乳房切除术患者的阿片类药物过度处方风险最高:实践模式与OPEN国家指南之间的比较
Emily P Swafford1, Sadhana Anantha2, Jenna Davis2
1Vanderbilt University Medical Center, Nashville, TN, USA. emily.swafford.1@vumc.org.
Annals of surgical oncology
|January 12, 2025
概括
过度处方阿片类药物在乳腺癌手术后很常见,特别是对于隆瘤切除术患者. 处方习惯与国家指导方针或患者需求不一致,突出需要改进方案.
科学领域:
- 在瘤学瘤学.
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 由于COVID-19加剧了阿片类药物流行,因此需要解决过度的阿片类药物处方问题.
- 近25%的阿片类药物相关死亡事件涉及处方阿片类药物.
- 手术后的阿片类药物处方需要与国家指南保持一致.
研究的目的:
- 将当地阿片类药物处方实践与非转移性乳腺癌患者的国家指导方针相协调.
- 分析乳腺癌手术患者的阿片类药物处方模式.
主要方法:
- 非转移性乳腺手术患者的单一机构分析 (2020年4月-2021年7月).
- "过度处方"被定义为超过密歇根州OPEN建议的阿片类药物量.
- 使用单变量和多变量分析识别了阿片类药物过度处方的风险因素.
主要成果:
- 在464名患者中,有52%的患者服用过多的阿片类药物; 74%的肺切除术患者和90%的手术患者服用过多的阿片类药物.
- 乳腺切除术患者 (< 25%) 过度处方的频率较少.
- 出院的阿片类药物数量与住院患者的需求无关 (r=0.024,p=0.604);年龄,吸烟和手术持续时间与更高的处方量有关.
结论:
- 接受少入侵性乳腺手术的患者面临阿片类药物过度处方的高风险.
- 目前的处方模式与国家指导方针和患者要求有所不同.
- 未来的努力将集中在遵守指导方针和量身定制的放电协议上.
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