Opioid Prescribing on an Internal Medicine Teaching Unit

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Samuel Quan https://orcid.org/0000-0002-1551-2696
Cheyenne Lawton
Allison Budd https://orcid.org/0000-0002-6664-3485

opioid prescriptions


To investigate the rationale and timing of opioid prescriptions for Internal Medicine inpatients in an academic center in Saskatoon, Canada.
We performed a cross-sectional study of Internal Medicine inpatients that were prescribed opioids in Saskatoon. We examined documentation of clinical rationale and timing of opioid initiation or first escalation.
Of 57 patients, 34 (60%) were opioid naive prior to admission and 48 (84%) had opioid doses either initiated or escalated. Of these 48 patients, 27 (56%) occurred during on-call hours. Rationale for escalation was documented in 31 cases (65%), with reasons including terminal care (17%), musculoskeletal pain (15%), and skin and soft tissue infections (13%).
Rationale for opioid use was frequently not documented. Initial decision to change opioid dose occurred equally between daytime and on-call hours.

Étudier la justification et le moment choisi pour prescrire des opioïdes chez les patients hospitalisés en médecine interne dans un centre universitaire de Saskatoon (Canada).
Nous avons mené une étude de prévalence sur des patients hospitalisés en médecine interne chez qui on a prescrit des opioïdes à Saskatoon. Nous avons examiné la documentation concernant la justification clinique et le moment choisi pour entreprendre le traitement par les opioïdes ou effectuer la première augmentation de dose.

Des 57 patients, 34 (60 %) n’avaient jamais pris d’opioïdes avant leur hospitalisation et 48 (84 %) ont reçu leur première dose d’opioïdes ou une augmentation de dose. De ces 48 patients, 27 (56 %) ont reçu leur dose durant les heures de garde. La justification de l’augmentation de dose est documentée dans 31 cas (65 %), les raisons étant les soins de fin de vie (17 %), la douleur musculosquelettique (15 %) et les infections de la peau et des tissus mous (13 %).
Souvent, la justification de l’utilisation des opioïdes n’est pas documentée. Le moment où la décision initiale de modifier la dose d’opioïde est prise est réparti de façon égale entre le jour et durant les heures de garde.

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