在ERAS途径中对分层阿片类药物处方算法的评估:探索进一步改进的机会
M Sol Basabe1, Tina S Suki1, Mark F Munsell2
1Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
概括
一个新的阿片类药物处方协议减少了,但没有消除手术患者的过度处方. 许多患者仍然缺乏关于安全处置阿片类药物的知识,这表明需要改进策略.
科学领域:
- 疼痛管理 疼痛管理
- 外科手术的结果
- 公共卫生 公共卫生
背景情况:
- 过度处方阿片类药物是导致持续的阿片类药物危机的一个重要问题.
- 浪费的处方做法需要进行干预,以优化阿片类药物使用.
研究的目的:
- 评估一个个性化的,分层排放阿片类药物协议和安全处置教育.
- 调查在下院后的阿片类药物消费和在接受腹腔骨盆外科手术的妇女中遵守处置教育.
主要方法:
- 在558名接受选择性妇科手术的患者中分析出院后的阿片类药物消费情况.
- 实施一个分层的处方算法和分发一项关于阿片类药物使用和处置知识的退院后调查.
- 过度处方的定义是剩余的原始处方>20%;用于分析的描述性统计数据.
主要成果:
- 很大一部分患者 (74.9%) 处方过多的阿片类药物,中位数年龄是一个重要的因素.
- 42.8%的患者报告说在出院后没有使用阿片类药物,在微创手术 (45.2%) 和开放手术 (38.6%) 队列之间有所不同.
- 近一半 (46.4%) 的受访者对安全的阿片类药物处置实践缺乏了解.
结论:
- 实施的分层阿片类药物算法并没有完全消除过度处方,需要进一步改进.
- 尽管接受了教育,但大量患者仍然不知道安全的阿片类药物处置方法.
- 需要采取额外的策略来减少阿片类药物过度处方,并加强患者对安全处置的教育.
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