• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Preventive Medicine: An International Journal Devoted to Practice and Theory >Provider specialty and odds of a new codeine, hydrocodone, oxycodone and tramadol prescription before and after the CDC opioid prescribing guideline publication
【24h】

Provider specialty and odds of a new codeine, hydrocodone, oxycodone and tramadol prescription before and after the CDC opioid prescribing guideline publication

机译：在CDC阿片类药物处方指南出版之前和之后，提供新的可用细准，氢酮，羟考酮和曲马多酮和曲马多的专业和次数

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

The CDC Guideline for Prescribing Opioids for Chronic Pain cautioned against high dose prescribing but did not provide guidance on type of opioid for new pain episodes. We determined if new prescriptions for Schedule II opioids vs. tramadol decreased in the 18 months after vs. before the CDC guideline and if this decrease was associated with physician specialty. New opioid prescriptions, provider type and covariates were measured using a nationally distributed, Optum (R) de-identified Electronic Health Record (EHR) data base. Eligible patients were free of cancer and HIV and started a new prescription for Schedule II opioids (i.e. codeine, hydrocodone, oxycodone) or Schedule IV (tramadol) in the 18 months before (n = 141,219) or 18 months after (n = 138,216) guideline publication. Fully adjusted multilevel multinomial models estimated the association between provider type (anesthesiology/pain medicine, surgical specialty, emergency, hospital, primary care, other specialty and unknown) before and after adjusting for covariates. New oxycodone prescriptions were most common among surgical and anesthesia/pain management, and new tramadol prescriptions were most common in primary care. The greatest decreases in odds of a Schedule II opioid vs. tramadol were observed in emergency care (oxycodone vs. tramadol OR = 0.82; 95%CI:0.76-0.88) and primary care (hydrocodone vs. tramadol OR = 0.85; 95%CI:0.81-0.89). Surgical specialists were least likely to start opioid therapy with tramadol. In the 18 months after vs. before the CDC guideline, emergency care and primary care providers increased tramadol prescribing. Guidelines tailored to specialists that frequently begin opioid therapy with oxycodone may enhance safe opioid prescribing.
机译：美国疾病控制与预防中心（CDC）的慢性疼痛类阿片处方指南警告不要开大剂量的处方，但没有为新的疼痛发作类阿片的类型提供指导。我们确定了在CDC指南发布后的18个月内，附表II阿片类药物与曲马多的新处方是否减少，以及这种减少是否与医生专业有关。新的阿片类药物处方、提供者类型和协变量使用一个全国分布的Optum（R）去识别电子健康记录（EHR）数据库进行测量。符合条件的患者在指南发布前18个月（n=141219）或发布后18个月（n=138216）开始新开附表II类阿片（即可待因、氢可酮、羟考酮）或附表IV类阿片（曲马多）的处方。完全调整的多水平多项式模型估计了调整协变量前后提供者类型（麻醉学/疼痛医学、外科专科、急诊、医院、初级保健、其他专科和未知）之间的关联。新的羟考酮处方在外科和麻醉/疼痛管理中最常见，而新的曲马多处方在初级保健中最常见。在急诊护理（羟考酮与曲马多OR=0.82；95%可信区间：0.76-0.88）和初级护理（氢可酮与曲马多OR=0.85；95%可信区间：0.81-0.89）中，观察到附表II阿片类药物与曲马多的几率降低最大。外科专家最不可能开始使用曲马多进行阿片类药物治疗。在CDC指南发布后和发布前的18个月内，急救和初级保健提供者增加了曲马多的处方。为经常开始使用羟考酮进行阿片类药物治疗的专家量身定制的指南可能会加强安全的阿片类药物处方。

著录项

相似文献

  • 外文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号