An Interdisciplinary Approach to Reducing Opioid Prescriptions to Patients with Chronic Pain in a Spinal Cord Injury Center.
An Interdisciplinary Approach to Reducing Opioid Prescriptions to Patients with Chronic Pain in a Spinal Cord Injury Center.
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减少脊髓损伤中心慢性疼痛患者阿片类药物处方的跨学科方法。
DOI：
10.1016/j.pmrj.2018.09.030
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Bourbeau,DennisJ
中科院分区：
文献类型：
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作者：
Brose,StevenW;Schneck,Heather;Bourbeau,DennisJ
背景处方阿片类药物的使用日益增加，导致了美国阿片类药物滥用的流行。需要努力减少阿片类药物处方并提供疼痛管理的替代方案。目的确定一个多学科项目的成功，以管理慢性疼痛，同时减少脊髓损伤（SCI）患者人群对阿片类药物的依赖设计回顾性分析设置本研究是在俄亥俄州东北部的一个SCI护理系统中进行的，包括接受门诊治疗的SCI患者。和疼痛管理专业制定了一项计划，以管理SCI患者，特别是使用阿片类药物的患者，包括物理，职业，娱乐和职业治疗。当确定慢性疼痛时，这些服务与SCI医生密切合作，以帮助更好地医学管理他们的病理，并支持多管齐下减少阿片类药物使用的努力。主要结果2008年至2016年阿片类药物处方数据的主要结果指标是接受阿片类药物的门诊患者百分比，阿片类药物处方率，结果接受阿片类药物的门诊患者的百分比和通过门诊服务的阿片类药物处方数量显着下降，从39%到16%，从2.5到1.5处方每名患者每季度分别与引进多学科干预。处方药物，特别是非美沙酮阿片类药物的总吗啡当量，也decreasedsignificant.ConclusionsThe多学科的干预方法与显着下降的百分比接受阿片类药物和阿片类药物的量被规定。这一减少可能对类阿片危机产生重大影响。
BackgroundThe increasing use of prescription opioids has contributed to the epidemic of opioid abuse in the United States. Efforts to reduce opioid prescriptions and offer alternatives for pain management are needed.ObjectiveTo determine the success of a multidisciplinary project to manage chronic pain while reducing reliance on opioids in a population of patients with spinal cord injury (SCI).DesignRetrospective analysis.SettingThis study was conducted in an SCI system of care in northeast Ohio.ParticipantsIndividuals with SCI receiving outpatient care were included.InterventionsClinicians in SCI and pain management specialties developed a plan to manage individuals with SCI, particularly for individuals using opioids, including physical, occupational, recreational, and vocational therapy. These services worked closely with the SCI physicians when chronic pain was identified to help better medically manage their pathology and support efforts to decrease opioid use in a multipronged approach.Main OutcomesThe primary outcome measures from opioid prescription data from 2008 to 2016 were the percent of outpatients receiving opioids, opioid prescription rates, and opioid prescription doses over time.ResultsThe percentage of outpatients receiving opioids and the number of opioid prescriptions through the outpatient service significantly decreased, from 39% to 16% and from 2.5 to 1.5 prescriptions per patient per quarter, respectively, correlating with the introduction of the multidisciplinary interventions. The total morphine equivalent quantities of prescription medications, particularly nonmethadone opioids, also decreased significantly.ConclusionsThe multidisciplinary interventional approach was associated with marked decreases in the percentage of patients receiving opioids and the amounts of opioids being prescribed. This reduction could have a significant impact on the opioid crisis.Level of EvidenceIV