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阿片类药物管理:成功,可扩展和可适应的部门阿片类药物减少计划
Alexa D Melucci1, Olivia Lynch2, Michele Lawrence1
1From the Department of Surgery, University of Rochester Medical Center, Rochester, NY (Melucci, Lawrence, Bramley, Levatino, Linehan, Moalem).
Journal of the American College of Surgeons
|October 6, 2025
概括
一个新的阿片类药物管理计划显著减少了手术后的阿片类药物处方. 这项低成本,可扩展的倡议使平均处方大小减少了67.1%,从而大大节省了阿片类药丸,并促进了无阿片类药物的出院.
科学领域:
- 外科手术 手术手术
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 以前的单阶段努力制手术阿片类药物处方的成功有限.
- 本研究介绍了首份关于一个全面,低成本,可扩展和自给自足的阿片类药物管理计划的报告,该计划涵盖了所有外科手术前阶段.
研究的目的:
- 评估新实施的多方面阿片类药物管理计划在减少手术出院时过度处方阿片类药物的有效性.
- 评估该计划对处方大小,阿片类药物减少百分比和出院后阿片类药物处方需求的影响.
主要方法:
- 实施了一项全面的阿片类药物管理计划,包括教育材料,处方章,EMR修改和处方仪表板.
- 一个回顾性分析比较了基线 (2019年) 的阿片类药物处方数据与从15个选择性手术中接受阿片类药物未使用的成年患者的前性数据 (2021-2022年).
- 测量的主要结果是出院处方大小,阿片类药物的百分比减少,以及需要出院后阿片类药物处方的患者比例.
主要成果:
- 该研究包括6,619名成年患者 (2,334名实施前,4285名实施后).
- 处方的中位数大小显著下降 (p < 0.0001),阿片类药丸总体减少了67.1% (24,212保存).
- 干预后,15项手术中的14项显示中位数下降了阿片类药物处方,而10项手术实现了0片药物的中位数. 使用阿片类药物出院的患者接受的氧化5毫克药丸减少了8次 (p < 0.0001),并且无阿片类药物出院的几率增加了 (OR 3.4).
结论:
- 实施的阿片类药物管理计划在减少在常见外科手术中出院时过度处方阿片类药物方面非常有效.
- 该计划的低成本和自我维持性使其成为其他机构寻求优化阿片类药物处方实践的可扩展模型.
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