Computational Opioid Prescribing: A Novel Application of Clinical Pharmacokinetics
نویسندگان
چکیده
We implemented a pharmacokinetics-based mathematical modeling technique using algebra to assist prescribers with point-of-care opioid dosing. We call this technique computational opioid prescribing (COP). Because population pharmacokinetic parameter values are needed to estimate drug dosing regimen designs for individual patients using COP, and those values are not readily available to prescribers because they exist scattered in the vast pharmacology literature, we estimated the population pharmacokinetic parameter values for 12 commonly prescribed opioids from various sources using the bootstrap resampling technique. Our results show that opioid dosing regimen design, evaluation, and modification is feasible using COP. We conclude that COP is a new technique for the quantitative assessment of opioid dosing regimen design evaluation and adjustment, which may help prescribers to manage acute and chronic pain at the point-of-care. Potential benefits include opioid dose optimization and minimization of adverse opioid drug events, leading to potential improvement in patient treatment outcomes and safety.
منابع مشابه
The interface between pain and drug abuse and the evolution of strategies to optimize pain management while minimizing drug abuse.
Pain management is facing continued undertreatment of pain despite a growing problem with prescription opioid abuse. This has created a tension among prescribers and feelings of helplessness with regards to what constitutes appropriate practice. This article provides a review of pain management efforts and focuses on two key areas of potential interest. First, the emergence of prescreening tool...
متن کاملQuality Improvement Initiative to Decrease Variability of Emergency Physician Opioid Analgesic Prescribing
INTRODUCTION Addressing pain is a crucial aspect of emergency medicine. Prescription opioids are commonly prescribed for moderate to severe pain in the emergency department (ED); unfortunately, prescribing practices are variable. High variability of opioid prescribing decisions suggests a lack of consensus and an opportunity to improve care. This quality improvement (QI) initiative aimed to red...
متن کاملOpioid utilization and opioid-related adverse events in nonsurgical patients in US hospitals.
BACKGROUND Recent studies in the outpatient setting have demonstrated high rates of opioid prescribing and overdose-related deaths. Prescribing practices in hospitalized patients are unexamined. OBJECTIVE To investigate patterns and predictors of opioid utilization in nonsurgical admissions to US hospitals, variation in use, and the association between hospital-level use and rates of severe o...
متن کاملHigh-Dose Opioid Prescribing and Opioid-Related Hospitalization: A Population-Based Study
AIMS To examine the impact of national clinical practice guidelines and provincial drug policy interventions on prevalence of high-dose opioid prescribing and rates of hospitalization for opioid toxicity. DESIGN Interventional time-series analysis. SETTING Ontario, Canada, from 2003 to 2014. PARTICIPANTS Ontario Drug Benefit (ODB) beneficiaries aged 15 to 64 years from 2003 to 2014. INT...
متن کاملA Call for Better Opioid Prescribing Training and Education
Pain is the most common complaint in the emergency department (ED), and emergency physicians face unique challenges in making opioid-related treatment decisions. Medical students and residents experience significant variation in the quality of education they receive both about opioid prescribing as well as substance-use detection and intervention in the ED. To achieve a better standard of educa...
متن کامل