病院内での整形外科リハビリテーション後に退院した高齢者のためのオピオイドの処方箋:遡及的研究
Stephanie Cullen, Carolyn M Tan, Qixuan Li1
1Biostatistics Research Unit, University Health Network, Toronto, Canada.
American journal of physical medicine & rehabilitation
|September 3, 2025
まとめ
ほとんどの高齢の整形外科患者 (60. 9%) はオピオイドの処方箋で退院しました. 長期の入院や高度の痛みのスコアなどの要因は オピオイドの使用を予測し,入院後の整形外科リハビリテーションで オピオイドの処方量を減らす必要性を強調しています.
科学分野:
- 高齢者医療
- 整形 術
- 痛みの管理
- 薬理学について
背景:
- 退院後のオピオイドの処方箋は,特に高齢者のための懸念事項です.
- 病院内での整形外科リハビリテーション (IOR) は 痛みとオピオイド使用の管理に ユニークな課題を提示しています
- オピオイドの処方パターンを理解することは 標的を絞った介入の開発に不可欠です
研究 の 目的:
- IORにおけるオピオイド未使用の高齢者の退院率を決定する.
- IORからの退院時にオピオイドの投与に関連する患者特有の要因を特定する.
- この集団におけるオピオイドの処方量を減らすための戦略を策定する.
主な方法:
- 単一センターでの症例対照研究が行われました.
- IORにおけるオピオイド未使用の高齢者を分析した.
- ロジスティック・リグレーションでは,退院後のオピオイド処方と関連した要因が特定されました.
主要な成果:
- 391人の患者の60. 9%が退院時にオピオイドを処方された.
- 予測要因には,急性治療の長期滞在,膝の置換治療の入院,高い痛みのスコア,高いオピオイド用量,短いリハビリ滞在,認知症の欠如が含まれています.
- 年齢は独立して予測できる要因ではなかった.
結論:
- 大多数の高齢の整形外科患者は オピオイドで退院しています
- オピオイドの処方決定には 患者の内在的および外在的な要因が影響する.
- オピオイドの使用を最適化し,IORでの処方量を減らすためにさらなる研究と介入が必要である.
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