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科学美国人60秒: 医生们有了更新的阿片类药物的习惯

所属教程:科学美国人60秒科学系列 更新:01-28
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Docs Given Updated Opioid Habit

医生们有了更新的阿片类药物的习惯

Used to be, when doctors prescribed a drug, they'd open up a book summarizing drugs and dosages—or go by memory, for the common stuff. But nowadays? "Now you can type in whatever it is, it's placing an order via the computer. So you type in an order of the name of the drug and it'll prepopulate everything."

过去,开处方时,医生会翻开一本书,总结药物和剂量,或者凭记忆查找常见的东西。但现在呢?“现在你可以输入,然后通过电脑下订单。所以按药物名称的顺序输入,它就会预先填满所有东西。”

Juan Carlos Montoy is an emergency medicine physician at San Francisco General Hospital. He also studies decision making in healthcare. He says, for an antibiotic, the default dose programmed into a doctor's computer might be pretty standard. But for pain, the number of opioids prescribed might vary a lot, depending on the patient and their type of pain.

Juan Carlos Montoy是旧金山总医院的急诊医师。他研究医疗决策,表示,对于一种抗生素,医生电脑预设的剂量可能是相当标准的。但是对于疼痛,处方的阿片类药物的数量可能会有很大的不同,这取决于病人和他们的疼痛类型。

"What we wanted to look at was tell whether and to what extent the presets, the default settings we have in the electronic medical record, influenced provider prescribing." Specifically, would lower defaults result in fewer opioids being prescribed?

“我们想要了解的是,电子医疗记录中的预设值(即默认设置)是否以及在多大程度上影响了医生的处方。”具体来说,低违约率会导致更少的阿片类药物被开出处方吗?

So Montoy's team systematically changed the recommended opioid pill number defaults in the computer systems of two hospitals in the San Francisco Bay Area, during an eight-month period. Each hospital's pre-existing defaults were 12 and 20 pills, respectively. The researchers dialed in new defaults of 5, 10, 15 or an unspecified number of pills.

因此,蒙托的团队在8个月的时间里,系统地改变了旧金山湾区两家医院计算机系统中推荐的阿片类药物默认数量。每家医院之前存在的违约分别是12片和20片。研究人员发现,新的默认值分别为5、10、15或数量不详的药片。

Compared to doctors' prior prescribing habits, the new default settings resulted in fewer opioid pills prescribed overall… and fewer prescriptions exceeding the maximum recommendations by the Centers for Disease Control and Prevention.

与医生以前开处方的习惯相比,新的默认设置导致总体开的阿片类药物更少,超过美国疾病控制与预防中心最大推荐量的处方也更少。

"This suggests that other hospitals, other emergency departments, can change those settings and impact opioid prescribing pretty much immediately. It's a really low cost intervention, and can be done really quickly." The results are in the Journal of the American Medical Association - Internal Medicine.

这表明,其他医院,其他急诊部门,可以改变这些设置,并立即影响阿片类药物的处方。这是一种非常低成本的干预,而且可以很快完成。” 研究结果发表在《美国内科医学会杂志》上。

"This is definitely not a silver bullet, the epidemic has a lot of different issues that need to be addressed, and this is one small tool we can use to address it." Still, it could be a useful prescription for physicians.

“这绝对不是什么灵丹妙药,艾滋病有很多不同的问题需要解决,这是我们可以用来解决问题的一个小工具。”不过,这对医生来说可能是一个有用的处方。

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