Affordable Access

deepdyve-link
Publisher Website

Trends in Acute Pain Management for Renal Colic in the Emergency Department at a Tertiary Care Academic Medical Center.

Authors
  • Kominsky, Hal D1
  • Rose, Justin1
  • Lehman, Amy2
  • Palettas, Marilly2
  • Posid, Tasha1
  • Caterino, Jeffrey M3
  • Knudsen, Bodo E1
  • Sourial, Michael W1
  • 1 Department of Urology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
  • 2 Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University College of Medicine, Columbus, Ohio, USA.
  • 3 Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Type
Published Article
Journal
Journal of Endourology
Publisher
Mary Ann Liebert
Publication Date
Nov 01, 2020
Volume
34
Issue
11
Pages
1195–1202
Identifiers
DOI: 10.1089/end.2020.0402
PMID: 32668985
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Introduction: Renal colic secondary to kidney stone disease is a common reason for emergency department (ED) visits and often leads to patients receiving narcotic medications. The objective of this study was to describe longitudinal analgesia prescribing patterns for kidney stone patients acutely managed in the ED. Methods: This was a retrospective chart review of patients who presented to the ED between 2013 and 2018 and were subsequently diagnosed with a kidney stone. Encounters during which opioids and nonopioids were administered in the ED and prescribed at discharge were stratified by year, race, ethnicity, insurance status, gender, and location of ED (main academic campus and community-based campus). Patients were excluded if they required hospital admission or a stone-related procedure related to the ED encounter. Results: We reviewed 1620 total encounters for 1376 unique patients. Frequency of patients receiving opioids in the ED decreased from 81% in 2013 to 57% in 2018 (p < 0.001). During the same time period, nonopioid administration in the ED remained relatively unchanged (64% vs 67%). The proportion of patients prescribed opioids at discharge decreased from 77% to 59% (p < 0.001), while nonopioid prescriptions at discharge increased from 32% to 41% (p = 0.010). Frequency of administering both a narcotic and non-narcotic during the same ED encounter decreased over the 5-year period from 27% to 8% (p < 0.001). Conclusion: Opioids are being given less both during the ED encounter and at discharge for acute renal colic, while nonopioid prescribing is increasing. These trends may be due to increasing physician awareness to opioid addiction, or as a result of stricter legislation prohibiting opioid prescribing.

Report this publication

Statistics

Seen <100 times