高リスクのオピオイド投与に関連する有害事象を,緊急事態省のトリガーツールを用いて特定する
Richard T Griffey1,2, Neha Bollam3, Ryan M Schneider1
1Department of Emergency Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
まとめ
EDトリガーツール (EDTT) は,オピオイド関連の有害事象 (AEs) を26%の高リスク管理でEDで検出しました. 特定のオピオイドトリガーを用いたこの監視戦略は,患者の安全リスクの特定に有効です.
科学分野:
- 緊急医療 緊急医療
- 患者の安全性についてです.
- 医薬品監視 医薬品監視
背景:
- ED解禁後のオピオイド関連の有害事象 (AE) は知られているが,ED滞在中のAEはあまり理解されていない.
- EDにおけるオピオイド副作用の検出は,頻繁な投与と非特異的な監視のために困難です.
- 緊急部トリガーツール (EDTT) は,ED内の高リスクオピオイド使用によるAEの検出に評価されました.
研究 の 目的:
- 緊急治療室 (ED) の訪問中にオピオイド関連の有害事象 (AEs) を特定するためのEDトリガーツール (EDTT) の有用性を評価する.
- AE検出のための高リスクオピオイド投与に関連する特定のトリガーを評価する.
主な方法:
- EDTTを用いた多センター遡及研究の二次分析.
- 2つのトリガーを分析した:M2 (ヒドロモルフォン≥3用量) とM18 (オピオイド+ベンゾジアゼピン投与).
- EDTTは18ヶ月間,サイトごとに約3000のレコードに適用され,二段階のレビュープロセスが行われました.
主要な成果:
- 訪問の3.0%は,高リスクのオピオイド投与トリガー (M2,M18,または両方) を含む.
- トリガーを含む記録のうち,少なくとも1つのトリガーは5.3%であった.
- オピオイド関連有害事象は,トリガーされた訪問の26.2%で特定され,M2 (47.4%) の割合はM18 (21.9%) よりも高い.
結論:
- ED診察の約5%は,高リスクオピオイドの投与を含み,そのうち26%がAEにつながりました.
- EDTTはAE検出に有効であることが証明され,サイト全体で一貫した割合を示しました.
- 高リスクオピオイド投与に焦点を当てたトリガーは,患者の安全性を改善するための監視戦略として有望であることが示されています.
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