Opioid prescription practices for patients discharged from the emergency department with acute musculoskeletal fractures
| Autor: | Garrick Mok, Ian G. Stiell, Marie-Joe Nemnom, Lisa Thurgur, Hailey Newton |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Chest Pain Thoracic spine business.industry Mortality rate Emergency department Hydromorphone Patient Discharge Analgesics Opioid Prescriptions Opioid Prescription opioid Emergency medicine Emergency Medicine medicine Humans Lumbar spine Female Medical prescription Practice Patterns Physicians' business Emergency Service Hospital medicine.drug Retrospective Studies |
| Zdroj: | CJEM. 22(4) |
| ISSN: | 1481-8043 1481-8035 |
| Popis: | BackgroundOpioid related mortality rate has increased 200% over the past decade. Studies show variable emergency department (ED) opioid prescription practices and a correlation with increased long-term use. ED physicians may be contributing to this problem. Our objective was to analyze ED opioid prescription practices for patients with acute fractures.MethodsWe conducted a review of ED patients seen at two campuses of a tertiary care hospital. We evaluated a consecutive sample of patients with acute fractures (January 2016–April 2016) seen by ED physicians. Patients admitted or discharged by consultant services were excluded. The primary outcome was the proportion of patients discharged with an opioid prescription. Data were collected using screening lists, electronic records, and interobserver agreement. We calculated simple descriptive statistics and a multivariable analysis.ResultsWe enrolled 816 patients, including 441 females (54.0%). Most common fracture was wrist/hand (35.2%). 260 patients (31.8%) were discharged with an opioid; hydromorphone (N = 115, range 1–120 mg) was most common. 35 patients (4.3%) had pain related ED visits ConclusionsThe majority of patients presenting to the ED with acute fractures were not discharged with an opioid. Hydromorphone was the most common opioid prescribed, with large variations in total dosage. Overall, there were few return to ED visits. We recommend standardization of ED opioid prescribing, with attention to limiting total dosage. |
| Databáze: | OpenAIRE |
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