在妇科手术后的术后处方实践
Rachel J Craven1, Madeline K Moureau1, Heidi W Brown1
1University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
概括
教育干预并没有减少妇科手术患者的阿片类药物处方,尽管有过度处方的证据. 居民报告的处方与实际做法有所不同,这表明需要进一步研究阿片类药物管理.
科学领域:
- 产科和妇科 产科和妇科
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 治疗手术后疼痛的阿片类药物处方往往超过美国患者的需求,导致阿片类药物流行.
- 预防干预数据显示,妇科手术患者所服用的阿片类药物的两倍.
研究的目的:
- 评估教育干预,根据实际术后使用推阿片类药物处方,是否会减少妇科外科医生的处方.
- 在妇科手术中解决处方和消费的阿片类药物之间的差异.
主要方法:
- 2021年1月实施了一项教育干预,根据患者需求提供了处方建议.
- 干预后的图表审查和居民调查评估了阿片类药物处方实践的变化.
- 使用描述性统计数据来比较干预前后阶段.
主要成果:
- 处方阿片类药物 (以吗啡毫克相当的剂量) 在干预后对大多数妇科手术的变化很小.
- 阴道切除术的MME中位数从150下降到112.5;不切除子宫的阴道手术从75下降到54.
- 腹腔镜切除子宫或腹腔镜手术没有切除子宫的MME中位数没有变化; 在两个阶段的腹腔镜和D&C中为零.
- 被调查的居民报告说,他们的处方金额低于他们的实际做法.
结论:
- 教育干预措施没有改变妇科外科医生的阿片类药物处方习惯,尽管他们意识到过度处方.
- 居民实际和自我报告的阿片类药物处方之间存在显著差异.
- 需要进一步调查,以了解处方行为,并改善阿片类药物管理.
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