牙医在儿科人群中开具阿片类药物处方的模式:一项回顾性观察性研究。

CMAJ open Pub Date : 2019-07-01 DOI:10.9778/cmajo.20190021
D. Matthews, M. Brillant, K. Jimoh, W. Singleton, Pam R McLean-Veysey, I. Sketris
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引用次数: 2

摘要

背景牙医是阿片类镇痛药物的常规处方医生;然而,很少有关于他们为儿童开处方的公开数据。本研究的目的是评估牙医为儿科患者开具阿片类药物处方的做法。方法我们使用新斯科舍省牙医为儿童和青少年(年龄<18岁)开具阿片类药物处方的行政健康数据进行了一项回顾性研究(2011/12至2017/18)。感兴趣的主要变量是牙医开出的阿片类药物“类型”和“负荷”(每年开出的处方数、提供的天数/处方和每次处方的剂量/d,单位为吗啡当量毫克[MME])阿片类药物处方,占7年研究期间MME总量的48.6%。口腔颌面外科医生负责80.7%的牙科相关阿片类药物的分配。处方最频繁的是可待因(占MME总量的78.6%),其次是羟考酮(11.1%)。在研究期间,阿片类止痛药的总量呈显著下降趋势(r=-0.903,p<0.01),主要是由于处方中可待因的总量和供应天数减少(r=-0.837,p<0.05)。很少有阿片类药物被分配给12岁以下的儿童。解释新斯科舍省的牙医在2011/12年至2017/18年期间减少了儿科人群中的阿片类药物处方,这可能表明当前的阿片处方原则正在影响牙医的处方习惯。尽管如此,患者和家长应接受适当的咨询,了解处方中阿片类药物的正确使用、风险、储存和滥用的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Patterns of opioid prescribing by dentists in a pediatric population: a retrospective observational study.
BACKGROUND Dentists are regular prescribers of opioid analgesic medications; however, there are few published data on their prescribing practices for children. The aim of this study was to assess opioid prescribing practices of dentists for pediatric patients. METHODS We conducted a retrospective study (2011/12 to 2017/18) using administrative health data of opioid prescribing practices of dentists in Nova Scotia for children and adolescents (age < 18 yr). The main variables of interest were opioid "type" and "load" dentists prescribed (number of dispensed prescriptions/yr, days supplied/prescription and dosage/d per prescription in milligrams of morphine equivalents [MME]). RESULTS Dentists accounted for a mean of 18.3% (standard deviation 1.5%) of all opioid prescribers for the pediatric population annually but were responsible for 59.9% of all opioid prescriptions and 48.6% of total MME dispensed during the 7-year study period. Oral and maxillofacial surgeons were responsible for 80.7% of all dental-related opioids dispensed. Codeine was most frequently prescribed (78.6% of total MME), followed by oxycodone (11.1%). There were significant downward trends over the study period in the total amount of opioid analgesics dispensed (r = -0.903, p < 0.01), primarily due to a reduction in the total amount of codeine dispensed and number of days supplied per prescription (r = -0.837, p < 0.05). Few opioids were dispensed to children less than 12 years. INTERPRETATION Dentists in Nova Scotia reduced prescriptions of opioids in the pediatric population between 2011/12 and 2017/18, which may indicate that current opioid prescribing principles are influencing dentists' prescribing habits. Nonetheless, patients and parents should receive appropriate counselling as to the proper use, risks, storage and potential for misuse of opioids when prescribed.
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