Vincent Bounes1, Baptiste Vallé2, François Concina2, Dominique Lauque2, Jean-Louis Ducassé2, Jonathan A Edlow3. 1. Pôle Médecine d'Urgence, Hôpital Universitaire de Purpan, Toulouse 31059, Cedex 9, France; Unité de Recherche de Pharmacoépidémiologie, INSERM UMR 1027 Toulouse, France. Electronic address: bounes.v@chu-toulouse.fr. 2. Pôle Médecine d'Urgence, Hôpital Universitaire de Purpan, Toulouse 31059, Cedex 9, France. 3. Department of Emergency Medicine Administrative Offices, West CC-2, Beth Israel Deaconess Medical Center, 1 Deaconess Place, Boston, MA 02215, USA.
Abstract
OBJECTIVES: To assess the prescribing patterns in acute renal colic in emergency departments in US and France, by comparing physicians' intended prescription practices with actual prescription data in a sample of emergency practitioners. METHODS: Pharmaco-epidemiological international study in two phases. First, we surveyed emergency physicians in US and France as to what analgesics they would use for simulated cases of renal colic. We then conducted a retrospective review of actual cases of emergency department patients with pain scores ≥6/10 with acute renal colic during a period of 6 months before the survey. We compared nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids used for pain treatment in the two groups, and the differences between the two countries. RESULTS: One hundred six prescribers and 100 patients were included in the study. Comparison between simulated and real cases showed that NSAIDs and opioids were less frequently prescribed in real life (78% vs 99% and 51% vs 100% respectively). Morphine was the most prescribed opioid (96% of simulated cases and 34% of real ones). Acetaminophen use was increased in real life cases (58% vs 0%). Concerning the differences between countries, US physicians are more likely to administer morphine (64% vs 38%) and French physicians NSAIDs (88% vs 68%). The NSAIDs used are ketorolac in the United States (94% of simulated cases vs 64%) and ketoprofen in France (94% and 88% respectively). DISCUSSION: We showed clear differences between intended and real analgesic prescription practices for patients suffering from renal colic. Some differences exist for pain perceptions and treatments between US and France.
OBJECTIVES: To assess the prescribing patterns in acute renal colic in emergency departments in US and France, by comparing physicians' intended prescription practices with actual prescription data in a sample of emergency practitioners. METHODS: Pharmaco-epidemiological international study in two phases. First, we surveyed emergency physicians in US and France as to what analgesics they would use for simulated cases of renal colic. We then conducted a retrospective review of actual cases of emergency department patients with pain scores ≥6/10 with acute renal colic during a period of 6 months before the survey. We compared nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids used for pain treatment in the two groups, and the differences between the two countries. RESULTS: One hundred six prescribers and 100 patients were included in the study. Comparison between simulated and real cases showed that NSAIDs and opioids were less frequently prescribed in real life (78% vs 99% and 51% vs 100% respectively). Morphine was the most prescribed opioid (96% of simulated cases and 34% of real ones). Acetaminophen use was increased in real life cases (58% vs 0%). Concerning the differences between countries, US physicians are more likely to administer morphine (64% vs 38%) and French physicians NSAIDs (88% vs 68%). The NSAIDs used are ketorolac in the United States (94% of simulated cases vs 64%) and ketoprofen in France (94% and 88% respectively). DISCUSSION: We showed clear differences between intended and real analgesic prescription practices for patients suffering from renal colic. Some differences exist for pain perceptions and treatments between US and France.
Authors: Hal D Kominsky; Justin Rose; Amy Lehman; Marilly Palettas; Tasha Posid; Jeffrey M Caterino; Bodo E Knudsen; Michael W Sourial Journal: J Endourol Date: 2020-10-22 Impact factor: 2.942
Authors: Russell G Witt; Brandon Cope; Yi-Ju Chiang; Timothy Newhook; Heather Lillemoe; Ching-Wei D Tzeng; Iris B Chen; Sarah B Fisher; Anthony Lucci; Jennifer A Wargo; Jeffrey E Lee; Merrick I Ross; Jeffrey E Gershenwald; Justine Robinson; Emily Z Keung Journal: J Surg Oncol Date: 2021-12-14 Impact factor: 2.885