title: Quality Assessment of Acute Inpatient Pain Management in an Academic Health Center.
abstract: The quality of acute inpatient pain management remains suboptimal and poorly understood. In this retrospective study, we analyze acute pain management practice in a large academic health center using several quality indicators. Not surprisingly, despite high rate of pain assessment, many patients still have frequent, prolonged, and unrelieved severe pain episodes. Upon examination of naloxone administration, we identify potential inappropriate opioid prescription practices such as the use of wrong opioids in hepatic and renal failure and simultaneous use of multiple short-acting opioids. Most importantly, we find that chronic opioid users appear to suffer the most in terms of undertreatment of pain as well as opioid overdose, highlighting the urgent need to target this underserved population of patients.
authors.affiliation: Department of Medicine, Weill Cornell Medical College, New York, NY, USA Department of Medicine, NYU Langone Medical Center, New York, NY, USA Richard.Lin2@nyumc.org.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Lin
authors.affiliation: Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
authors.forename: M Carrington
authors.initials: MC
authors.lastname: Reid
authors.affiliation: Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Chused
authors.affiliation: Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Arthur T
authors.initials: AT
authors.lastname: Evans
mesh_terms: D000046:Academic Medical Centers; D059787:Acute Pain / Q000188:drug therapy*; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D009293:Opioid-Related Disorders / Q000517:prevention & control; D059408:Pain Management; D010147:Pain Measurement; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care
chemical_list: D000701:Analgesics, Opioid
keywords: chronic pain; inpatient pain management; naloxone; opioid overdose; quality improvement; root cause analysis
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