Abstract：
BACKGROUND: Despite widespread efforts to combat the opioid epidemic, an ongoing contributor to opioid misuse remains post-operative opioid overprescribing by residents. The goal of this study was to evaluate the impact of a low-cost, reproducible \"just in time\" intervention on opioid prescribing in dialysis access operations.
METHODS: Standardized opioid prescribing guidelines were emailed to residents on the vascular service on the first day of the rotation. Opioid prescriptions were reviewed for four years before and one year after this intervention. Wilcoxon rank-sum test and tests of proportions were used to compare groups.
RESULTS: Overall, 299 patients underwent dialysis access procedures. There was a decrease in patients discharged with opioids following the intervention from 58% to 36% (p = 0.003). For patients prescribed opioids, the median quantity decreased from 90 to 45 oral morphine equivalents (p = 0.03).
CONCLUSIONS: This low-cost and timely learning intervention may be a useful adjunct to reduce post-operative opioid prescriptions.
METHODS: Standardized opioid prescribing guidelines were emailed to residents on the vascular service on the first day of the rotation. Opioid prescriptions were reviewed for four years before and one year after this intervention. Wilcoxon rank-sum test and tests of proportions were used to compare groups.
RESULTS: Overall, 299 patients underwent dialysis access procedures. There was a decrease in patients discharged with opioids following the intervention from 58% to 36% (p = 0.003). For patients prescribed opioids, the median quantity decreased from 90 to 45 oral morphine equivalents (p = 0.03).
CONCLUSIONS: This low-cost and timely learning intervention may be a useful adjunct to reduce post-operative opioid prescriptions.
摘要：
背景：尽管为对抗阿片类药物的流行做出了广泛的努力，阿片类药物滥用的一个持续原因仍然是居民术后阿片类药物的过度处方.这项研究的目的是评估低成本的影响，可重复的“及时”干预透析进入手术中的阿片类药物处方。
方法：标准阿片类药物处方指南在轮换的第一天通过电子邮件发送给血管服务的居民。在此干预之前和之后的四年中对阿片类药物处方进行了审查。使用Wilcoxon秩和检验和比例检验来比较组。
结果：总体而言，299名患者接受了透析接入程序。干预后使用阿片类药物出院的患者从58%下降到36%(p=0.003)。对于处方阿片类药物的患者，中位量从90降至45口服吗啡当量(p=0.03)。
结论：这种低成本且及时的学习干预措施可能是减少术后阿片类药物处方的有用辅助手段。
方法：标准阿片类药物处方指南在轮换的第一天通过电子邮件发送给血管服务的居民。在此干预之前和之后的四年中对阿片类药物处方进行了审查。使用Wilcoxon秩和检验和比例检验来比较组。
结果：总体而言，299名患者接受了透析接入程序。干预后使用阿片类药物出院的患者从58%下降到36%(p=0.003)。对于处方阿片类药物的患者，中位量从90降至45口服吗啡当量(p=0.03)。
结论：这种低成本且及时的学习干预措施可能是减少术后阿片类药物处方的有用辅助手段。
