UWSpace is currently experiencing technical difficulties resulting from its recent migration to a new version of its software. These technical issues are not affecting the submission and browse features of the site. UWaterloo community members may continue submitting items to UWSpace. We apologize for the inconvenience, and are actively working to resolve these technical issues.
 

A Quality Assurance Evaluation of Hydromorphone Adverse Events Post-Implementation of a Safety Initiative

Simple item page
dc.contributor.authorPurivatra, Elsa
dc.contributor.authorHaluk-McMahon, Charlene
dc.contributor.authorEl-Masri, Maher
dc.contributor.authorYrigoyen-Dacruz, Lidia
dc.contributor.authorDuronio, Antoinette
dc.date.accessioned2020-09-11T16:19:36Z
dc.date.available2020-09-11T16:19:36Z
dc.date.issued2019-08
dc.degree.departmentSchool of Pharmacyen
dc.description.abstractPurpose: Hydromorphone is a potent opioid that may lead to respiratory and central nervous system depression prompting naloxone use. The primary objective of this study was to evaluate whether a safety initiative implemented at Windsor Regional Hospital involving interchanging hydromorphone intravenous or subcutaneous doses of 1 mg or greater to low dose (0.5 mg) in opioid naïve, medical and surgical patients was associated with naloxone events. The secondary objective was to assess whether there was a compromise in patient pain control with the low dose. Methods: We conducted a retrospective, multicenter, observational study of medical and surgical opioid-naïve patients admitted to Windsor Regional Hospital who received intravenous or subcutaneous hydromorphone within an eighteen-month timeframe. To determine if there is an association between naloxone events and implementation of the safety initiative, we compared patients who experienced a naloxone event (cases) with patients who did not experience a naloxone event (controls) in approximately 1:4 ratio. Efficacy outcomes assessed changes in patient pain control before and after interchange policy implementation (i.e. need for increase in dose, frequency or additional analgesics). Results: Of the 4343 patients who received hydromorphone, 143 opioid naïve patients were included in the final analysis. Of the 27 patients who experienced a naloxone event, 0% of patients were interchanged. In contrast, of the 116 patients who did not experience a naloxone event, 52% were interchanged (OR = 0, 95% 0 to 0.13, p<0.01). There were no significant differences in terms of patient pain control before and after interchange policy implementation. Conclusions: The pharmacist-led safety initiative of interchanging all opioid naïve patients to low dose hydromorphone was not associated with naloxone events and did not compromise patient pain control.en
dc.identifier.urihttp://hdl.handle.net/10012/16282
dc.language.isoenen
dc.publisherUniversity of Waterlooen
dc.subjecthydromorphoneen
dc.subjectnaloxoneen
dc.subjectopioiden
dc.subjectsafetyen
dc.subjectpain managementen
dc.titleA Quality Assurance Evaluation of Hydromorphone Adverse Events Post-Implementation of a Safety Initiativeen
dc.typeResidency Paperen
uws.affiliation.institutionWindsor Regional Hospitalen
uws.contributor.affiliation1Faculty of Scienceen
uws.peerReviewStatusUnrevieweden
uws.published.cityWaterlooen
uws.published.countryCanadaen
uws.published.provinceOntarioen

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Purivatra_Elsa.pdf
Size:
581.49 KB
Format:
Adobe Portable Document Format
Download

Collections

Pharmacy