对阿片类药物替代方案对外送阿片类药物处方在创伤患者中的影响
Steven F Nerenberg1, Caitlin E Kulig1,2, Alexis M LaPietra3
1Department of Pharmacy, St. Joseph's University Medical Center, Paterson, NJ, USA.
Journal of pharmacy practice
|July 13, 2023
概括
"阿片类药物替代方案" (ALTO) 计划没有减少在医院或出院后对创伤患者的阿片类药物处方. 阿片类药物仍然是创伤相关疼痛管理的主要治疗方法.
科学领域:
- 创伤外科手术是什么
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 在过去的二十年中,阿片类药物过量死亡人数显著增加.
- 尽管努力制阿片类药物处方,但比例仍然很高.
- 为了解决这个问题,实施了阿片类药物替代品 (ALTO) 计划.
研究的目的:
- 评估全医院ALTO计划对阿片类药物处方模式的影响.
- 确定ALTO计划是否减少了创伤患者在住院期间和出院后的阿片类药物使用.
主要方法:
- 一个单一中心,对24小时以上住院的成人创伤患者进行了回顾性分析.
- 数据从2018年8月到2019年10月收集,比较ALTO实施前后的时间.
- 排除标准包括药物滥用,慢性阿片类药物使用和住院死亡率.
主要成果:
- 在阿尔托后组 (43.8%) 与阿尔托前组 (39.4%) 相比,在出院时处方阿片类药物的比例更高,尽管在统计学上并不显著 (P = .1237).
- 在医院内使用阿片类止痛药在ALTO后显著增加 (87.5%对70.4%,P<.0001).
- 非阿片类药物和多模式止痛药的使用也增加了,而住院和ICU停留时间在各组之间保持相似.
结论:
- ALTO计划与对创伤患者的阿片类药物处方减少无关.
- 阿片类药物仍然是治疗创伤相关疼痛的主要方法.
- 可能需要进一步的策略,以有效地减少在创伤护理中使用阿片类药物.
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