Normal view MARC view ISBD view

Trends in Opioid Analgesic Use in Encounters Involving Physician Trainees in U.S. Emergency Departments.

MedStar author(s):

Citation: Pain Medicine. 17(12):2389-2396, 2016 DecPMID: 28025373Institution: MedStar Washington Hospital CenterDepartment: Emergency MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Analgesics, Opioid/tu [Therapeutic Use] | *Emergency Service, Hospital/sn [Statistics & Numerical Data] | *Practice Patterns, Physicians'/sn [Statistics & Numerical Data] | Health Care Surveys | Humans | Internship and Residency | United StatesYear: 2016 ISSN:

1526-2375

Name of journal: Pain medicine (Malden, Mass.)Abstract: BACKGROUND: Opioid analgesic use has increased dramatically in emergency departments (EDs), but the relative contribution of physician trainees has not been explored. We assessed trends in opioid utilization focusing on ED encounters where a physician trainee was involved.CONCLUSION: Opioid utilization patterns for visits involving trainees reflect similar trends in attending practice, and highlights the more liberal opioid prescribing climate over time.Copyright c 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: [email protected]: We studied ED visits from the National Hospital Ambulatory Medical Care Survey, 2001-2011. Adult ED visits in which an opioid was administered in the ED or prescribed at discharge were stratified by whether or not there was trainee involvement. Trends in use over time for five common opioids (codeine, hydrocodone, hydromorphone, morphine, oxycodone) were tested using survey-weighted logistic regression.RESULTS: From 2001-02 to 2009-11, the proportion of ED visits where an opioid analgesic was used increased 31.5% from 21.9% (95% CI: 20.3-23.6) of visits to 28.8% (95% CI: 27.5-30.1). Trainee involvement in ED visits was stable, with 9.3% (95% CI: 7.7-11.3) seen by a trainee in 2001-02 vs. 10.2% (95% CI: 8.1-12.7) in 2010-11. Opioid use in visits with trainee involvement did not change significantly over time relative to visits without a trainee (increase of 36.8% compared to 31.2% without trainees, P=0.652). Trends in opioid utilization for trainee visits paralleled non-trainee visits. Hydromorphone had the greatest relative increase in use for all providers. Adjusted for patient- and hospital-level factors, the probability of receiving opioids when a trainee was involved increased to a greater extent than among non-trainee visits (30.9% vs. 24.0%).All authors: Mazer-Amirshahi M, Mullins PM, Nelson LS, Perrone J, Pines JM, Sun CFiscal year: FY2016Digital Object Identifier:

https://dx.doi.org/10.1093/pm/pnw048

Date added to catalog: 2017-05-24

Holdings ( 1 )
Title notes ( 6 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	28025373	Available		28025373

BACKGROUND: Opioid analgesic use has increased dramatically in emergency departments (EDs), but the relative contribution of physician trainees has not been explored. We assessed trends in opioid utilization focusing on ED encounters where a physician trainee was involved.

CONCLUSION: Opioid utilization patterns for visits involving trainees reflect similar trends in attending practice, and highlights the more liberal opioid prescribing climate over time.

METHODS: We studied ED visits from the National Hospital Ambulatory Medical Care Survey, 2001-2011. Adult ED visits in which an opioid was administered in the ED or prescribed at discharge were stratified by whether or not there was trainee involvement. Trends in use over time for five common opioids (codeine, hydrocodone, hydromorphone, morphine, oxycodone) were tested using survey-weighted logistic regression.

RESULTS: From 2001-02 to 2009-11, the proportion of ED visits where an opioid analgesic was used increased 31.5% from 21.9% (95% CI: 20.3-23.6) of visits to 28.8% (95% CI: 27.5-30.1). Trainee involvement in ED visits was stable, with 9.3% (95% CI: 7.7-11.3) seen by a trainee in 2001-02 vs. 10.2% (95% CI: 8.1-12.7) in 2010-11. Opioid use in visits with trainee involvement did not change significantly over time relative to visits without a trainee (increase of 36.8% compared to 31.2% without trainees, P=0.652). Trends in opioid utilization for trainee visits paralleled non-trainee visits. Hydromorphone had the greatest relative increase in use for all providers. Adjusted for patient- and hospital-level factors, the probability of receiving opioids when a trainee was involved increased to a greater extent than among non-trainee visits (30.9% vs. 24.0%).

English