Patient-centered Opioid Prescribing: Breaking Away From One-Size-Fits-All Prescribing Guidelines
| Autor: | Josh Bleicher, Robert E. Glasgow, Lyen C. Huang, Sean M. Stokes, Benjamin S. Brooke |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Drug Prescriptions Opioid prescribing Article Young Adult 03 medical and health sciences 0302 clinical medicine Patient-Centered Care medicine Humans Pain Management Practice Patterns Physicians' Medical prescription Aged Pain Measurement Retrospective Studies Colectomy Aged 80 and over Pain Postoperative business.industry Retrospective cohort study Length of Stay Middle Aged Opioid-Related Disorders Patient Discharge Analgesics Opioid Treatment Outcome Opioid 030220 oncology & carcinogenesis Practice Guidelines as Topic Emergency medicine Morphine Female 030211 gastroenterology & hepatology Surgery business Abdominal surgery Patient centered medicine.drug |
| Zdroj: | J Surg Res |
| ISSN: | 0022-4804 |
| DOI: | 10.1016/j.jss.2021.01.048 |
| Popis: | BACKGROUND: Procedure-based opioid prescribing guidelines have reduced the amount of opioids prescribed after surgery; however, many patients still are over-prescribed opioids. The 24-hour pre-discharge opioid consumption (PDOC) metric has been proposed to guide patient-centered prescribing. MATERIALS AND METHODS: This is a single-institution, retrospective study of patients who underwent major abdominal surgery. We assessed the correlation between inpatient opioid use and discharge prescriptions using morphine milligram equivalents (MME). The adequacy of discharge prescriptions for individual patients was assessed using 2 models, one assuming constant opioid use (based on 24-hour PDOC) and the other assuming a linear taper. RESULTS: Of 596 included patients, gastric bypass and colectomy were the most common operations. Median length-of-stay was 3.5 days. Inpatient opioid use and discharge prescriptions were weakly correlated (r=0.35). Patients with no opioid use 24 hours prior to discharge (n=133, 22.3%) were frequently discharged with opioid prescriptions. Patients with high opioid use (24-hour PDOC >60 MME) were often discharged with prescriptions that would have lasted |
| Databáze: | OpenAIRE |
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