当前位置： SCI文献检索 > UROLOGY期刊下所有文献 > Prescribing Trends in Post-Operative Pain Management After Urologic Surgery: A Quality Care Investigation for Healthcare Providers.

Prescribing Trends in Post-Operative Pain Management After Urologic Surgery: A Quality Care Investigation for Healthcare Providers.

Abstract：

OBJECTIVE:To assess prescribing and refilling trends of narcotics in postoperative urology patients at our institution. Although the opioid epidemic remains a public health threat, no series has assessed prescribing patterns across urologic surgery disciplines following discharge. METHODS:All urologic surgeries were retrospectively reviewed from May 2017-April 2018. Demographics, comorbidities, and postoperative pain management strategies were analyzed. Narcotics usage following surgery were reported in total morphine equivalents (TME). Opioid refill rate was characterized by medical specialty and stratified by urologic discipline. RESULTS:817 cases were reviewed. Mean age and TME at discharge was 57±15.6 years and 35.43±19.5 mg, respectively. 13.6% (mean age 55±15.9) received a narcotic refill following discharge (mean TME/refill 37.7±28.9 mg). A higher proportion of patients with a pre-operative opioid prescription received a refill compared to opioid naïve patients (38.2% vs. 21.6%, p<0.01). Refill rate did not differ between urologic subspecialties (p=0.3). Urologists were only responsible for 20.4% of all refills filled, despite all patients continuing follow-up with their surgeon. Procedures with the highest rates of post-operative refills were in oncology, male reconstruction/trauma and endourology. Patients with a history of chronic pain (OR 1.9, CI 1.1-3.3) pre-operative narcotic prescription (OR 1.6, CI 1.0-2.6), and higher ASA score (OR 1.8, CI 1.6-2.8) were more likely to obtain a postoperative opioid prescription refill. CONCLUSIONS:Approximately 1 in 7 postoperative urology patients receive a postoperative narcotics refill; however, nearly two-thirds receive refills exclusively from non-urologic providers. Attempts to avoid overprescribing of post-operative narcotics need to account for both surgeon and non-surgeon sources of opioid refills.

journal_name

Urology

journal_title

Urology

authors

Ellis JL,Ghiraldi EM,Cohn JA,Nitti M,Friedlander JI,Ginzburg S,Sterious SN,Abbosh P,Ohmann E,Uzzo RG,Simhan J

doi

10.1016/j.urology.2020.11.070

subject

Has Abstract

pub_date

2021-01-23 00:00:00

eissn

0090-4295

issn

1527-9995

pii

S0090-4295(21)00097-2

pub_type

杂志文章

在线工具

Prescribing Trends in Post-Operative Pain Management After Urologic Surgery: A Quality Care Investigation for Healthcare Providers.