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Auteur Reed W. R. Bratches
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Ajouter le résultat dans votre panier Affiner la rechercheAmerican Podiatric Surgeons’ Postoperative Multimodal Analgesic-Prescribing Practice: A 2019–2020 National Survey / Brandon M. Brooks in Journal of the American Podiatric Medical Association, vol. 113, 04 (Juillet 2023)
[article]
in Journal of the American Podiatric Medical Association > vol. 113, 04 (Juillet 2023)
Titre : American Podiatric Surgeons’ Postoperative Multimodal Analgesic-Prescribing Practice: A 2019–2020 National Survey Type de document : article de périodique Auteurs : Brandon M. Brooks ; Reed W. R. Bratches ; Ashley M. Nettles ; Adam E. Fleischer ; Bradley M. Brooks ; Rachel H. Albright Année de publication : 2023 Langues : Anglais (eng) Descripteurs (mots clés) : [Thésaurus Mesh]Analgésiques
[Thésaurus Mesh]Analgésiques morphiniques
[Thésaurus Mesh]Collecte de données
[Thésaurus Mesh]Douleur postopératoire
[Thésaurus Mesh]États-Unis d'Amérique
[Thésaurus Mesh]Ordonnances médicamenteuses
[Thésaurus Mesh]Période postopératoire
[Thésaurus Mesh]PodologieRésumé : Background: Surgery is a common setting for opioid-naive patients to first be exposed to opioids. Understanding the multimodal analgesic-prescribing habits of podiatric surgeons in the United States may be helpful to refining prescribing protocols. The purpose of this benchmark study was to identify whether certain demographic characteristics of podiatric surgeons were associated with their postoperative multimodal analgesic-prescribing practices.
Methods: We administered a scenario-based, voluntary, anonymous, online questionnaire that consisted of patient scenarios with a unique podiatric surgery followed by a demographics section. We developed multiple logistic regression models to identify associations between prescriber characteristics and the odds of supplementing with a nonsteroidal anti-inflammatory drug, regional nerve block, and anticonvulsant agent for each scenario. We developed multiple linear regression models to identify the association of multimodal analgesic-prescribing habits and the opioid dosage units prescribed at the time of surgery.
Results: Eight hundred sixty podiatric surgeons completed the survey. Years in practice was a statistically significant variable in multiple scenarios. Compared with those in practice for more than 15 years, podiatric surgeons in practice 5 years or less had increased odds of reporting supplementation with an anticonvulsant agent in scenarios 1 (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.11–5.18; P = .03), 3 (OR, 2.97; 95% CI, 1.55–5.68; P = .001), 4 (OR, 2.54; 95% CI, 1.56–4.12; P < .001), and 5 (OR, 2.07; 95% CI, 1.29–3.32; P = .003).
Conclusions: Podiatric surgeons with fewer years in practice had increased odds of supplementing with an anticonvulsant. Approximately one-third of podiatric surgeons reported using some form of a nonopioid analgesic and an opioid in every scenario. The use of multimodal analgesics was associated with a reduction in the number of opioid dosage units prescribed at the time of surgery and may be a reasonable adjunct to current protocols.Permalink : https://bibliotheque.helb-prigogine.be/opac_css/index.php?lvl=notice_display&id= [article]Exemplaires
Cote Support Localisation Section Disponibilité aucun exemplaire Opioid-Prescribing Approaches—One-Size-Fits-All versus Patient-Centric and Procedure-Focused—Among Podiatric Physicians: A Cross-Sectional Study / Brandon M. Brooks in Journal of the American Podiatric Medical Association, vol. 113, 04 (Juillet 2023)
[article]
in Journal of the American Podiatric Medical Association > vol. 113, 04 (Juillet 2023)
Titre : Opioid-Prescribing Approaches—One-Size-Fits-All versus Patient-Centric and Procedure-Focused—Among Podiatric Physicians: A Cross-Sectional Study Type de document : article de périodique Auteurs : Brandon M. Brooks ; Reed W. R. Bratches ; Kristina B. Wolff ; Mickey D. Stapp ; Kyle W. Bruce ; Dyane E. Tower Année de publication : 2023 Langues : Anglais (eng) Descripteurs (mots clés) : [Thésaurus Mesh]Analgésiques morphiniques
[Thésaurus Mesh]Collecte de données
[Thésaurus Mesh]Douleur postopératoire
[Thésaurus Mesh]États-Unis d'Amérique
[Thésaurus Mesh]Ordonnances médicamenteuses
[Thésaurus Mesh]Période postopératoire
[Thésaurus Mesh]PodologieMots-clés : approche universelle approche centrée sur le patient Résumé : Background: More than half of opioid misusers last obtained opioids from a friend or relative, a problematic reflection of the commonly known opioid reservoir maintained by variable prescription rates and, notably, excessive postoperative prescription. We examined the postoperative opioid-prescribing approaches among podiatric physicians.
Methods: We administered a scenario-based, anonymous, online questionnaire via an online survey platform. The questionnaire consisted of five patient–foot surgery scenarios aimed at discerning opioid-prescribing approaches. Respondents were asked how many opioid “pills” (dosage units) that they would prescribe at the time of surgery. We divided respondents into two opioid-prescribing approach groups: one-size-fits-all (prescribed the same dosage units regardless of the scenario) and patient-centric and procedure-focused (prescribed varied amounts of opioid dosage units based on the patient’s opioid history and the procedure provided in each scenario). We used the Mann-Whitney U test to determine the difference between the opioid dosage units prescribed at the time of surgery by the two groups.
Results: Approximately half of the respondents used a one-size-fits-all postoperative opioid-prescribing approach. Podiatric physicians who used a patient-centric and procedure-focused approach reported prescribing significantly fewer opioid dosage units in scenarios 1 (partial toe amputation; –9.1; P = .0087) and 2 (incision and drainage with partial fifth-ray resection; –12.3; P = .0024), which represented minor procedures with opioid-naive patients.
Conclusions: Podiatric physicians who used a one-size-fits-all opioid-prescribing approach prescribed more postoperative opioid dosage units regardless of the scenario. Given that the patient population requiring foot surgery is diverse and may have multiple comorbidities, the management of postoperative pain, likewise, should be diverse and nuanced. The patient-centric and procedure-focused approach is suited to limit excess prescribing while defending the physician-patient relationship.Permalink : https://bibliotheque.helb-prigogine.be/opac_css/index.php?lvl=notice_display&id= [article]Exemplaires
Cote Support Localisation Section Disponibilité aucun exemplaire Opioid Problems Within Our Profession: Cognitive Bias in Postoperative Opioid-Prescribing Practice A Novel Effect / Bradley M. Brooks in Journal of the American Podiatric Medical Association, vol. 113, 03 (Mai 2023)
[article]
in Journal of the American Podiatric Medical Association > vol. 113, 03 (Mai 2023)
Titre : Opioid Problems Within Our Profession: Cognitive Bias in Postoperative Opioid-Prescribing Practice A Novel Effect Type de document : article de périodique Auteurs : Bradley M. Brooks ; Chia-Ding Shih ; Reed W. R. Bratches ; Allison S. Arp ; Gerard J. Coughlin ; Kristina B. Wolff ; Brandon M. Brooks Année de publication : 2023 Langues : Anglais (eng) Descripteurs (mots clés) : [Thésaurus HELB]:Paramédical:Podologue
[Thésaurus HELB]:Paramédical:prescription
[Thésaurus Mesh]Analgésiques morphiniques
[Thésaurus Mesh]Collecte de données
[Thésaurus Mesh]Douleur postopératoire
[Thésaurus Mesh]Gestion de la douleur
[Thésaurus Mesh]Prescription inappropriéeRésumé : Background: Given that excess opioid prescriptions contribute to the US opioid epidemic and there are few national opioid-prescribing guidelines for the management of acute pain, it is pertinent to determine whether prescribers can sufficiently assess their own prescribing practice. We investigated podiatric surgeons’ ability to evaluate whether their own opioid-prescribing practice is less than, near, or above that of an “average” prescriber.
Methods: We administered a scenario-based, voluntary, anonymous, online questionnaire consisting of five surgery-based scenarios commonly performed by podiatric surgeons. Respondents were asked the quantity of opioids they would prescribe at the time of surgery. Respondents were also asked to rate their prescribing practice compared with the average (median) podiatric surgeon. We compared self-reported behavior to self-reported perception (“I prescribe less than average,” “I prescribed about average,” and “I prescribe more than average”). Analysis of variance was used for univariate analysis among the three groups. We used linear regression to adjust for confounders. Data restriction was used to account for restrictive state laws.
Results: One hundred fifteen podiatric surgeons completed the survey in April 2020. Less than half of the time, respondents accurately identified their own category. Consequently, there were no statistically significant differences among podiatric surgeons who reported that they “prescribe less,” “prescribe about average,” and “prescribe more.” Paradoxically, there was a flip in scenario 5: respondents who reported they “prescribe more” actually prescribed the least and respondents who believed they “prescribe less” actually prescribed the most.
Conclusions: Cognitive bias, in the form of a novel effect, occurs in postoperative opioid-prescribing practice; in the absence of procedure-specific guidelines or an objective standard, podiatric surgeons, more often than not, were unaware of how their own opioid-prescribing practice measured up to that of other podiatric surgeons.Permalink : https://bibliotheque.helb-prigogine.be/opac_css/index.php?lvl=notice_display&id= [article]Exemplaires
Cote Support Localisation Section Disponibilité aucun exemplaire