Background: To describe opioid prescribing practices in adults presenting to the Emergency Department (ED) with upper limb fractures.
Methods: A retrospective descriptive study was conducted in ambulatory adult patients who presented to two EDs in Southeast Queensland and were diagnosed and discharged with upper limb fractures between 1 January and 28 February 2019. Electronic Medical Records of eligible patients were independently extracted by two reviewers. Patient demographics, clinical variables and prescribing practices are described.
Results: Of the 137 individual patients analysed, opioids were prescribed in over half of patients (54.7%) in the ED, with an additional 6.6% of patients receiving opioids prior to presentation. Around one-third of patients (32.1%) received opioid prescriptions on discharge with 90% of these patients being prescribed 20 tablets or more. Severity of injury was associated with higher rate of opioid prescription. Discharge opioid prescriptions were more common in women and older patients. In over half of patients (54%), recommendation to use simple over-the-counter analgesia was not documented as part of discharge pain management.
Conclusion: These findings provide insights in current practice and provide a reference rate of both ED and discharge opioid prescription for discharged ED patients with upper limb fractures. Implementation of guidelines, particularly surrounding the appropriate quantity of opioids supplied on discharge and explicit inclusion of simple analgesia as part of pain management may optimise care. However, opioid prescription is only one aspect of pain management and other pain management strategies, patient factors and patient education should be considered in future studies.
Tasman Medical Journal 2021: 3(3): 102-109
We describe a case of psoriasis complicated by periodontitis and discuss the relationship between the two conditions.
Tasman Medical Journal 2021; 3(3): 110-111
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