Provider education leads to sustained reduction in pediatric opioid prescribing after surgery.
Provider education leads to sustained reduction in pediatric opioid prescribing after surgery.
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DOI：
10.1016/j.jpedsurg.2021.08.004
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发表时间：
2022-03
影响因子：
2.4
通讯作者：
Raval MV
中科院分区：
文献类型：
--
作者：
Slater BJ;Corvin CG;Heiss K;Vandewalle R;Shah SR;Cunningham M;Huang E;Lipskar AM;Denning NL;Dassinger M;Cina RA;Rothstein DH;Kauffman J;Gonzalez R;Ingram MC;Raval MV
儿科患者中大多数阿片类药物过量入院病例与处方阿片类药物有关。术后处方是家庭中阿片类药物的一个可管控来源。本研究旨在评估在九个中心实施基于医护人员的教育后，阿片类药物处方是否持续减少。
在2018年12月至2019年1月（教育干预开始一年后）期间，收集了九个中心接受脐疝修补术的儿科患者的阿片类药物处方信息，并将其与九个中心在干预前和干预后即刻的处方模式进行比较。
在当前研究期间，29/127（22.8%）的患者在手术后收到了阿片类药物处方（中位数为8剂）。没有因该手术而出现药物补充、急诊科复诊或再次入院的情况。与干预前相比，阿片类药物处方持续减少（22.8%的患者对比75.8%的患者，p<0.001，图1）。五个中心显示出统计学上的显著改善，另外四个中心处方量有所减少，但无统计学意义。
我们的多中心研究表明，在基于医护人员的教育干预后，儿科脐疝修补术后阿片类药物处方持续减少。类似的低强度医护人员教育干预可能有利于改善更广泛的儿科手术的阿片类药物管理。
（治疗研究） - 3级
The majority of opioid overdose admissions in pediatric patients are associated with prescription opioids. Post-operative prescriptions are an addressable source of opioids in the household. This study aims to assess for sustained reduction in opioid prescribing after implementation of provider-based education at nine centers. Opioid prescribing information was collected for pediatric patients undergoing umbilical hernia repair at nine centers between December 2018 and January 2019, one year after the start of an education intervention. This was compared to prescribing patterns in the immediate pre- and post-intervention periods at each of the nine centers. In the current study period, 29/127 (22.8%) patients received opioid prescriptions (median 8 doses) following surgery. There were no medication refills, emergency department returns or readmissions related to the procedure. There was sustained reduction in opioid prescribing compared to pre-intervention (22.8% vs 75.8% of patients, p<0.001, Fig. (1). Five centers showed statistically significant improvement and the other four demonstrated decreased prescribing, though not statistically significant. Our multicenter study demonstrates sustained reduction in opioid prescribing after pediatric umbilical hernia repair after a provider-based educational intervention. Similar low-fidelity provider education interventions may be beneficial to improve opioid stewardship for a wider variety of pediatric surgical procedures. (treatment study)-level 3.
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DOI：
10.1016/j.jaac.2018.11.018
发表时间：
2019-07-01
影响因子：
13.3
作者：
McCabe, Sean Esteban;Veliz, Philip;Boyd, Carol J.
通讯作者：
Boyd, Carol J.
影响因子：
2.4
作者：
Piper, Kaitlin N.;Baxter, Katherine J.;Raval, Mehul V.
通讯作者：
Raval, Mehul V.
影响因子：
6.6
作者：
Cardona-Grau, Diana;Bush, Ruth A.;Chiang, George
通讯作者：
Chiang, George
影响因子：
2
作者：
Ahn, J. J.;Ellison, J. S.;Merguerian, P. A.
通讯作者：
Merguerian, P. A.
影响因子：
3.8
作者：
Eid, Ahmed I.;DePesa, Christopher;Kaafarani, Haytham M. A.
通讯作者：
Kaafarani, Haytham M. A.