探索带回家阿片类药物管理(ETHOS)在英国术后患者。

IF 1.3 Q4 CLINICAL NEUROLOGY
Zoe K Reed, Samantha Lai Sheung Ma, Hanin Ramadan, Edward Wd Flewitt, Nicole Hasler, Amy Hussey, Antony Palmer, Jane Quinlan
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引用次数: 0

摘要

背景:手术是患者第一次阿片类药物处方最常见的适应症之一,一些患者进展到意外的长期使用。联合王国目前没有关于患者在出院时使用了多少阿片类药物的数据。本研究调查了常见外科手术后阿片类药物的出院处方和使用情况。方法:本队列研究在牛津大学医院NHS基金会信托进行,涉及20例最常用的成人外科手术。出院后6-8天,使用标准化电话问卷对每个程序至少20名患者进行调查,以确定使用和未使用阿片类药物的数量。阿片类药物剂量转换为口服吗啡当量(OME)进行分析。结果:所有类型手术后给予患者的阿片类药物数量远远超过需求,同一手术的处方做法往往存在很大差异,最明显的是在创伤和骨科。在426名患者中,出院时共分配了55 080 mg OME,只有34.4%的患者实际使用,在社区中总共有36 108.5 mg OME未使用,存在阿片类药物使用不当、过量或转移的风险。结论:手术后阿片类药物的过量处方是常见的,对患者来说是浪费、费用和风险。显然,有必要为出院时开具阿片类药物处方制定一个特定程序的证据基础,采用“足够但不过量”的方法,确保患者有足够的镇痛药,以促进手术功能恢复,但不能超过所需的剂量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Exploring take-home opioid stewardship (ETHOS) in UK postoperative patients.

Background: Surgery is one of the most common indications for a patient's first opioid prescription, with some patients progressing to unintended long-term use. There is no current data from the United Kingdom on how much patients use of the opioid medication dispensed at discharge from hospital. This study investigates discharge opioid prescribing and usage following common surgical procedures.

Methods: This cohort study was conducted at the Oxford University Hospitals NHS Foundation Trust and involved 20 of the most commonly performed adult surgical procedures. At least 20 patients per procedure were surveyed using a standardised telephone questionnaire 6-8 days after discharge to establish the amount of used and unused opioids. Opioid doses were converted to oral morphine equivalent (OME) for analysis.

Results: The amount of opioid given to patients after all types of surgery far exceeded requirement, with often large variations in prescribing practices for the same procedures, most notably in trauma and orthopaedics.For the cohort of 426 patients, a total of 55 080 mg OME was dispensed on discharge, with only 34.4% actually used by patients, leaving a total of 36 108.5 mg OME unused in the community, risking inappropriate opioid use, overdose, or diversion.

Conclusions: Opioid overprescribing is common after surgery and represents waste, expense, and risk to patients. There is a clear need to develop a procedure-specific evidence-base for discharge opioid prescribing, adopting an "enough but not too much" approach to ensure that patients have adequate analgesia to facilitate functional surgical recovery, but not more than is needed.

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来源期刊
British Journal of Pain
British Journal of Pain CLINICAL NEUROLOGY-
CiteScore
3.20
自引率
11.10%
发文量
42
期刊介绍: British Journal of Pain is a peer-reviewed quarterly British journal with an international multidisciplinary Editorial Board. The journal publishes original research and reviews on all major aspects of pain and pain management. Reviews reflect the body of evidence of the topic and are suitable for a multidisciplinary readership. Where empirical evidence is lacking, the reviews reflect the generally held opinions of experts in the field. The Journal has broadened its scope and has become a forum for publishing primary research together with brief reports related to pain and pain interventions. Submissions from all over the world have been published and are welcome. Official journal of the British Pain Society.
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