降低手术后麻醉剂处方的默认药丸数量的持续好处是:
Nathan Coppersmith1, Joshua Sznol1, Andrew Esposito1
1Department of Surgery, Yale School of Medicine, New Haven, Connecticut, United States of America.
PloS one
|June 4, 2024
概括
减少电子医疗记录中的默认阿片类药丸数量显著减少了长期的术后阿片类药物处方. 这种变化有效地降低了阿片类药物的数量,但没有影响补充率,证明了可持续的干预.
科学领域:
- 医疗保健管理的管理
- 临床药房 临床药房
- 疼痛管理 疼痛管理
背景情况:
- 一所大学的医疗保健系统在2017年将默认的阿片类药丸数量从30个减少到12个.
- 电子健康记录 (EHR) 的默认设置会影响临床医生的处方行为.
- 研究了这种减少对术后阿片类药物处方的长期影响.
研究的目的:
- 评估减少电子默认阿片类药丸数量的持续影响,对术后处方实践的持续影响.
- 评估随着时间的推移,阿片类药物处方量和补充率的变化.
主要方法:
- 从2017-2021年对电子病历 (EMR) 的回顾性审查.
- 包括接受手术和处方阿片类药物的患者在出院时.
- 计算总阿片类药物量以吗啡等价物 (MME) 计算,并分析补充数据.
主要成果:
- 平均处方阿片类药物的数量从2017年的236MME下降到2021年的154MME (p<0.001).
- 在既往阿片类药物使用者和未使用阿片类药物患者中,在默认MME以上的处方量显著减少.
- 对于这两组患者来说,在手术后90天内补充率没有显著变化.
结论:
- 降低默认的阿片类药丸数量产生累积的长期益处.
- 医生采用修改后的EHR默认值是一个可持续的策略,以减少术后阿片类药物处方.
- 这种干预有效地降低了阿片类药物的数量,而不会对门诊患者的需求产生不利影响.
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