Analgesic Administration for Patients with Renal Colic in the Emergency Department Before and After Implementation of an Opioid Reduction Initiative

Autor: Peter Flom, Sergey Motov, Antonios Likourezos, Mahlaqa Butt, Jefferson Drapkin, Andrew Thorson, John Marshall
Rok vydání: 2018
Předmět:
Adult
Male
medicine.medical_specialty
Analgesic
New York
lcsh:Medicine
03 medical and health sciences
0302 clinical medicine
medicine
Retrospective analysis
Electronic Health Records
Humans
Pain Management
030212 general & internal medicine
Renal colic
Medical prescription
Practice Patterns
Physicians'
Renal Colic
Retrospective Studies
Original Research
Dose-Response Relationship
Drug
business.industry
lcsh:R
lcsh:Medical emergencies. Critical care. Intensive care. First aid
Electronic medical record
030208 emergency & critical care medicine
Retrospective cohort study
lcsh:RC86-88.9
General Medicine
Emergency department
Analgesics
Non-Narcotic
Middle Aged
Analgesics
Opioid
Logistic Models
Opioid
Emergency medicine
Analgesia
Emergency Department
Opioids
Emergency Medicine
Female
Public Health
medicine.symptom
business
Emergency Service
Hospital
Risk Reduction Behavior
medicine.drug
Program Evaluation
Zdroj: Western Journal of Emergency Medicine
Motov, Sergey; Drapkin, Jefferson; Butt, Mahlaqa; Thorson, Andrew; Likourezos, Antonios; Flom, Peter; et al.(2018). Analgesic Administration for Patients with Renal Colic in the Emergency Department Before and After Implementation of an Opioid Reduction Initiative. Western Journal of Emergency Medicine, 19(6). doi: 10.5811/westjem.2018.9.38875. Retrieved from: http://www.escholarship.org/uc/item/7m48n3k7
Western Journal of Emergency Medicine, Vol 19, Iss 6 (2018)
ISSN: 1936-9018
DOI: 10.5811/westjem.2018.9.38875.
Popis: Author(s): Motov, Sergey; Drapkin, Jefferson; Butt, Mahlaqa; Thorson, Andrew; Likourezos, Antonios; Flom, Peter; Marshall, John | Abstract: Introduction: We aimed to evaluate the patterns of analgesic prescribing for emergency department (ED) patients suffering from pain of renal colic before, during, and after implementation of an opioid reduction initiative. We hypothesized that this initiative based on the concept of channels/enzymes/receptors-targeted analgesia would result in overall decrease in opioid utilization in the ED and at discharge. Methods: We performed a retrospective analysis of ED electronic medical record of patients presenting with renal colic who received analgesics in the ED and at discharge over a five-year period. Patients were divided into three groups based on the following periods: 2012-2014 (pre-implementation phase); 2014-2015 (implementation phase); and 2015-2017 (post-implementation).Results: A total of 4,490 patients presented to the ED with renal colic over a five-year study period. Analgesics were administered to 3,793 ED patients of whom 1,704 received opioids and 2,675 received non-opioid analgesics. A total of 3,533 ED patients received a prescription for analgesic(s) upon discharge from the ED: 2,692 patients received opioids, and 2,228 received non-opioids. We observed a 12.7% overall decrease from the pre-implementation to post-implementation time period in opioid prescribing in the ED and a 25.5% decrease in opioid prescribing at discharge, which translated into 432 and 768 fewer patients receiving opioids, respectively. Conclusion: Implementation of an opioid-reduction initiative based on patient-specific, pain syndrome-targeted opioid alternative protocols resulted in a reduction in opioid administration in the ED by 12.7% and at prescriptions at discharge by 25.5%. Adoption of similar ED initiatives nationwide has the potential to foster effective non-opioid analgesic practices for ED patients presenting with renal colic and to reduce physicians’ reliance on administering and prescribing opioids.
Databáze: OpenAIRE
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