Characterizing and Reducing New Persistent Opioid Use in Patients Undergoing Complex Major Surgery

描述和减少接受复杂大手术的患者中新的持续阿片类药物的使用

• 批准号: 10065067
• 负责人: Craig Brown
• 金额: $ 7.38万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10065067
• 关键词: Abate; Acute Pain; Address; Admission activity; Blood Vessels; Blue Cross; Blue Shield; Caring; Centers for Disease Control and Prevention (U.S.); Characteristics; Complex; Consumption; Continuity of Patient Care; Country; Data; Databases; Development; Epidemic; Excision; Exposure to; Family member; Guidelines; Gynecologic Surgical Procedures; Hospitals; Hydrocodone; Individual; Institution; Intervention; Interview; Investigation; Length of Stay; Lung; Measures; Michigan; Morbidity - disease rate; Operative Surgical Procedures; Opiate Addiction; Opioid; Opioid Analgesics; Outpatients; Oxycodone; Pain; Pain management; Pathway interactions; Patient Care; Patient Outcomes Assessments; Patients; Pattern; Peer Pressure; Play; Postoperative Pain; Postoperative Period; Predictive Factor; Preparation; Prescription drug overdose; Prescription opioid overdose; Procedures; Public Health; Recovery; Reporting; Research Proposals; Role; Sampling; Structure; Support System; Surgeon; Surgical complication; System; Treatment Efficacy; Universities; Work; chronic pain; chronic pain management; coping; depressive symptoms; design; evidence base; heroin use; high risk; high risk population; improved; interest; mortality; operation; opioid epidemic; opioid exposure; opioid mortality; opioid use; prescription opioid; prevent; programs; psychologic; skills

Abstract The opioid epidemic represents a public health crisis that continues to worsen with mortality due to unintentional prescription opioid overdose increasing by 450% over the last two decades. Despite major advancements in the management of chronic pain and opioid prescription practices for chronic pain, prescriptions for acute pain have not declined. Additionally, opioid prescriptions following surgical operations represent a common entry pathway to new persistent opioid use. Our previous work has shown high rates of new persistent opioid use among patients following multiple common outpatient surgical procedures, but investigation into patients after major surgical operations and those that suffer complications from those procedures is lacking. Patients with complicated post-operative courses often undergo repeated procedures and have prolonged lengths of hospital stay, altering the trajectory with which their pain abates and potentially drastically increasing their exposure to post-operative opioid medications both in an out of the hospital. In this research proposal, we will focus on gathering data from several statewide databases including those available through the partnership between the Michigan Surgical Quality Collaborative (MSQC) as well as Blue Cross Blue Shield of Michigan (BCBSM) to investigate the magnitude of new persistent opioid use development among patients having complex surgery. In addition, we will define the role that post-operative opioid exposure plays in development of new persistent opioid use and what patient level factors are predictive of new opioid dependency in this high-risk group of patients. Finally, we will utilize these findings to develop, implement and assess an evidence-based pain plan for patients undergoing complex surgical procedures.

摘要

项目成果

Assessment of Patterns of Atherectomy Use.

• DOI: 10.1161/jaha.121.023356
• 发表时间: 2022-11-15
• 期刊: JOURNAL OF THE AMERICAN HEART ASSOCIATION
• 影响因子: 5.4
• 作者: Brown, Craig S.;Eton, Ryan E.;Yaser, Jessica M.;Syrjamaki, John D.;Corriere, Matthew A.;Henke, Peter K.;Englesbe, Michael J.;Osborne, Nicholas H.
• 通讯作者: Osborne, Nicholas H.

Exploring the rapid expansion of office-based laboratories and peripheral vascular interventions across the United States.

• DOI: 10.1016/j.jvs.2021.01.061
• 发表时间: 2021-09
• 期刊: Journal of vascular surgery
• 影响因子: 4.3
• 作者: Brown CS;Smith ME;Kim GY;Sutzko DC;Henke PK;Corriere MA;Siracuse JJ;Goodney PP;Osborne NH
• 通讯作者: Osborne NH

CT-measured Cortical Volume Ratio Is an Accurate Alternative to Nuclear Medicine Split Scan Ratio Among Living Kidney Donors.

CT 测量的皮质体积比是活体肾脏捐赠者中核医学分裂扫描比的准确替代方案。

• DOI: 10.1097/tp.0000000000003676
• 发表时间: 2021
• 期刊: Transplantation
• 影响因子: 6.2
• 作者: Montgomery,JohnR;Brown,CraigS;Zondlak,AllyseN;Walsh,KevinW;Kozlowski,JuliaE;Pinsky,AlexaM;Herriman,EmilyA;Sussman,Jeremy;Lu,Yee;Stein,EricaB;Shankar,PrasadR;Sung,RandallS;Woodside,KennethJ
• 通讯作者: Woodside,KennethJ

Introduction to the Best-Case/Worst-Case Framework Within Transplantation Surgery to Improve Decision-Making for Increased Risk Donor Organ Offers.

介绍移植手术中的最佳情况/最坏情况框架，以改善增加风险的供体器官供应的决策。

• DOI: 10.1177/1526924820958116
• 发表时间: 2020
• 期刊: Progress in transplantation (Aliso Viejo, Calif.)
• 作者: Highet,Alexandra;Cassidy,DevonE;Gomez-Rexrode,AmaliaE;Kirsch,MichaelJ;Eton,Ryan;Brown,CraigS;Waits,SethA;Englesbe,MichaelJ
• 通讯作者: Englesbe,MichaelJ

The Association of Postoperative Opioid Prescriptions with Patient Outcomes.

• DOI: 10.1097/sla.0000000000004965
• 发表时间: 2022-12-01
• 期刊: Annals of surgery
• 影响因子: 9
• 作者: Howard R;Brown CS;Lai YL;Gunaseelan V;Chua KP;Brummett C;Englesbe M;Waljee J;Bicket MC
• 通讯作者: Bicket MC