title: Tracking the effects of policy changes in prescribing analgesics in one emergency department: a 10-year analysis.
abstract: According to the WHO, the yearly national consumption of opioids is one indicator of a country's investment on relieving moderate-to-severe pain. We implemented guidelines for treatment of pain in our emergency department (ED) and tracked the major analgesics used in this ED to monitor trends in pain management over a decade. The study was carried out in a Level I trauma center ED. Data were obtained from the pharmacy's computerized records before (1998-2002) and after (2003-2007) implementing the guidelines. The hospital's admission system provided accurate patient census data. Parenteral morphine and oral oxycodone use increased significantly (P = 0.016 and P = 0.008, respectively). Meperidine use did not change. In conclusion, our ED patients are now generally receiving more analgesics than 10 years ago. Electronically stored data on analgesics are accurate and easily accessible for tracking the nature and quantity of prescriptions, but not for correlating their association with patient outcome.
authors.affiliation: Friedrich Schiller University Jena, Department of Anesthesia and Intensive Care, Erlanger Allee 101, 07747 Jena, Germany. ruth.zaslansky@gmail.com
authors.forename: Ruth
authors.initials: R
authors.lastname: Zaslansky
authors.forename: Devora
authors.initials: D
authors.lastname: Hertz
authors.forename: Silviu
authors.initials: S
authors.lastname: Brill
authors.forename: Jacob
authors.initials: J
authors.lastname: Or
authors.forename: Winfried
authors.initials: W
authors.lastname: Meissner
authors.forename: Pinchas
authors.initials: P
authors.lastname: Halpern
mesh_terms: D000284:Administration, Oral; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D004630:Emergencies; D004632:Emergency Medical Services / Q000379:methods / Q000458:organization & administration; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D019983:Guideline Adherence; D006801:Humans; D007275:Injections, Intravenous; D008485:Medical Audit; D008614:Meperidine / Q000627:therapeutic use; D009020:Morphine / Q000627:therapeutic use; D010098:Oxycodone / Q000627:therapeutic use; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D009020:Morphine; D008614:Meperidine; D010098:Oxycodone