The effect of a statewide prescription drug monitoring program on opioid prescribing patterns

被引：2
作者：
Rubin, Samuel J. [1 ,2 ]
Wang, Judy J. [1 ,2 ]
Nodoushani, Ariana Y. [1 ,2 ]
Yarlagadda, Bharat B. [2 ,3 ]
Wulu, Jacqueline A. [1 ,2 ]
Edwards, Heather A. [1 ,2 ]
机构：
[1] Boston Med Ctr, Dept Otolaryngol Head & Neck Surg, 800 Harrison Ave BCD 5th Floor, Boston, MA 02118 USA
[2] Boston Univ, Sch Med, 72 East Concord St, Boston, MA 02118 USA
[3] Lahey Hosp & Med Ctr, Div Otolaryngol Head & Neck Surg, 41 Burlington Mall Rd, Burlington, MA 01850 USA
来源：
AMERICAN JOURNAL OF OTOLARYNGOLOGY | 2022年 / 43卷 / 01期
关键词：
General otolaryngology; Opioids; Tonsillectomy; Thyroid; Parotid; Direct laryngoscopy; Postoperative pain management; SURGERY; ANALGESIA; ABUSE; USAGE; HEAD;
D O I：
10.1016/j.amjoto.2021.103262
中图分类号：
R76 [耳鼻咽喉科学];
学科分类号：
100213 ;
摘要：
Purpose: Determine whether opioid prescribing patterns have changed as a result of implementation of a prescription drug monitoring program (PDMP) in the state of Massachusetts. Materials and methods: A multicentered retrospective study was performed including patients who received tonsillectomy, parotidectomy, thyroidectomy or direct laryngoscopy and biopsy with or without rigid esophagoscopy and/or rigid bronchoscopy at Lahey Hospital and Medical Center (Burlington, MA) or Boston Medical Center (Boston, MA). Opioid prescribing patterns were compared for the 12 months prior to implementation of the Massachusetts Prescription Awareness Tool (MassPAT) to 36 months of prescribing patterns post implementation. Quantity of opioids prescribed was based on morphine milligram equivalents (MME). Continuous variables were compared using analysis of variance (ANOVA) while categorical variables were compared using chi-squared test or Fisher's exact test. Multivariate analysis was performed using linear regression. Results: A total of 2281 patients were included in the study. There was a significant association in mean overall MME prescribed comparing pre-MassPAT and post-MassPAT data [tonsillectomy: 635.9 +/- 175.6 vs 463.3 +/- 177.7 (p < 0.0001), parotidectomy: 250.4 +/- 71.33 vs 169.8 +/- 79.26 (p < 0.0001), thyroidectomy: 186.2 +/- 81.14 vs 118.3 +/- 88.79 (p < 0.0001), direct laryngoscopy with biopsy: 308.3 +/- 246.9 vs 308.3 +/- 246.9 (p = 0.0201)]. There was also a significant association between length of opioid prescription (days) and implementation of MassPAT, but there was no significant difference in the percent of patients requiring refills preMassPAT and post-MassPAT. Conclusion: This study demonstrates that prescribers have been able to significantly decrease the amount of opioids prescribed for tonsillectomy, parotidectomy, thyroidectomy, and direct laryngoscopy and biopsy and patients have not required additional opioid refills.
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