Evaluation of knowledge and comfort with opioid prescribing among pediatric hematology/oncology fellows.
Evaluation of knowledge and comfort with opioid prescribing among pediatric hematology/oncology fellows.
复制标题
儿科血液学/肿瘤学研究员对阿片类药物处方的了解和舒适度评估。
DOI：
10.1002/pbc.28786
复制
发表时间：
2021
影响因子：
3.2
通讯作者：
Welch,JenniferG
中科院分区：
文献类型：
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作者：
MacDonell-Yilmaz,RebeccaE;Murillo,Anarina;Panicker,Cia;Welch,JenniferG
背景在成人血液学/肿瘤学研究员中已证实与疼痛管理相关的知识和舒适度方面的缺陷。在儿科血液学/肿瘤学(Pho)实习生中还没有进行过这样的评估。一项IRB批准的调查在美国各地进行，以评估阿片类药物剂量的舒适度，与阿片类药物使用相关的态度，以及基本概念的知识，包括基于体重的剂量，不完全交叉耐受，以及副作用的管理。结果从37个项目获得132名研究员的电子邮件地址。78名(59%)研究员参加。在阿片类药物幼稚患者中，训练水平和服用阿片类药物的舒适度之间没有显著差异，尽管一年级研究员报告舒适度的比例(65%)低于较高级别研究员(第二年研究员85.2%，第三和第四年研究员80.6%)。在10道客观知识题中，一年级学员答对的平均分为5.05±40.43；二年级学员答对的平均值为5.74±40.35；三、四年级学员答对的平均值为5.58±0.30。大多数受访者根据体重选择适当剂量的静脉注射吗啡(92%)，并认为小剂量纳洛酮滴注是治疗阿片类药物引起的瘙痒的合适干预方案(91%)。然而，其余问题的正确回答率为15-68%。结论本研究表征了医生对阿片类药物处方的知识和舒适度。尽管报告的舒适度很高，但各级培训的Pho研究员都显示出了知识差距。PHO研究员可以从疼痛管理方面的进一步教育中受益。
BackgroundDeficits in knowledge and comfort related to pain management have been demonstrated in adult hematology/oncology fellows. No such evaluation has been undertaken in pediatric hematology/oncology (PHO) trainees.ProcedureAn IRB‐approved survey was administered to PHO fellows throughout the United States (US) to assess comfort with opioid dosing, attitudes related to the use of opioids, and knowledge of basic concepts including weight‐based dosing, incomplete cross‐tolerance, and management of side effects.ResultsEmail addresses were obtained for 132 fellows from 37 programs. Seventy‐eight (59%) fellows participated. No significant difference was demonstrated between training level and comfort with dosing opioids in an opioid‐naive patient, though a smaller proportion of first‐year fellows (65%) reported comfort compared to more senior fellows (85.2% of second‐year fellows, 80.6% of third‐ and fourth‐year fellows). First‐year fellows correctly answered a mean of 5.05 ± 0.43 out of 10 objective knowledge questions; second‐year fellows answered 5.74 ± 0.35 correctly, and third‐ and fourth‐year fellows 5.58 ± 0.30. The majority of respondents chose an appropriate dose of intravenous morphine based on weight (92%), and identified a low‐dose naloxone drip as an appropriate intervention for opioid‐induced pruritis (91%). However, the remainder of the questions had a correct response rate of 15‐68%.ConclusionThis study characterizes PHO fellows’ knowledge and comfort with prescribing opioids. Despite high levels of reported comfort, PHO fellows in all levels of training demonstrated knowledge gaps. PHO fellows may benefit from further education in pain management.