An expert panel consensus on opioid-prescribing guidelines for dermatologic procedures
| Autor: | John G. Albertini, Di Anne S. Davis, Jarad Levin, Whitney D. Tope, Margaret W. Mann, Elizabeth M. Billingsley, Lauren D. Crow, Thomas Knackstedt, Mary E. Maloney, Brian C. Leach, Thomas A. Jennings, Seaver L. Soon, Daniel P. Friedmann, John A. Carucci, Arisa E. Ortiz, Stanley J. Miller, Matthew P. Stephany, William E. Bruhn, Travis W. Blalock, Brett M. Coldiron, Richard A. Krathen, Edward H. Yob, Ramona Behshad, Rohit Kakar, Justin M McLawhorn, C. William Hanke, Drew K. Saylor, Nathaniel J. Jellinek, Holly H. Mccoppin, Nathalie C. Zeitouni, Christopher K. Bichakjian, Scott W. Fosko, Thomas Stasko, George J. Hruza, Natalie M. Curcio, Michael S. Graves, William B. Henghold, Lindsey Collins, William G. Stebbins, Faramarz H. Samie |
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| Rok vydání: | 2019 |
| Předmět: |
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medicine.medical_specialty Dermatologic Surgical Procedures Psychological intervention Delphi method Dermatology Drug Prescriptions 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Medicine Dermatologic surgery Humans Practice Patterns Physicians' Intensive care medicine Dermatologic Procedures Pain Postoperative business.industry Public health Analgesics Opioid Opioid 030220 oncology & carcinogenesis Practice Guidelines as Topic Female Outcomes research business Oxycodone medicine.drug |
| Zdroj: | Journal of the American Academy of Dermatology. 82(3) |
| ISSN: | 1097-6787 |
| Popis: | Background Opioid overprescribing is a major contributor to the opioid crisis. The lack of procedure-specific guidelines contributes to the vast differences in prescribing practices. Objective Create opioid-prescribing consensus guidelines for common dermatologic procedures. Methods We utilized a four-step modified Delphi method to conduct a systematic discussion among a panel of providers in the fields of general dermatology, dermatologic surgery, and cosmetics/phlebology to develop opioid-prescribing guidelines for some of the most common dermatologic procedural scenarios. Guidelines were developed for opioid-naive patients undergoing routine procedures. Opioid tablets were defined as oxycodone 5-mg oral equivalents. Results Postoperative pain after most uncomplicated procedures (76%) can be adequately managed with acetaminophen and/or ibuprofen. Group consensus identified no specific dermatological scenario that routinely requires more than 15 oxycodone 5-mg oral equivalents to manage postoperative pain. Group consensus found that 23 percent of the procedural scenarios routinely require 1-10 opioid tablets, while only one routinely requires 1-15 opioid tablets. Limitations These recommendations are based on expert consensus in lieu of quality evidence-based outcomes research. These recommendations must be individualized to accommodate patients’ comorbidities. Conclusions Procedure-specific opioid-prescribing guidelines may serve as a foundation to produce effective and responsible postoperative pain management strategies after dermatologic interventions. |
| Databáze: | OpenAIRE |
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