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Impact of Policy Interventions on Postoperative Opioid Prescribing

机译：政策干预对术后阿片类规定的影响

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Objective. To assess postoperative opioid prescribing in response to state and organizational policy changes. Methods. We used an observational study design at an academic medical center in the Northeast United States over a time during which there were two important influences: 1) implementation of state rules regarding opioid prescribing and 2) changes in organization policies reflecting evolving standards of care. Results were summarized at the surgical specialty and procedure level and compared between baseline (July-December 2016) and postrule (July-December 2017) periods. Results. We analyzed data from 17,937 procedures from July 2016 to December 2017, two-thirds of which were outpatient. Schedule II opioids were prescribed in 61% of cases and no opioids at all in 28%. The median morphine milligram equivalent (MME) prescribed at discharge decreased 40%, from 113 MME in the baseline period to 68 MME in the postrule period. Decreases were seen across all the surgical specialties. Conclusions. Postoperative opioid prescribing at the time of hospital discharge decreased between 2016 and 2017 in the setting of targeted and replicable state and health care organizational policies. Policy Implications. Policies governing the use of opioids are an effective and adoptable approach to reducing opioid prescribing following surgery.
机译：客观的。以响应国家和组织政策变革评估术后阿片类药物。方法。我们在美国东北地区的学术医疗中心使用了一个观察研究设计，在此期间有两个重要影响：1）关于表述规定的国家规则和2）组织政策的变化，反映了不断变化的护理标准。结果总结了外科专业和程序水平，并在基线（2016年7月至12月）与Postrule（2017年7月）期间的比较。结果。我们分析了2016年7月至2017年12月的17,937个程序的数据，其中三分之二是门诊。附表II阿片类药物在61％的病例中规定，没有阿片类药物，也没有28％。在排出时规定的中位Milphine毫克等效（MME）降低了40％，从基线期间的113mme到Postrule时期的68mme。在所有手术专业中看到了减少。结论。术后阿片类药物在医院卸货时的处方于2016年至2017年在目标和可复制的国家和医疗保健组织政策中减少。政策影响。管理阿片类药物的策略是一种有效且可采用的方法，可在手术后减少阿片类药物处方。

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