In:
Journal of Pharmacy Practice, SAGE Publications
Abstract:
Opioid overdose deaths have increased over the last two decades, despite efforts to reduce prescribing. This study aimed to determine if a hospital-wide Alternatives to Opiates (ALTO SM ) program reduced opioid prescribing in hospital and upon discharge after trauma. Objectives The primary outcome was incidence of opioid prescribing at hospital discharge Pre- and Post-ALTO. Secondary outcomes were the percent of patients with in-hospital opioid, non-opioid and multimodal analgesia, and hospital and intensive care unit (ICU) length of stay (LOS). Methods This is a single-center, retrospective analysis of patients 〉 / = 18 years old admitted for 〉 24 hours with the primary diagnosis of traumatic injury between August 2018 - October 2019. Patients with alcohol or polysubstance abuse, chronic opioid use, or in-hospital mortality were excluded. Results A total of 703 patients were included, 471 in Pre-ALTO and 232 in Post-ALTO groups. The mean age was 59 ± 22 years and most were male (58.7%). Mean initial Injury Severity Score (ISS) was 9.1 ± 7.7. Opioid prescribing at hospital discharge occurred more in the Post-ALTO group (132/332, 39.4% vs 90/203, 43.8%; P = .1237). Most patients were prescribed in-hospital opioid (332/471, 70.4% vs 203/232, 87.5%, P 〈 .0001) and non-opioid (441/471, 93.6% vs 229/232, 98.7%; P = .0027) analgesics, or multimodal analgesia (397/471, 84.3% vs 203/232, 87.5%; P = .2591). Median hospital and ICU LOS were also similar between groups [5 (3-9) vs 4(3-7), P = .3427] and ICU [2(0-4) vs 3(2-5), P = .3461] . Conclusion Opioids remain mainstay for trauma-related pain treatment. ALTO SM was not associated with less in-hospital or discharge opioid prescribing.
Type of Medium:
Online Resource
ISSN:
0897-1900
,
1531-1937
DOI:
10.1177/08971900231189353
Language:
English
Publisher:
SAGE Publications
Publication Date:
2023
detail.hit.zdb_id:
2131091-9
SSG:
15,3
Bookmarklink