背景:未使用的阿片类药物处方可能是阿片类药物滥用的驱动因素。我们的目标是确定在急诊科出院时急性疼痛患者处方阿片类药物的最佳数量。以满足他们的镇痛需求,同时限制未使用的阿片类药物的量。
方法:在前瞻性中,多中心队列研究,我们纳入了18岁及以上出现急性疼痛症状少于2周的患者,这些患者使用阿片类药物处方从急诊科出院.参与者完成了止痛药日记,以便实时记录数量,剂量,以及在14天随访期间消耗的所有镇痛药的名称。
结果:我们包括2240名参与者,平均年龄51岁;48%为女性。超过14天,参与者消耗的中位数为5(四分位数,1-14)吗啡5毫克片剂当量,在不同疼痛条件下存在显著差异(p<0.001)。处方的大多数阿片类药物片剂(63%)未使用。为了满足80%患者的阿片类药物需求2周,我们发现,那些经历肾绞痛或腹痛的患者需要更少的阿片类药物片剂(8吗啡5毫克片剂当量)比骨折患者(24片),背痛(21片),颈部疼痛(17片),或其他肌肉骨骼疼痛(16片)。
结论:急诊科出院治疗急性疼痛的阿片类药物片剂有三分之二未使用,而根据急性疼痛的原因,阿片类药物的需求差异很大。较小,特定原因的阿片类药物处方可以提供足够的疼痛管理,同时降低阿片类药物滥用的风险.
背景:ClinicalTrials.gov,不。NCT03953534。
BACKGROUND: Unused opioid prescriptions can be a driver of opioid misuse. Our objective was to determine the optimal quantity of opioids to prescribe to patients with acute pain at emergency department discharge, in order to meet their analgesic needs while limiting the amount of unused opioids.
METHODS: In a prospective, multicentre cohort study, we included consecutive patients aged 18 years and older with an acute pain condition present for less than 2 weeks who were discharged from emergency department with an opioid prescription. Participants completed a pain medication diary for real-time recording of quantity, doses, and names of all analgesics consumed during a 14-day follow-up period.
RESULTS: We included 2240 participants, who had a mean age of 51 years; 48% were female. Over 14 days, participants consumed a median of 5 (quartiles, 1-14) morphine 5 mg tablet equivalents, with significant variation across pain conditions (p < 0.001). Most opioid tablets prescribed (63%) were unused. To meet the opioid need of 80% of patients for 2 weeks, we found that those experiencing renal colic or abdominal pain required fewer opioid tablets (8 morphine 5 mg tablet equivalents) than patients who had fractures (24 tablets), back pain (21 tablets), neck pain (17 tablets), or other musculoskeletal pain (16 tablets).
CONCLUSIONS: Two-thirds of opioid tablets prescribed at emergency department discharge for acute pain were unused, whereas opioid requirements varied significantly based on the cause of acute pain. Smaller, cause-specific opioid prescriptions could provide adequate pain management while reducing the risk of opioid misuse.
BACKGROUND: ClinicalTrials.gov, no. NCT03953534.