Decrease in Urologic Discharge Opioid Prescribing after Mandatory Query of Statewide Prescription Drug Monitoring Program
Decrease in Urologic Discharge Opioid Prescribing after Mandatory Query of Statewide Prescription Drug Monitoring Program
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DOI：
10.1016/j.urology.2020.02.002
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发表时间：
2020-05-01
期刊：
影响因子：
2.1
通讯作者：
Davies, Benjamin J.
中科院分区：
文献类型：
--
作者：
Myrga, John M.;Macleod, Liam C.;Davies, Benjamin J.
目的探讨宾夕法尼亚州处方药监测计划(PDMP)对某大型三级医院泌尿外科手术患者术后阿片类药物处方出院的影响。历史上，阿片类药物一直被用来控制术后疼痛，但随着人们对阿片类药物过量、滥用和转移的日益关注，已经出台了限制阿片类药物处方的措施。许多州都推出了PDMP计划，作为搜索患者先前的阿片类药物处方的一种方法。这些计划减少了急诊科和门诊部的阿片类药物处方，但它们在减少术后阿片类药物处方方面的有效性和处方人员查询任务的使用尚未确定。方法我们确定了2016年7月1日至2017年6月30日在一家大型学术医院接受大手术的582名患者。我们检查了在2017年1月1日强制执行PDMP查询前后阿片类药物幼稚患者和阿片耐受患者5毫克羟考酮类药物的处方趋势。结果在引入所需的PDMP查询后，阿片类药物处方数量没有显著差异，但在PDMP查询前后5 mg羟考酮类药物处方的中位数减少了18%(P<；.001)。这在阿片类药物幼稚人群和阿片类药物暴露人群中都是一致的。结论这是第一项建立所需PDMP查询可能减少外科环境中阿片类药物处方数量的研究。所需的PDMP查询可能有助于减少与阿片类药物过度开药相关的危害。(C)2020年爱思唯尔公司。
OBJECTIVE To examine the effectiveness of the introduction of the Pennsylvania Prescription Drug Monitoring Program (PDMP) on discharge postoperative opioid prescriptions in patients undergoing major urologic procedures within a large single tertiary care hospital. Opioids have historically been prescribed to control postoperative pain, but with growing concern regarding opioid overdose, misuse, and diversion, measures have been introduced to curb opioid prescribing. Numerous states have introduced PDMP programs as a method to search patients' prior opioid prescriptions. These programs have reduced opioid prescriptions in emergency department and outpatient settings, but their effectiveness, and the use of a prescriber query mandate, in reducing postoperative opioid prescribing has not been established.METHODS We identified 582 patients who underwent major prostate or renal surgery between July 1st 2016 and June 30th 2017 at a single large academic hospital. We examined prescribing trends in both opioid naive and opioid tolerant patients measuring 5mg oxycodone equivalents before and after a PDMP query was mandated on January 1st 2017.RESULTS There was no significant difference is the number of opioid prescriptions given after introduction of the required PDMP query, but there was an 18% decrease in the median number of 5mg oxycodone equivalents prescribed before and after the PDMP query (P < .001). This was consistent in both an opioid naive and opioid exposed population.CONCLUSION This is the first study to establish that required PDMP queries may reduce the number of discharge opioid pills prescribed in a surgical setting. Required PDMP queries may help reduce the harm associated with opioid overprescribing. (c) 2020 Elsevier Inc.