Evaluating Fentanyl Prescriptions in Emergency Rooms
Author Information
Author(s): Gary Punjabi, Elena RamÃrez
Primary Institution: La Paz University Hospital-IdiPAZ, School of Medicine, Autonomous University of Madrid, Spain
Hypothesis
Does hospitalization lead to modifications in prescribing practices and improved appropriateness of TIRF treatment for patients initially receiving it in the emergency room?
Conclusion
Inappropriate TIRF prescriptions were common, but hospitalization improved appropriateness among survivors, especially in 2022.
Supporting Evidence
- Only 32.9% of patients met the appropriateness criteria for TIRF use pre-hospitalization.
- Appropriateness improved to 42.5% at discharge among surviving patients.
- 68.75% of patients with cancer received low-dose opioid therapy at discharge.
- 36.8% of patients over 80 years old were co-prescribed benzodiazepines.
- Prior TIRF prescriptions remained stable from pre-hospitalization to discharge.
Takeaway
Doctors need to be careful when prescribing a strong pain medicine called fentanyl, especially for patients who might not need it. This study shows that while some patients got better care in the hospital, many still didn't get the right medicine.
Methodology
This retrospective observational study analyzed TIRF prescriptions in an emergency room over two years, comparing appropriateness before and after hospitalization.
Potential Biases
Potential underreporting of adverse effects and reliance on medical records may introduce bias.
Limitations
The study only analyzed prescriptions, not actual dispensed medications, and was limited to a single center, which may affect generalizability.
Participant Demographics
77.9% of participants had a cancer diagnosis, with a mean age of approximately 69 years.
Statistical Information
P-Value
0.002
Statistical Significance
p = 0.002
Digital Object Identifier (DOI)
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