克服长期阿片类药物治疗在住院诊所处方的挑战
Kathryn Brown1, Joel Farley2, Ezra Golberstein3
1St. John's Family Medicine Residency Program, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota.
Journal of opioid management
|September 25, 2024
概括
在家庭医学住院诊所进行的一项标准化阿片类药物处方干预,与非住院诊所相比,阿片类药物使用的减少也相似. 这凸显了标准化流程在培训环境中改善阿片类药物处方实践的潜力.
科学领域:
- 医疗教育 医学教育
- 公共卫生 公共卫生
- 药理学 药理学是指药理学的学科.
背景情况:
- 家庭医学 (FM) 住院诊所面临运营挑战,包括住院人员流动,影响标准化护理.
- 有效的阿片类药物处方需要一致的流程,特别是在高员工变化的学术环境中.
- 之前的干预措施并没有完全解决住院诊所独特的环境.
研究的目的:
- 评估FM住院诊所中标准化阿片类药物处方干预措施的影响.
- 为了比较一个大型学术卫生系统内的住院和非住院诊所之间的长期阿片类药物处方模式.
- 在培训环境中评估标准化流程在解决阿片类药物处方挑战方面的有效性.
主要方法:
- 追溯队列研究比较三个FM住院诊所 (干预) 与三个非住院FM诊所 (控制).
- 从2015年到2018年在住院诊所实施标准化阿片类药物处方过程.
- 分析每年的阿片类药物暴露和高风险药物的联合处方,使用差异模型.
主要成果:
- 住院和非住院诊所都显示,阿片类药物处方的平均数量在统计学上显著下降.
- 在这两种诊所类型中,平均每日吗啡毫克相当的剂量也显著下降.
- 在住院和非住院诊所之间,观察到的阿片类药物处方减少是可比的.
结论:
- 标准化阿片类药物处方干预措施,包括EHR整合和指标管理,可以产生与非住院诊所相似的结果.
- 住院诊所可以成功实施创新解决方案,与阿片类药物管理的最佳实践保持一致.
- 这些发现表明,在具有挑战性的学术培训环境中改进阿片类药物处方有价值的策略.
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