Evaluation of a hospital-based opioid stewardship program on high-risk opioid prescribing in a Canadian setting: an interrupted time series analysis
Guardat en:
| Publicat a: | Addiction Science & Clinical Practice vol. 20 (2025), p. 1 |
|---|---|
| Autor principal: | |
| Altres autors: | , , , , , , , |
| Publicat: |
Springer Nature B.V.
|
| Matèries: | |
| Accés en línia: | Citation/Abstract Full Text Full Text - PDF |
| Etiquetes: |
Sense etiquetes, Sigues el primer a etiquetar aquest registre!
|
MARC
| LEADER | 00000nab a2200000uu 4500 | ||
|---|---|---|---|
| 001 | 3216563944 | ||
| 003 | UK-CbPIL | ||
| 022 | |a 1940-0632 | ||
| 022 | |a 1940-0640 | ||
| 022 | |a 1930-4307 | ||
| 022 | |a 1930-4315 | ||
| 024 | 7 | |a 10.1186/s13722-025-00574-x |2 doi | |
| 035 | |a 3216563944 | ||
| 045 | 2 | |b d20250101 |b d20251231 | |
| 084 | |a 264929 |2 nlm | ||
| 100 | 1 | |a Ti, Lianping | |
| 245 | 1 | |a Evaluation of a hospital-based opioid stewardship program on high-risk opioid prescribing in a Canadian setting: an interrupted time series analysis | |
| 260 | |b Springer Nature B.V. |c 2025 | ||
| 513 | |a Journal Article | ||
| 520 | 3 | |a BackgroundHigh-risk opioid prescribing (e.g., high daily dose opioids, concurrent opioid-sedatives) is prevalent in hospitals and linked to adverse outcomes. Opioid stewardship programs (OSP) have the potential to reduce high-risk opioid prescribing through audit-and-feedback recommendations.MethodsWe evaluated an audit-and-feedback based OSP implemented in January 2020 at a Vancouver, Canada tertiary care hospital using interrupted time series analysis. An electronic health record (EHR) system with computerized provider order entry (CPOE) was simultaneously operationalized. The main outcome was: any high-risk opioid prescribing (based on 10 evidence-based indicators), including high daily dose of morphine milligram equivalent (MME) prescribing (> 90MME), long opioid prescription duration (> 5 days post-admission), and concurrent opioid-sedative prescribing.ResultsBetween January 2018 and March 2022, 5,477 active opioid patient encounters were included. While no significant change occurred in overall high-risk opioid prescribing post-OSP (p > 0.05), a significant reduction was seen in the level of high daily dose of MME prescriptions (estimate: -0.044; 95% confidence interval [CI]: -0.082, -0.006). Conversely, the trend in long opioid duration increased (estimate: 0.006; 95%CI: 0.000, 0.011), likely due to the removal of automatic stop dates with the implementation of the EHR with CPOE. Post-OSP intervention, we initially saw an acute increase in concurrent opioid-sedative prescriptions (estimate: 0.013; 95%CI: 0.005, 0.020). A benzodiazepine ordering intervention implemented in May 2021 reversed this trend, reducing both the level (estimate: 0.874; 95%CI: 0.374, 1.375) and slope (estimate: -0.022, 95%CI: -0.034, -0.011) of concurrent prescriptions.ConclusionThe implementation of a new EHR concordant with that of the OSP may have impacted our study’s results. While our research suggests the OSP reduced high-dose opioid prescribing, other indicators impacted by the EHR system did not benefit as highly from the OSP. Nevertheless, the OSP proved able to rapidly respond to unintended consequences by introducing interventions to reduce concurrent opioid and sedative prescribing. | |
| 651 | 4 | |a United States--US | |
| 653 | |a Prescriptions | ||
| 653 | |a Risk reduction | ||
| 653 | |a Emergency medical care | ||
| 653 | |a Intervention | ||
| 653 | |a Pain management | ||
| 653 | |a Sedative drugs | ||
| 653 | |a Time series | ||
| 653 | |a Opioids | ||
| 653 | |a Prescribing | ||
| 653 | |a Drug stores | ||
| 653 | |a Anesthesia | ||
| 653 | |a Benzodiazepines | ||
| 653 | |a Learning activities | ||
| 653 | |a Feedback | ||
| 653 | |a Prescription drugs | ||
| 653 | |a Drug dosages | ||
| 653 | |a Narcotics | ||
| 653 | |a Clinical practice guidelines | ||
| 653 | |a Electronic health records | ||
| 653 | |a Patient safety | ||
| 653 | |a Medicine | ||
| 653 | |a Addictions | ||
| 653 | |a Audits | ||
| 653 | |a Hospitals | ||
| 653 | |a High risk | ||
| 653 | |a Palliative care | ||
| 653 | |a Morphine | ||
| 653 | |a Computerization | ||
| 653 | |a Hospitalization | ||
| 653 | |a Critical care | ||
| 653 | |a Management | ||
| 653 | |a Medical records | ||
| 653 | |a Risk | ||
| 653 | |a Tranquilizing drugs | ||
| 653 | |a Health services | ||
| 653 | |a Sedatives | ||
| 700 | 1 | |a Mihic, Tamara | |
| 700 | 1 | |a Beauchesne, Arielle | |
| 700 | 1 | |a Cameron, Grant | |
| 700 | 1 | |a Frank, Ingrid | |
| 700 | 1 | |a Haji, Nooreen | |
| 700 | 1 | |a Legal, Michael | |
| 700 | 1 | |a Shalansky, Stephen | |
| 700 | 1 | |a Nolan, Seonaid | |
| 773 | 0 | |t Addiction Science & Clinical Practice |g vol. 20 (2025), p. 1 | |
| 786 | 0 | |d ProQuest |t Health & Medical Collection | |
| 856 | 4 | 1 | |3 Citation/Abstract |u https://www.proquest.com/docview/3216563944/abstract/embedded/6A8EOT78XXH2IG52?source=fedsrch |
| 856 | 4 | 0 | |3 Full Text |u https://www.proquest.com/docview/3216563944/fulltext/embedded/6A8EOT78XXH2IG52?source=fedsrch |
| 856 | 4 | 0 | |3 Full Text - PDF |u https://www.proquest.com/docview/3216563944/fulltextPDF/embedded/6A8EOT78XXH2IG52?source=fedsrch |