Assessment of Unused Opioids Following Ambulatory Surgery
Assessment of Unused Opioids Following Ambulatory Surgery
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DOI：
10.1177/0003134820923309
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发表时间：
2020-06-01
期刊：
影响因子：
1
通讯作者：
Manuel, Solmaz P.
中科院分区：
文献类型：
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作者：
Dixit, Anjali A.;Chen, Catherine L.;Manuel, Solmaz P.
背景 手术是阿片类药物开始使用和随后滥用的危险因素。术后出院阿片类药物处方模式通常各不相同且缺乏证据，这可能导致不必要的阿片类药物处方。我们的目的是评估我们学术医院门诊手术患者的阿片类药物处方和未使用的阿片类药物处方。方法我们根据电话调查和电子病历进行了回顾性观察研究。在我们大型、多站点、三级护理医院系统接受门诊手术的成年患者被问及是否使用出院时开出的阿片类药物。我们的主要结果是阿片类药物处方（定义为出院时开出阿片类药物）和未使用的阿片类药物处方（定义为术后第一天开出阿片类药物但未服用任何阿片类药物）。我们通过单变量和多变量分析评估了阿片类药物处方和未使用的阿片类药物处方的预测因素。我们还按手术服务对结果进行了分层。结果 在 4248 名接受门诊手术的成年患者中，3279 名 (77.2%) 回应了调查。在所有应答者中，2146 名（65.4%）人在术后开了阿片类药物，1240 名（57.8%）人报告在术后第一天没有服用阿片类药物。未使用阿片类药物处方的比例最高的是主要服务于骨科手术（65%）和整形外科（62%）的患者。讨论阿片类药物处方和未使用的阿片类药物处方在我们医院的门诊手术人群中很普遍。接受选定的门诊手术的患者可能不需要目前处方的阿片类药物。
Background Surgery is a risk factor for opioid initiation and subsequent abuse. Discharge opioid prescription patterns after surgery are often varied and not evidence based, which may lead to unnecessary prescription of opioids. We aimed to assess opioid prescribing and unused opioid prescriptions in ambulatory surgery patients at our academic hospital.Methods We conducted a retrospective observational study based on phone survey and electronic medical records. Adult patients who underwent ambulatory surgery at our large, multisite, tertiary-care hospital system were asked whether they were using the opioids that were prescribed at discharge. Our main outcomes were opioid prescription (defined as being prescribed an opioid on discharge) and unused opioid prescription (defined as being prescribed an opioid but not taking any opioids on postoperative day 1). We evaluated predictors of opioid prescription and unused opioid prescription through univariable and multivariable analyses. We also stratified outcomes by surgical service.Results Of 4248 adult patients who underwent ambulatory surgical procedures, 3279 (77.2%) responded to the survey. Of all responders, 2146 (65.4%) were prescribed postoperative opioids, and 1240 (57.8%) reported not taking them on postoperative day 1. The highest rates of unused opioid prescriptions were for patients whose primary service were orthopedic surgery (65%) and plastic surgery (62%).Discussion Opioid prescribing and unused opioid prescriptions are prevalent in our hospital's ambulatory surgical population. Patients undergoing selected ambulatory surgical procedures may not require as much opioid as is currently being prescribed.