美国住院婴儿处方阿片类药物的机构和区域差异
Olivia A Keane1, Shadassa Ourshalimian1, Ashwini Lakshmanan2
1Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California.
JAMA network open
|March 12, 2024
概括
在儿童医院中,对高危婴儿的阿片类药物处方有很大差异. 在这个弱势群体中标准化阿片类药物使用对于改善结果和减少危害至关重要.
科学领域:
- 新生儿科学 新生儿科学
- 儿科药理学 儿科药理学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 高风险的婴儿经常因医疗复杂性而经历长时间的阿片类药物暴露,这与不良结果有关.
- 了解阿片类药物处方实践的变化对于质量改善举措至关重要.
研究的目的:
- 调查对高风险婴儿的阿片类药物处方的区域和机构差异.
- 分析使用短效和长效阿片类药物和甲治疗的变化.
主要方法:
- 在47家美国儿童医院 (2016-2022) 中,对132,658名高风险婴儿 (<1岁) 进行了回顾性队列研究.
- 来自儿科健康信息系统 (PHIS) 的数据,按美国人口普查地区分层.
- 用于评估阿片类药物和美沙暴露累积日数变化的等级通用线性模型.
主要成果:
- 76.5%的高风险婴儿接触过阿片类药物;7.9%接受过甲.
- 在美国所有地区观察到阿片类药物和美沙暴露持续时间的医院级显著变化.
- 医院占阿片类药物处方总体变化的16%和甲治疗的20%.
结论:
- 在全国范围内,在高危住院婴儿中,阿片类药物和甲暴露的机构水平变化很普遍.
- 这些发现强调了在这个脆弱的儿科群体中标准化阿片类药物处方指南的急需.
- 标准化可以减轻与长期阿片类药物暴露相关的风险,并改善患者的治疗结果.
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