Empowering Post-Surgical Patients to Improve Opioid Disposal: A Before and After Quality Improvement Study
Empowering Post-Surgical Patients to Improve Opioid Disposal: A Before and After Quality Improvement Study
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DOI：
10.1016/j.jamcollsurg.2017.11.023
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发表时间：
2018-03-01
影响因子：
5.2
通讯作者：
Mackinnon, Susan E.
中科院分区：
文献类型：
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作者：
Hasak, Jessica M.;Bettlach, Carrie L. Roth;Mackinnon, Susan E.
背景：我国正处于阿片类药物的流行之中。虽然这个问题是多因素的，但其中一个问题是我们社区中流通的过量处方阿片类药物的存在。我们的目的是确定教育手册的传播是否会改善手术后未使用阿片类药物的处理。研究设计：2017年2月至2017年9月，上肢/周围神经诊所的符合条件的手术患者被纳入这项前瞻性研究前后。术前报告使用阿片类药物的患者被排除在本研究之外。对未接受干预和接受干预的一组患者进行了同样的调查。我们的主要终点是处理未使用阿片类药物的患者比例。结果：共纳入334例患者，其中164例未收到宣传册，170例收到宣传册。76例患者因术前使用阿片类药物而被排除在外。宣传册散发后，处理未使用阿片类药物的患者比例显著增加（11% vs 22%, p = 0.02）。在处置阿片类药物的患者中，每组按照手册推荐的方式处置阿片类药物的患者比例没有显著差异（43% vs 64%, p = 0.19）。结论：教育手册的传播改善了手术后未使用阿片类药物的处理。这种低成本、易于实施的干预措施可以改善对未使用阿片类药物的处置，并最终减少我们社区中流通的过量阿片类药物的数量。[J] .中华医学杂志，2018;26:235-240。(C) 2017年由美国外科医师学会发布。Elsevier Inc.出版。版权所有。)
BACKGROUND: Our country is in the midst of an opioid epidemic. Although the problem is multifactorial, one issue is the presence of excess prescription opioid medications circulating in our communities. Our objective was to determine whether dissemination of an educational brochure would improve the disposal of unused opioids after surgery.STUDY DESIGN: Eligible surgery patients from an upper extremity/peripheral nerve clinic were enrolled into this prospective before and after study between February 2017 and September 2017. Patients who reported opioid use preoperatively were excluded from this study. The same survey was administered to the group of patients who did not receive the intervention and to those who did receive the intervention. Our primary endpoint was the proportion of patients who disposed of unused opioid medications.RESULTS: A total of 334 patients were studied: 164 who did not receive the brochure and 170 who received the brochure. Seventy-six patients were excluded for preoperative opioid use. After dissemination of the brochure, there was a significant increase in the proportion of patients who disposed of their unused opioids ( 11% vs 22%, p = 0.02). Of those who disposed of their opioids, there was no significant difference in the proportion of patients from each group who disposed in a manner that was recommended by the brochure ( 43% vs 64%, p = 0.19).CONCLUSIONS: Dissemination of the educational brochure improved disposal of unused opioids after surgery. This low-cost, easily implemented intervention can improve disposal of unused opioids and ultimately, decrease the amount of excess opioids circulating in our communities. ( J Am Coll Surg 2018; 226: 235-240. (C) 2017 by the American College of Surgeons. Published by Elsevier Inc. All rights reserved.)