Better Guidance Needed for Acute Pain Management
Researchers from the Perelman School of Medicine at the University of Pennsylvania are voicing concern over disparate opioid prescribing patterns for minor injuries and the contribution of these to the public health crisis of opioid abuse and overdose death. In an examination of patient records of emergency department visits for ankle sprain, the team found prescriptions issued for anywhere from 15 to 40 doses, and that patients who received 30 or more pills were 2 times as likely to fill an additional opioid prescription, compared to patients whose first prescriptions were for 15 pills. The study findings were scheduled for presentation last week at the Society for Academic Emergency Medicine annual meeting in Orlando.
The study examined over 53,000 patient records of emergency department visits for ankle sprain between 2011 and 2012. While 1.6% of patients in Delaware were treated with opioids, 16% of Mississippi patients received opioid prescriptions. Although the median prescription quantity was 20 pills, 5% of prescriptions were for 60 doses or more. Lead author M. Kit Delgado, MD, commented, “The substantial variation in prescribing patterns of such extremely addictive medications for minor injuries results in many thousands of pills entering the community, and places patients at an increased risk of continued use and potentially addiction.” A further concern raised by the study findings is the use of opioid therapy for minor injury in the first place, according to the authors. Better guidance on patient selection for opioid treatment in the emergency department is needed. The management of acute pain will once again be part of the curriculum at PAINWeek 2017, September 5-9 in Las Vegas.
Read more about the research conclusions and recommendations.
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