Reducing Opioid Use in Endocrine Surgery Through Patient Education and Provider Prescribing Patterns.
Reducing Opioid Use in Endocrine Surgery Through Patient Education and Provider Prescribing Patterns.
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通过患者教育和提供者处方模式减少内分泌手术中阿片类药物的使用。
DOI：
10.1016/j.jss.2020.06.025
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发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Seib CD
中科院分区：
文献类型：
--
作者：
Kwan SY;Lancaster E;Dixit A;Inglis-Arkell C;Manuel S;Suh I;Shen WT;Seib CD
术后使用阿片类药物可导致依赖，导致美国阿片类药物流行，5.9%的患者在小手术后持续使用阿片类药物。随着术后持续使用阿片类药物的记录增加，外科医生必须采取干预措施以减少围手术期阿片类药物的使用。我们进行了一项前瞻性队列研究，以评估通过患者教育/咨询进行术前干预的可行性，并改变提供者处方模式，以减少术后阿片类药物的使用。我们纳入了2019年1月22日至2019年2月28日在三级转诊学术内分泌外科实践中接受甲状腺切除术和甲状旁腺切除术的成人患者。进行调查以评估术后疼痛和患者满意度。从电子健康记录中收集处方、人口统计学和合并症数据。66名患者（74.2%女性，平均年龄58.6 [SD 14.9]岁）接受了甲状腺切除术（n= 35）、甲状旁腺切除术（n=24）和其他宫颈内分泌手术（n= 7）。所有患者均接受了以纸质讲义形式进行的术前教育干预。90.9%的患者出院时接受了非阿片类止痛药处方，7.6%的患者出院时接受了阿片类处方。在接受阿片类药物处方的患者中，阿片类药物处方量的中位数为135（IQR 120-150）口服吗啡当量。在调查中，4例患者（6.1%）报告了任何术后阿片类药物使用，94.6%的患者对术前教育和术后疼痛管理表示满意。关于术后疼痛管理的明确和标准化教育是可行的，并且与高患者满意度相关。启动此类教育可能有助于尽量减少内分泌手术人群中不必要的阿片类药物处方。
Postoperative opioid use can lead to dependence, contributing to the opioid epidemic in the U.S. New persistent opioid use after minor surgeries occurs in 5.9% of patients. With increased documentation of persistent opioid use postoperatively, surgeons must pursue interventions to reduce opioid use perioperatively. We performed a prospective cohort study to assess the feasibility of a preoperative intervention via patient education/counseling and changes in provider prescribing patterns to reduce postoperative opioid use. We included adult patients undergoing thyroidectomy and parathyroidectomy from 1/22/2019-2/28/2019 at a tertiary referral, academic endocrine surgery practice. Surveys were administered to assess pain and patient satisfaction postoperatively. Prescription, demographic, and comorbidity data were collected from the electronic health record. 66 patients (74.2% women, mean age 58.6 [SD 14.9] years) underwent thyroidectomy (n= 35), parathyroidectomy (n=24), and other cervical endocrine operations (n= 7). All patients received a preoperative educational intervention in the form of a paper handout. 90.9% of patients were discharged with prescriptions for non-opioid pain medications and 7.6% were given an opioid prescription on discharge. Among those whom received an opioid prescription, the median quantity of opioids prescribed was 135 (IQR 120-150) oral morphine equivalents. On survey, four patients (6.1%) reported any postoperative opioid use and 94.6% of patients expressed satisfaction with their preoperative education and postoperative pain management. Clear and standardized education regarding postoperative pain management is feasible and associated with high patient satisfaction. Initiation of such education may support efforts to minimize unnecessary opioid prescriptions in the endocrine surgery population.
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DOI：
10.15585/mmwr.mm6610a1
发表时间：
2017-03-17
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Shah A;Hayes CJ;Martin BC
通讯作者：
Martin BC
影响因子：
5.7
作者：
Brandal D;Keller MS;Lee C;Grogan T;Fujimoto Y;Gricourt Y;Yamada T;Rahman S;Hofer I;Kazanjian K;Sack J;Mahajan A;Lin A;Cannesson M
通讯作者：
Cannesson M
影响因子：
9
作者：
Thiels, Cornelius A.;Anderson, Stephanie S.;Habermann, Elizabeth B.
通讯作者：
Habermann, Elizabeth B.
影响因子：
2.2
作者：
Chen, Yufei;Nwaogu, Iheoma;Suh, Insoo
通讯作者：
Suh, Insoo
影响因子：
9
作者：
Ruffolo, Luis I.;Jackson, Katherine M.;Moalem, Jacob
通讯作者：
Moalem, Jacob