دورية أكاديمية
Candidate metrics for evaluating the impact of prescriber education on the safe use of extended-release/long-acting (ER/LA) opioid analgesics.
| العنوان: | Candidate metrics for evaluating the impact of prescriber education on the safe use of extended-release/long-acting (ER/LA) opioid analgesics. |
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| المؤلفون: | Willy ME; Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA., Graham DJ, Racoosin JA, Gill R, Kropp GF, Young J, Yang J, Choi J, MaCurdy TE, Worrall C, Kelman JA |
| المصدر: | Pain medicine (Malden, Mass.) [Pain Med] 2014 Sep; Vol. 15 (9), pp. 1558-68. Date of Electronic Publication: 2014 May 15. |
| نوع المنشور: | Journal Article; Research Support, U.S. Gov't, P.H.S. |
| اللغة: | English |
| بيانات الدورية: | Publisher: published by Oxford University Press on behalf of the American Academy of Pain Medicine Country of Publication: England NLM ID: 100894201 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1526-4637 (Electronic) Linking ISSN: 15262375 NLM ISO Abbreviation: Pain Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2016- : Oxford, England : published by Oxford University Press on behalf of the American Academy of Pain Medicine Original Publication: Malden, MA : Blackwell Science, Inc., c2000- |
| مواضيع طبية MeSH: | Education, Medical, Continuing*, Drug Prescriptions/*statistics & numerical data , Narcotics/*administration & dosage , Oxycodone/*administration & dosage , Practice Patterns, Physicians'/*statistics & numerical data, Adult ; Aged ; Aged, 80 and over ; Chronic Pain/drug therapy ; Chronic Pain/epidemiology ; Comorbidity ; Delayed-Action Preparations ; Dose-Response Relationship, Drug ; Drug Monitoring/statistics & numerical data ; Drug Tolerance ; Female ; Humans ; Inappropriate Prescribing/prevention & control ; Inappropriate Prescribing/statistics & numerical data ; Kidney Failure, Chronic/epidemiology ; Male ; Medicare/statistics & numerical data ; Middle Aged ; Narcotics/analysis ; Narcotics/therapeutic use ; Oxycodone/analysis ; Oxycodone/therapeutic use ; Practice Guidelines as Topic ; United States |
| مستخلص: | Objective: The objective of this study was to develop metrics to assess opioid prescribing behavior as part of the evaluation of the Extended-Release/Long-Acting (ER/LA) Opioid Analgesic Risk Evaluation and Mitigation Strategies (REMS). Design: Candidate metrics were selected using published guidelines, examined using sensitivity analyses, and applied to cross-sectional rolling cohorts of Medicare patients prescribed with extended-release oxycodone (ERO) between July 2, 2006 and July 1, 2011. Potential metrics included prescribing opioid-tolerant-only ER/LA opioid analgesics to non-opioid-tolerant patients, prescribing early fills to patients, and ordering drug screens. Results: Proposed definitions for opioid tolerance were seven continuous days of opioid usage of at least 30 mg oxycodone equivalents, within the 7 days (primary) or 30 days (secondary) prior to first opioid-tolerant-only ERO prescription. Forty-four percent of opioid-tolerant-only ERO episodes met the primary opioid tolerance definition; 56% met the secondary definition. Fills were deemed "early" if a prescription was filled before 70% (primary) or 50% (secondary) of the prior prescription's days' supply was to be consumed. Five percent (primary) and 2% (secondary) of episodes had more than or equal to two early fills during treatment. At least one drug screen was billed in 14% of episodes. Stratified analyses indicated that older patients were less likely to be opioid tolerant at the time of the first opioid-tolerant-only ERO prescription. Conclusions: Investigators propose three metrics to monitor changes in prescribing behaviors for opioid analgesics that might be used to evaluate the ER/LA Opioid Analgesics REMS. Low frequencies of patients, particularly those >85 years, were likely to be opioid tolerant prior to receiving prescriptions for opioid-tolerant-only ERO. (Wiley Periodicals, Inc.) |
| فهرسة مساهمة: | Keywords: Evaluation; Metrics; Opioids; REMS |
| المشرفين على المادة: | 0 (Delayed-Action Preparations) 0 (Narcotics) CD35PMG570 (Oxycodone) |
| تواريخ الأحداث: | Date Created: 20140516 Date Completed: 20150528 Latest Revision: 20181202 |
| رمز التحديث: | 20240829 |
| DOI: | 10.1111/pme.12459 |
| PMID: | 24828968 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1526-4637 |
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| DOI: | 10.1111/pme.12459 |