Opioid Prescribing Recommendations After Mohs Micrographic Surgery and Reconstruction: A Delphi Consensus.

Autor:	Donigan JM; Department of Dermatology, University of Utah, Salt Lake City, Utah., Srivastava D; Department of Dermatology, University of Texas Southwestern, Dallas, Texas., Maher I; Department of Dermatology, University of Minnesota, Minneapolis, Minnesota., Abdelmalek M; Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania., Bar AA; Department of Dermatology, Oregon Health and Science University, Portland, Oregon., Blalock TW; Department of Dermatology, Emory University, Atlanta, Georgia., Bordeaux JS; Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio., Brodland DG; Zitelli & Brodland, P.C. Skin Cancer Center, Pittsburgh, Pennsylvania.; Zitelli & Brodland, P.C. Skin Cancer Center, Clairton, Pennsylvania.; Departments of Dermatology, Otolaryngology, and Plastic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania., Carroll BT; Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio., Council ML; Division of Dermatology, Washington University School of Medicine in St. Louis, St. Louis, Missouri., Duffy K; Department of Dermatology, University of Utah, Salt Lake City, Utah., Fathi R; Phoenix Surgical Dermatology Group, LLC, Phoenix, Arizona., Golda N; Department of Dermatology, University of Missouri, Columbia, Missouri., Johnson-Jahangir H; Department of Dermatology, University of Iowa, Iowa City, Iowa., Konda S; Department of Dermatology, University of Florida, Gainesville, Florida., Leitenberger JJ; Department of Dermatology, Oregon Health and Science University, Portland, Oregon., Moye M; Forefront Dermatology, Louisville, Kentucky., Nelson JL; Avera Medical Group Dermatology Sioux Falls, Sioux Falls, South Dakota., Patel VA; Department of Dermatology, The George Washington University School of Medicine & Health Sciences, Washington, District of Columbia., Shaffer JJ; Dermatology Consultants, St. Paul, Minnesota., Soltani-Arabshahi R; Department of Dermatology, University of Southern California Keck School of Medicine, Los Angeles, California., Tristani-Firouzi P; Revere Health, Provo, Utah; and., Tschetter AJ; Dermatology Specialists, Edina, Minnesota., Nijhawan RI; Department of Dermatology, University of Texas Southwestern, Dallas, Texas.
Jazyk:	angličtina
Zdroj:	Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] [Dermatol Surg] 2021 Feb 01; Vol. 47 (2), pp. 167-169.
DOI:	10.1097/DSS.0000000000002551
Abstrakt:	Background: Prescription opioids play a large role in the opioid epidemic. Even short-term prescriptions provided postoperatively can lead to dependence. Objective: To provide opioid prescription recommendations after Mohs micrographic surgery (MMS) and reconstruction. Methods: This was a multi-institutional Delphi consensus study consisting of a panel of members of the American College of Mohs Surgery from various practice settings. Participants were first asked to describe scenarios in which they prescribe opioids at various frequencies. These scenarios then underwent 2 Delphi ratings rounds that aimed to identify situations in which opioid prescriptions should, or should not, be routinely prescribed. Consensus was set at ≥80% agreement. Prescription recommendations were then distributed to the panelists for feedback and approval. Results: Twenty-three Mohs surgeons participated in the study. There was no scenario in which consensus was met to routinely provide an opioid prescription. However, there were several scenarios in which consensus were met to not routinely prescribe an opioid. Conclusion: Opioids should not be routinely prescribed to every patient undergoing MMS. Prescription recommendations for opioids after MMS and reconstruction may decrease the exposure to these drugs and help combat the opioid epidemic. (Copyright © 2020 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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