2010年至2017年,DENTAC与德克萨斯州胡德堡卡尔·r·达纳尔陆军医疗中心选定部门阿片类药物处方模式趋势的比较

Angelica Bedoya-Astrauskas
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引用次数: 0

摘要

背景:目的:本观察性回顾性队列研究的目的是比较2010年1月1日至2017年12月31日期间,德克萨斯州胡德堡卡尔·r·达纳尔陆军医疗中心(Carl R. Darnall Army Medical Center)牙科健康活动(DENTAC)、妇产科(OBGYN)、急诊室(ER)和家庭医学部门的阿片类药物处方模式趋势。此外,作为次要结果,将在同一时间框架内探讨阿片类药物的处方类型。方法:通过药学数据交易服务(PDTS)收集的报告进行观察性回顾性队列纵向档案医疗图表回顾。数据分析采用重复测量方差分析(ANOVA)进行,以便在重复观察的基础上比较多个变量的平均值。采用混合因素模型,对各部门内部变量(学科内效应检验)和部门之间变量(学科间效应检验)进行分析。结果:统计分析显示,在DENTAC和OBGYN部门分配的药片数量没有显著差异。据报道,急诊科的处方模式适度减少,家庭医学系的处方模式急剧减少。8年间,各科室的患者数量和处方数量无显著差异。统计分析显示,家庭医学和急诊科与DENTAC和OBGYN科相比有显著差异。从2010年到2016年,家庭医学和急诊科的阿片类药物处方大幅减少。从2010年到2016年,DENTAC和OBGYN部门呈现恒定的线性因子,表明分配的药片数量变化很小,并且显示2017年分配的药片数量略有减少。2010年1月1日至2017年12月31日,四个科室最常见的阿片类药物是硫酸吗啡和盐酸氢吗啡酮。结论:在本研究中,DENTAC和OBGYN的阿片类药物数量和处方数量与家庭医学和急诊室相比没有明显减少。总体而言,2010年1月1日至2017年12月31日,德克萨斯州胡德堡Carl R. Darnall陆军医疗中心的家庭医学部门的阿片类药物处方模式变化最为剧烈。四个部门在同一时期内最常见的阿片类药物处方类型以吗啡和氢吗啡酮成分为特征。
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Comparison of Opioid Prescription Pattern Trends amongst DENTAC and Selected Departments of the Carl R. Darnall Army Medical Center, Fort Hood, TX, from 2010 to 2017.

Background: Purpose: The purpose of this Observational Retrospective Cohort is to compare opioid prescription pattern trends from 1 January 2010 to 31 December 2017 amongst the Dental Health Activity (DENTAC), Obstetrics/Gynecology (OBGYN), Emergency Room (ER), and Family Medicine departments assigned to the Carl R. Darnall Army Medical Center, Fort Hood, TX. In addition, as a secondary outcome, the type of opioids prescribed will be explored during the same time frame.

Methods: An Observational Retrospective Cohort Longitudinal Archival Medical Chart Review was executed by a report collection from the Pharmacy Data Transaction Service (PDTS). Data analysis was developed with a Repeated Measures Analysis of Variance (ANOVA) in order to compare means across multiple variables based on repeated observations. By utilizing a mix of factors model, variables within each department (Test of Within-Subjects Effects) and between departments (Test of Between-Subjects Effects) were analyzed.

Results: The statistical analysis demonstrated no significant differences within the number of pills dispensed from the DENTAC and OBGYN departments. A moderate decrease in prescription patterns at the Emergency Department and extreme decrease at the Family Medicine Department was reported. No significant differences between the number of patients and number of prescriptions dispensed were found within each department over the 8-year period. The statistical analysis showed significant differences between the Family Medicine and Emergency departments in comparison with the DENTAC and OBGYN departments. From 2010-2016, Family Medicine and Emergency Departments demonstrated a substantial decrease in opioid prescribing. The DENTAC and OBGYN departments showed a constant linear factor from 2010 to 2016 indicating minimal changes in number of pills dispensed and revealing a small decrease of pills dispensed during 2017. The most common types of opioid medication prescribed in the four departments from 1 JAN 2010 to 31 DEC 2017 were Morphine Sulfate and Hydromorphone HCL.

Conclusions: In this study, the DENTAC AND OBGYN departments did not show a significant decrease in number of opioid pills and number of prescriptions dispensed compared to the Family Medicine and ER departments. Overall, the Family Medicine department showed the most drastic change in opioid prescription patterns from 1 JAN 2010 to 31 DEC 2017 at the Carl R. Darnall Army Medical Center, Fort Hood, TX. The most common types of opioid medication prescribed in the same period of time within the four departments were characterized by morphine and hydromorphone components.

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