Patterns of Opioid Prescribing for an Orthopaedic Trauma Population

被引:50
|
作者
Ruder, John [1 ,2 ]
Wally, Meghan K. [1 ,2 ]
Oliverio, McKell [1 ,2 ]
Seymour, Rachel B. [1 ,2 ]
Hsu, Joseph R. [1 ,2 ]
机构
[1] Carolinas HealthCare Syst, Dept Orthopaed Surg, Charlotte, NC USA
[2] Carolinas HealthCare Syst, Carolinas Trauma Network Res Ctr Excellence, 1320 Scott Ave, Charlotte, NC 28204 USA
关键词
prescription narcotics; opioids; orthopaedic trauma; CONTROLLED-RELEASE OXYCODONE; AMERICAN PAIN SOCIETY; UNITED-STATES; DOUBLE-BLIND; PATIENT SATISFACTION; OPERATIVE TREATMENT; POSTOPERATIVE PAIN; RISK-FACTORS; DRUG-ABUSE; PRESCRIPTION;
D O I
10.1097/BOT.0000000000000834
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Objectives: To determine opioid-prescribing practices to the orthopaedic trauma (OT) population at one Level I trauma center. Design: A retrospective study of discharge prescriptions for adult patients with OT. Prescription details, injury burden, and patient demographics were abstracted for patients from initial injury through a 2-month follow-up. Setting: Level I trauma center. Patients/Participants: Adult patients with OT admitted over a 30-day period (n = 110). Intervention: All discharge and follow-up opioid prescriptions were recorded. Main Outcome Measurements: Morphine milligram equivalents (MMEs) per day, number of opioid prescriptions, type/dose of medication prescribed. Results: One hundred thirty-five discharge prescriptions were written for 110 patients with orthopaedic injuries during the review period. All patients received opioids at the time of discharge. The MMEs prescribed at the time of discharge was 114 mg (54-300 mg) for a mean of 7.21 days (2-36.7 days). Although patients with preinjury risk factors were prescribed discharge opioids for a similar duration (7.00 days vs. 7.30 days, P = 0.81) than those without risk factors, they were prescribed significantly more MMEs than those without (130 vs. 108, P, 0.05) and were more likely to receive extended-release and long-acting opioids than those without (42.11% vs. 21.98%). Conclusions: Pain management after OT continues to be opioid-centric despite involving a population at risk. Further focus on prescriber and patient education, risk evaluation with mitigation, guideline development, and comprehensive pain management strategies are warranted in the OT population.
引用
收藏
页码:E179 / E185
页数:7
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