data of 100 adult inpatients of a major Australian metropolitan hospital network between August–September 2022. The multidisciplinary AGS program involving pharmacy, nursing, and medical staff provided clinical interventions and recommendations for patients, supported by organisational interventions, including education and guideline reinforcement. Data collection included patient demographics, clinical data, and AGS program recommendations documented in patient medical records. Ethical approval was granted by the Eastern Health Office of Research and Ethics (Reference no: QA23-015-91886) and the study confirms to the <i>Australian Statement on Ethical Conduct in Human Research</i>.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>It was found that 51% of opioid-naïve patients were prescribed modified-release opioids for acute non-cancer pain, contrary to local guidelines. The AGS program recommendations resulted in an 89.7% cessation of these prescriptions. For non-opioid-naïve patients, there was a statistically significant reduction in mean Oral Morphine Equivalent Daily Dose of 19.85 mg (95% confidence interval [CI] 10.3–29.4 mg, p < 0.05). AGS recommendations were predominantly adhered to, with 82% showing full or partial compliance.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>This study highlights the positive impact of an AGS program on the appropriateness of opioid analgesic prescribing for adult inpatients. These findings support the implementation of AGS programs into healthcare systems to mitigate opioid-related harm and improve patient outcomes.</p>\n </section>\n </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"54 3","pages":"228-235"},"PeriodicalIF":1.0000,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cultivating optimal analgesic prescribing practices in a metropolitan hospital network: evaluating an analgesic stewardship program\",\"authors\":\"Jeremy Szmerling BPharm (Hons), GradCertPharmPrac, ANZCAP-Reg (PainMgmt, Steward), Sam Maleki BPharm, MPharmPrac, FANZCAP (OncHaem, Research), Gordon Mar BA, MB, Mmed, FANZCA, Anne Goulopoulos BPharm(Hons), GradCertPharmPrac, MClinPharm, AdvPracPharm, FANZCAP (Lead&Mgmt)\",\"doi\":\"10.1002/jppr.1914\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>The increasing incidence of opioid-related harm associated with inappropriate opioid prescription underscores the need for effective interventions directed at enhancing analgesic prescribing practices. Analgesic stewardship (AGS) programs have emerged to facilitate appropriate analgesic use, reducing analgesic-related harm and optimising patient outcomes.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Aim</h3>\\n \\n <p>This study aimed to assess the impact of an AGS program on the appropriateness of opioid analgesia prescribing for adult inpatients within a metropolitan health network during the initial two months following program implementation.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Method</h3>\\n \\n <p>This retrospective audit examined de-identified aggregate data of 100 adult inpatients of a major Australian metropolitan hospital network between August–September 2022. The multidisciplinary AGS program involving pharmacy, nursing, and medical staff provided clinical interventions and recommendations for patients, supported by organisational interventions, including education and guideline reinforcement. Data collection included patient demographics, clinical data, and AGS program recommendations documented in patient medical records. Ethical approval was granted by the Eastern Health Office of Research and Ethics (Reference no: QA23-015-91886) and the study confirms to the <i>Australian Statement on Ethical Conduct in Human Research</i>.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>It was found that 51% of opioid-naïve patients were prescribed modified-release opioids for acute non-cancer pain, contrary to local guidelines. The AGS program recommendations resulted in an 89.7% cessation of these prescriptions. For non-opioid-naïve patients, there was a statistically significant reduction in mean Oral Morphine Equivalent Daily Dose of 19.85 mg (95% confidence interval [CI] 10.3–29.4 mg, p < 0.05). 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Cultivating optimal analgesic prescribing practices in a metropolitan hospital network: evaluating an analgesic stewardship program
Background
The increasing incidence of opioid-related harm associated with inappropriate opioid prescription underscores the need for effective interventions directed at enhancing analgesic prescribing practices. Analgesic stewardship (AGS) programs have emerged to facilitate appropriate analgesic use, reducing analgesic-related harm and optimising patient outcomes.
Aim
This study aimed to assess the impact of an AGS program on the appropriateness of opioid analgesia prescribing for adult inpatients within a metropolitan health network during the initial two months following program implementation.
Method
This retrospective audit examined de-identified aggregate data of 100 adult inpatients of a major Australian metropolitan hospital network between August–September 2022. The multidisciplinary AGS program involving pharmacy, nursing, and medical staff provided clinical interventions and recommendations for patients, supported by organisational interventions, including education and guideline reinforcement. Data collection included patient demographics, clinical data, and AGS program recommendations documented in patient medical records. Ethical approval was granted by the Eastern Health Office of Research and Ethics (Reference no: QA23-015-91886) and the study confirms to the Australian Statement on Ethical Conduct in Human Research.
Results
It was found that 51% of opioid-naïve patients were prescribed modified-release opioids for acute non-cancer pain, contrary to local guidelines. The AGS program recommendations resulted in an 89.7% cessation of these prescriptions. For non-opioid-naïve patients, there was a statistically significant reduction in mean Oral Morphine Equivalent Daily Dose of 19.85 mg (95% confidence interval [CI] 10.3–29.4 mg, p < 0.05). AGS recommendations were predominantly adhered to, with 82% showing full or partial compliance.
Conclusion
This study highlights the positive impact of an AGS program on the appropriateness of opioid analgesic prescribing for adult inpatients. These findings support the implementation of AGS programs into healthcare systems to mitigate opioid-related harm and improve patient outcomes.
期刊介绍：
The purpose of this document is to describe the structure, function and operations of the Journal of Pharmacy Practice and Research, the official journal of the Society of Hospital Pharmacists of Australia (SHPA). It is owned, published by and copyrighted to SHPA. However, the Journal is to some extent unique within SHPA in that it ‘…has complete editorial freedom in terms of content and is not under the direction of the Society or its Council in such matters…’. This statement, originally based on a Role Statement for the Editor-in-Chief 1993, is also based on the definition of ‘editorial independence’ from the World Association of Medical Editors and adopted by the International Committee of Medical Journal Editors.
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