Impact of opioid law on prescriptions and satisfaction of pediatric burn and orthopedic patients: An epidemiologic study.
Impact of opioid law on prescriptions and satisfaction of pediatric burn and orthopedic patients: An epidemiologic study.
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DOI：
10.1371/journal.pone.0294279
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发表时间：
2023
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
作者：
这项研究的目的是确定经历急性疼痛的儿科患者减少阿片类药物处方疼痛剂量单位的情况，并评估患者在2017年俄亥俄州阿片类药物处方上限法律颁布后90天内对疼痛控制的满意度。回顾性图表回顾包括2015年8月1日至2019年8月31日期间接受治疗的960名儿童(0-18岁)烧伤和膝关节镜检查患者。前瞻性地，法定监护人完成了对50名患者的便利样本的调查。收集了俄亥俄州法律实施前后出院时规定的阿片类药物(天数和吗啡毫克当量(MME)/公斤)。监护人报告了他们的孩子在出院后90天对阿片类药物处方的体验和满意度。从法律实施前到法律实施后，烧伤和膝部队列中的中位数天数(分别为1.7%至1.0%和5.0%至3.8%)和总MME中位数(分别为15.0%至2.5%和150.0至0.001)显著减少(p<；0.001)。中断的时间序列分析显示，2017年俄亥俄州阿片类药物处方法生效时，MMES/公斤和出院时处方天数在统计上显著下降，水平突然变化。前瞻性地，超过一半的参与者对他们的疼痛控制感到满意(72%烧伤和68%膝盖)，并认为他们接受了适量的药物治疗(84%烧伤和56%膝盖)。住院患者阿片类药物的使用在法律实施前后没有变化。2015-2019年，用于儿童烧伤和膝关节镜手术的阿片类药物使用量有所减少。照顾者对疼痛控制和阿片类药物处方数量的满意度差异很大。
The objective of this study was to determine the reduction in prescribed opioid pain dosage units to pediatric patients experiencing acute pain and to assess patient satisfaction with pain control 90-day post discharge following the 2017 Ohio opioid prescribing cap law. The retrospective chart review included 960 pediatric (age 0–18 years) burn injury and knee arthroscopy patients treated between August 1, 2015-August 31, 2019. Prospectively, legal guardians completed a survey for a convenience sample of 50 patients. Opioid medications (days and morphine milligram equivalents (MMEs)/kg) prescribed at discharge before and after the Ohio law implementation were collected. Guardians reported experience and satisfaction with their child’s opioid prescription at 90-days post discharge. From pre-law to post-law, there was a significant decrease (p<0.001) within the burn and knee cohorts in the median days (1.7 to 1.0 and 5.0 to 3.8, respectively) and median total MMEs prescribed (15.0 to 2.5 and 150.0 to 90.0, respectively). An interrupted time series analysis revealed a statistically significant decrease in MMEs/kg and days prescribed at discharge when the 2017 Ohio opioid prescription law went into effect, with an abrupt level change. Prospectively, more than half of participants were satisfied (72% burn and 68% knee) with their pain control and felt they received the right amount of medication (84% burn and 56% knee). Inpatient opioid use was not changed pre- and post-law. Discharge opioids prescribed for pediatric burn and knee arthroscopy procedures has decreased from 2015–2019. Caregivers varied greatly in their satisfaction with pain control and the amount of opioid prescribed.
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影响因子：
1.7
作者：
Armstrong, Megan;Lun, Jonathan;Groner, Jonathan, I;Thakkar, Rajan K.;Fabia, Renata;Noffsinger, Dana;Ni, Ai;Keesari, Rohali;Xiang, Henry
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