オピオイドの処方量は,患者の致死性過剰摂取を知った後に減少しています
Jason N Doctor1, Andy Nguyen2, Roneet Lev3
1Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA. jdoctor@usc.edu.
Science (New York, N.Y.)
|August 11, 2018
まとめ
過剰摂取による患者の死亡に関する医師の通知と安全な処方命令により,オピオイドの処方量が著しく減少しました. この介入により オピオイドの投与量と服用開始率が低下し,処方薬による死亡の重要な要因に 対処することができました.
科学分野:
- 公衆衛生
- 医学心理学
- 臨床薬理学
背景:
- オピオイドの処方による死亡は重要な公衆衛生問題であり,しばしばリスクが利益よりも大きい一般的な状態に関連しています.
- 個人的なリスクの過小評価,観察なしに注意の減少,権威への敬意などの心理的要因は,処方行動に影響します.
研究 の 目的:
- オピオイドの処方パターンについて,患者の過剰摂取による死亡に関する臨床医への情報提供と,安全な処方命令の提供の影響を調査する.
- リスクの高いオピオイド処方に関する仮説を検証する.
主な方法:
- ランダム化試験で 861人の臨床医が 170人の患者にオピオイドを処方し 過剰摂取で死亡しました
- 介入グループの臨床医は 患者の死亡に関する通知と 検死医からの安全な処方命令を受け取った.
- 対照群の臨床医はこれらの通知を受けませんでした.
主要な成果:
- 3ヶ月間の対照群と比較して,介入臨床医の患者による処方箋におけるモルヒンのミリグラム相当量の9. 7% の減少 (P < 0. 001).
- 新しいオピオイドの開始と高用量オピオイドの処方量の減少が観察されました.
結論:
- 患者の過剰摂取による死亡について臨床医に情報を与え,安全な処方に関する明確な指示を与えることで,オピオイドの処方頻度と開始を効果的に減らすことができます.
- この介入は,臨床的意思決定に対する心理的影響に対処することによって,オピオイド関連の害を軽減する潜在的な戦略を示しています.
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