scholarly journals Patient Knowledge of Opioid Usage and Side Effects Prior to Surgery

2021 ◽  
Vol 5 (0) ◽  
Author(s):  
Anthony Duncan ◽  
Mitchell Alameddine ◽  
Timothy Baerg ◽  
Nonie Arora ◽  
Hannah Cottrell ◽  
...  
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Elective Surgery ◽  
Tertiary Care ◽  
Care Facility ◽  
The United States ◽  
Prescription Opioid ◽  
Prescription Opioids ◽  
Opioid Use ◽  
Tertiary Care Facility

BackgroundGiven the increasing morbidity and mortality related to prescription opioids in the United States, it is critical for patients to understand the risks and proper usage of opioid analgesics.MethodsWe surveyed 166 patients undergoing elective surgery at a single tertiary care facility preoperatively. We queried patients regarding aspects of prescription opioid use, side effects and adverse effects, and storage and disposal behaviors.ResultsOverall knowledge regarding prescription opioids was high (mean score = 8.05/12, range 0–12). The average number of questions answered correctly was not significantly different based on opioid use at the time of the survey (65% vs 67.5%, p = 0.52). Characteristics significantly associated with higher knowledge included young age (p = 0.01), female gender (p < 0.01), and white race (p = 0.01).ConclusionsPatient knowledge regarding prescription opioids is high preceding surgery, but gaps remain regarding side effects and adverse effects. Knowledge did not differ by prior or current opioid use, and these findings may help target important knowledge gaps to improve patient education regarding opioids during the preoperative period.

Prescription Opioid Exposures Among Children and Adolescents in the United States: 2000–2015

2018 ◽  
pp. 5-15
Author(s):  
Jakob D. Allen ◽  
Marcel J. Casavant ◽  
Henry A. Spiller ◽  
Thiphalak Chounthirath ◽  
Nichole L. Hodges ◽  
...  
Keyword(s):  
United States ◽  
Children And Adolescents ◽  
Care Facility ◽  
Health Care Facility ◽  
The United States ◽  
Annual Number ◽  
Prescription Opioid ◽  
Prescription Opioids ◽  
Medical Outcomes ◽  
National Poison Data System

OBJECTIVES This study analyzes and compares exposures to prescription opioids among children and adolescents younger than 20 years old in the United States. METHODS Data from the National Poison Data System for 2000 through 2015 were analyzed. RESULTS Poison control centers received reports of 188 468 prescription opioid exposures among children aged <20 years old from 2000 through 2015. The annual number and rate of exposures increased early in the study period, but declined after 2009, except for buprenorphine exposures, which increased during the last 3 study years. Hydrocodone accounted for the largest proportion of exposures (28.7%), and 47.1% of children exposed to buprenorphine were admitted to a health care facility (HCF). The odds of being admitted to an HCF were higher for teenagers than for children aged 0 to 5 years (odds ratio [OR]: 2.86; 95% confidence interval [CI]: 2.78–2.94) or children aged 6 to 12 years (OR: 6.62; 95% CI: 6.06–7.02). Teenagers also had greater odds of serious medical outcomes than did children aged 0 to 5 years (OR: 3.03; 95% CI: 2.92–3.15) or children aged 6 to 12 years (OR: 4.59; 95% CI: 4.21–5.00). The rate of prescription opioid–related suspected suicides among teenagers increased by 52.7% during the study period. CONCLUSIONS Prescription opioid–related HCF admissions and serious medical outcomes were higher among teenagers. Contrary to trends for other prescription opioids, exposures to buprenorphine have increased in recent years; children aged 0 to 5 years accounted for almost 90% of buprenorphine exposures. These findings indicate that additional prevention efforts are needed.

Patterns of heroin use following index prescription opioid exposure

2020 ◽  
Vol 16 (1) ◽  
pp. 49-57
Author(s):  
Scott M. Sexton, PharmD ◽  
Christopher M. Herndon, PharmD, BCACP ◽  
Jordan D. Sinclair, PharmD
Keyword(s):  
Primary Care Physicians ◽  
Outcome Measure ◽  
The United States ◽  
Prescription Opioid ◽  
Prescription Opioids ◽  
Opioid Use ◽  
Cross Sectional ◽  
Heroin Use ◽  
Chronic Pain Condition ◽  
Prescription Opioid Use

Objective: This study examined the means of obtainment, indication, and prescriber of an index opioid in self-reporting heroin users.Design: Cross-sectional, observational study.Setting: A survey was submitted by participants in the United States with current or past heroin use.Participants: Three hundred twenty-three participants greater than 18 years of age completed the survey.Main outcome measure: Participants were surveyed regarding prescription opioid use prior to heroin initiation and specifically how they were obtained. Surveys were comprehensive in nature, divulging information including which opioid(s) was/were used, how they were obtained, by which prescriber (if prescribed), and if there was a diagnosis for chronic pain.Results: Roughly 47 percent of participants reported using prescription opioids prior to heroin. The most commonly used prescription opioid prior to heroin initiation was oxycodone (92.5 percent). The most common acquisition of opioids was through the prescribing of a physician, which occurred in roughly 63 percent of cases. These prescriptions were obtained most often from primary care physicians and emergency departments. Only 34 percent of participants reported being diagnosed with a chronic pain condition prior to using heroin.Conclusions: This study further supports the role that prescription opioids play in the transition to heroin use. It suggests that oxycodone is the most common prescription opioid used prior to heroin initiation. Additionally, it reports descriptive information as to how and where prescription opioids are obtained. 

scholarly journals Genomic Characterization of Tissue Invasive Klebsiella pneumoniae Complex in a Hospital System with a Focus on Species Distribution and Hypervirulence

2020 ◽  
Author(s):  
Jessica Bohrhunter ◽  
Samantha Taffner ◽  
Jun Wang ◽  
Dwight Hardy ◽  
Nicole Pecora
Keyword(s):  
New York ◽  
Klebsiella Pneumoniae ◽  
Tertiary Care ◽  
Care Facility ◽  
Opportunistic Pathogen ◽  
The United States ◽  
Sensu Stricto ◽  
Pathogenic Potential ◽  
Hospital System ◽  
Tertiary Care Facility

AbstractKlebsiella pneumoniae is an opportunistic pathogen known for multidrug resistance. Current research indicates that K. pneumoniae is a complex of closely related organisms (K. pneumoniae sensu stricto, K. quasipneumoniae, K. variicola, K. quasivariicola, and K. africana). Additionally, some strains of K. pneumoniae sensu stricto, known as hypervirulent K. pneumoniae (hvKp), cause severe infections in healthy members of the community. There is a paucity of research into rates of hvKp in the United States, the distribution of K. pneumoniae complex members in clinical specimens, and the pathogenic potential of complex members other than K. pneumoniae sensu stricto. We assessed the rates of hvKp and K. pneumoniae complex members in our 886 bed tertiary care facility in Rochester, New York. We performed whole genome sequencing on all inpatient, sterile-source isolates identified by routine culture work-up as K. pneumoniae from October 2018 – October 2019 (n=35). We additionally sequenced all K. pneumoniae liver isolates available in our collection, spanning 2017-2019 (n=18). In the yearlong collection of K. pneumoniae complex isolates, we found that 92.4% were K. pneumoniae sensu stricto (n=32), 5.7% were K. quasipneumoniae (n=2), and 2.9% were K. variicola (n=1). Five hvKp isolates were found, representing 5.7% (n=2) of K. pneumoniae sensu stricto isolates in the yearlong collection and 27.7% (n=5) of the liver isolate collection. All hvKp isolates were from liver; 60% were not associated with prior international residence.

Attitudes and self-reported practices of orthopedic providers regarding prescription opioid use

2019 ◽  
Vol 15 (3) ◽  
pp. 213-228 ◽  
Author(s):  
Deepa Kattail, MD, MHS ◽  
Aaron Hsu, MHS ◽  
Myron Yaster, MD ◽  
Paul T. Vozzo, BA ◽  
Shuna Gao, BA ◽  
...  
Keyword(s):  
Online Survey ◽  
Tertiary Care ◽  
Inverse Correlation ◽  
The United States ◽  
Prescribing Patterns ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Prescribing Practices ◽  
Prescription Drug Monitoring Programs ◽  
History Of

Objective: Orthopedic surgeons are the third-highest opioid prescribers in the United States. Their prescribing practices can significantly affect the quantity of unconsumed opioids available to fuel the current opioid epidemic. The aim of this study was to identify prescribing patterns and knowledge gaps among orthopedic providers for targeted future interventions and investigation.Design: An online survey describing six common orthopedic surgical scenarios was distributed electronically to determine opioid type and quantity prescribed at discharge, medication disposal instructions, and the use of prescription drug monitoring programs (PDMPs) in the prescription writing process.Setting: Tertiary care academic hospitals.Participants: Orthopedic physicians and mid-level providers practicing at Johns Hopkins Medical Institutions and University of Maryland Medical System. Of 179 providers contacted, 127 (71 percent) completed the survey.Main outcome measures: Quantity of opioid prescribed, utilization of PDMPs, and provision of opioid disposal instructions.Results: While statistically significant associations were identified between quantity of opioid prescribed and surgical procedure, for five of six scenarios 95 percent of respondents recommended prescribing 55 oxycodone 5 mg pill equivalents (PEs) at discharge. An inverse correlation between years of clinical practice and mean number of PEs prescribed was observed. Fewer than 40 percent of respondents modified prescribing when presented with clinically relevant changes in scenario (history of depression or drug abuse). Over 60 percent of respondents do not use PDMPs, and 79 percent do not provide opioid disposal instructions.Conclusions: Our findings support a need for targeted education to mitigate the role of orthopedic postoperative prescribing practices on the current opioid abuse epidemic.

scholarly journals Declines and pronounced regional disparities in prescription opioid use in the United States

2021 ◽  
Author(s):  
Joshua D. Madera ◽  
Amanda E. Ruffino ◽  
Adriana Feliz ◽  
Kenneth L. McCall ◽  
Brian J. Piper
Keyword(s):  
United States ◽  
Regional Differences ◽  
The United States ◽  
Prescription Opioid ◽  
Prescription Opioids ◽  
Opioid Use ◽  
The Past ◽  
The Us ◽  
Per Capita ◽  
Prescription Opioid Use

AbstractBackgroundThe United States (US) opioid epidemic is a persistent and pervasive public health emergency as it continues to claim the lives of Americans through addiction and overdose. There have been sustained efforts to reverse this iatrogenic crisis over the past decade. This study analyzed the changes in prescription opioid distribution for pain and identified regional differences between 2010 and 2019.Methods and FindingsOpioid production data was obtained from the DEA’s annual production quotas. Total opioid production has decreased 41.5% from 2013 (87.6 morphine mg equivalent metric tons) to 2019 (51.3). Opioid distribution from 2010 to 2019 was collected for ten prescription opioids (codeine, fentanyl, hydrocodone, hydromorphone, meperidine, methadone, morphine, oxycodone, oxymorphone, and tapentadol) from the US Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System. Regional variance was expressed as the ratio of the 95th to 5th percentiles of opioid distribution per state, corrected for population. The peak year for all ten prescription opioids was identified, individually, as between 2010 and 2013, except for codeine (2015). There was a 51.96% overall decrease in opioid distribution per capita with the largest decrease in Florida (−61.61%) and smallest in Texas (−18.64%). The largest quantities of opioid distribution were observed in Tennessee (520.70 morphine mg equivalent or MME per person) and Delaware (251.45) in 2011 and 2019. The smallest was Nebraska (153.39) in 2011 and Minnesota (90.49) in 2019. The highest to lowest state ratio of total opioid use, corrected for population, was sizable in 2011 (5.25) and 2019 (2.78). Similarly, the mean 95th/5th ratio was relatively stable in from 2011 (4.78 +0.70) and 2019 (5.64+0.98). The 95th/5th ratio in 2019 was greatest for methadone (10.23) and oxymorphone (10.09) and smallest for morphine (2.20) and fentanyl (2.12). Southern states (e.g MS, TN, AL, AK, DE, and NC) had the highest per capita distribution for eight of the ten opioids in 2019. The strength of the correlation between per capita hydrocodone and codeine, and hydromorphone and codeine increased significantly from 2011 to 2019ConclusionsThis study found a decline in total production and distribution for ten prescription opioids during the last half-decade. However, distribution was non-homogeneous at a state level. Analysis of regional differences revealed a three-fold difference in the 95th:5th percentile ratio between states which was unchanged over the past decade. Future research focused on identifying factors contributing to the observed regional variability could prove valuable to understanding, and potentially remediating, the pronounced disparities in prescription opioid use in the US.

Assessing Acute St-Elevation Myocardial Infarction With Prognostic Significance Of The Hyponatramia

2020 ◽  
Vol 11 (3) ◽  
pp. 3251-3260
Author(s):  
Makrand B Mane
Keyword(s):  
Myocardial Infarction ◽  
Ejection Fraction ◽  
Tertiary Care ◽  
Prognostic Significance ◽  
Care Facility ◽  
Early Death ◽  
Public Health Issue ◽  
Care Hospital ◽  
Tertiary Care Facility ◽  
Significant Public Health

Acute Myocardial Infarction (AMI) has become a significant public health issue in developed and developing nations, following extensive diagnostic and management research over recent decades. The study intended to research the prognostic values of inexplicable Hyponatremia in patients with severe STelevation of myocardial infarction, in 100 consecutive patients admitted to Tertiary care hospital. In the analysis, identified patients on admission were diagnosed with or produced Hyponatremia within 72 hours—a lower ejection fraction than those with usual amounts of sodium. The research aimed to evaluate the prognosis significance of Hyponatremia for the estimation of early death in acute ST-elevated myocardial infarction. One hundred straight patients admitted in the Coronary Centre Tertiary Care Facility with severe STelevated myocardial infarction were studied. The data of the study on various risk factors in association with the development of Hyponatremia like as age, sex, use of tobacco, diabetes, hypertension, ejection fraction etc. were analyzed. Thus, the researchers reported that in patients diagnosed with severe ST section escalation, Hyponatremia showed the initial emergence of hyponatremia myocardial infarctions. This condition correlates with the severity of LV dysfunction (in term of LVEF) and can be considered as an individual early death indicator as well as a prediction exacerbates with hyponatremia frequency.

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