{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:56:53Z","timestamp":1777859813375,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2023,7,12]],"date-time":"2023-07-12T00:00:00Z","timestamp":1689120000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Practice"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:p>\n                    Background: Opioid overdose deaths have increased over the last two decades, despite efforts to reduce prescribing. This study aimed to determine if a hospital-wide Alternatives to Opiates (ALTO\n                    <jats:sup>SM<\/jats:sup>\n                    ) program reduced opioid prescribing in hospital and upon discharge after trauma. Objectives: The primary outcome was incidence of opioid prescribing at hospital discharge Pre- and Post-ALTO. Secondary outcomes were the percent of patients with in-hospital opioid, non-opioid and multimodal analgesia, and hospital and intensive care unit (ICU) length of stay (LOS). Methods: This is a single-center, retrospective analysis of patients &gt;\/ = 18\u00a0years old admitted for &gt;24\u00a0hours with the primary diagnosis of traumatic injury between August 2018 - October 2019. Patients with alcohol or polysubstance abuse, chronic opioid use, or in-hospital mortality were excluded. Results: A total of 703 patients were included, 471 in Pre-ALTO and 232 in Post-ALTO groups. The mean age was 59 \u00b1 22\u00a0years and most were male (58.7%). Mean initial Injury Severity Score (ISS) was 9.1 \u00b1 7.7. Opioid prescribing at hospital discharge occurred more in the Post-ALTO group (132\/332, 39.4% vs 90\/203, 43.8%; P = .1237). Most patients were prescribed in-hospital opioid (332\/471, 70.4% vs 203\/232, 87.5%, P &lt; .0001) and non-opioid (441\/471, 93.6% vs 229\/232, 98.7%; P = .0027) analgesics, or multimodal analgesia (397\/471, 84.3% vs 203\/232, 87.5%; P = .2591). Median hospital and ICU LOS were also similar between groups [5 (3-9) vs 4(3-7), P = .3427] and ICU [2(0-4) vs 3(2-5), P = .3461]. Conclusion: Opioids remain mainstay for trauma-related pain treatment. ALTO\n                    <jats:sup>SM<\/jats:sup>\n                    was not associated with less in-hospital or discharge opioid prescribing.\n                  <\/jats:p>","DOI":"10.1177\/08971900231189353","type":"journal-article","created":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T00:32:03Z","timestamp":1689208323000},"page":"854-861","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of Alternatives to Opiates Program on Discharge Opioid Prescribing in Trauma Patients"],"prefix":"10.1177","volume":"37","author":[{"given":"Steven F.","family":"Nerenberg","sequence":"first","affiliation":[{"name":"Department of Pharmacy, St. Joseph\u2019s University Medical Center, Paterson, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caitlin E.","family":"Kulig","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, St. Joseph\u2019s University Medical Center, Paterson, NJ, USA"},{"name":"Department of Pharmacy Practice and Administration, Rutgers, The State University of New Jersey, Piscataway, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexis M.","family":"LaPietra","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Services, RWJBarnabas Health, West Orange, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osama A.","family":"Elsawy","sequence":"additional","affiliation":[{"name":"Department of Surgery - Trauma Division, St. Joseph\u2019s University Medical Center, Paterson, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antai","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Mathematical Sciences, New Jersey Institute of Technology, Newark, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsey A.","family":"Foran","sequence":"additional","affiliation":[{"name":"Department of Surgery - Trauma Division, St. Joseph\u2019s University Medical Center, Paterson, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad F.","family":"Hlayhel","sequence":"additional","affiliation":[{"name":"Department of Surgery - Trauma Division, St. Joseph\u2019s University Medical Center, Paterson, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Surgery - Trauma Division, St. Joseph\u2019s University Medical Center, Paterson, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dinesh","family":"Parmar","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, St. Joseph\u2019s University Medical Center, Paterson, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0176-1752","authenticated-orcid":false,"given":"Jackie P.","family":"Rowe","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, St. Joseph\u2019s University Medical Center, Paterson, NJ, USA"},{"name":"Department of Pharmacy Practice and Administration, Rutgers, The State University of New Jersey, Piscataway, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,7,12]]},"reference":[{"key":"bibr1-08971900231189353","unstructured":"National Center for Health Statistics, and Centers for Disease Control and Prevention. Emergency department visits [Data set]. Retrieved from: https:\/\/www.cdc.gov\/nchs\/fastats\/emergency-department.htm. 2020."},{"key":"bibr2-08971900231189353","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002292"},{"key":"bibr3-08971900231189353","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2010.00983.x"},{"key":"bibr4-08971900231189353","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2015.11.033"},{"key":"bibr5-08971900231189353","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3182ab10de"},{"key":"bibr6-08971900231189353","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2020.07.015"},{"key":"bibr7-08971900231189353","doi-asserted-by":"publisher","DOI":"10.1186\/s13011-020-00308-z"},{"key":"bibr8-08971900231189353","volume-title":"Trends in Opioids Prescribed at Discharge from Emergency Departments Among Adults: United States, 2006-2017","author":"Rui P","year":"2020"},{"key":"bibr9-08971900231189353","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.1685"},{"key":"bibr10-08971900231189353","unstructured":"Center for Disease Control and Prevention. Drug overdose deaths remain high. Retrieved from: https:\/\/www.cdc.gov\/drugoverdose\/deaths\/index.html. 2022."},{"key":"bibr11-08971900231189353","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr6501e1"},{"key":"bibr12-08971900231189353","unstructured":"Centers for Disease Control and Prevention. Annual surveillance report of drug-related risks and outcomes \u2014 United States. Surveillance Special Report. Available at: https:\/\/www.cdc.gov\/drugoverdose\/pdf\/pubs\/2018-cdc-drug-surveillance-report.pdf. 2018"},{"key":"bibr13-08971900231189353","volume-title":"Drug Overdose Deaths in the U.S. Top 100,000","author":"National Center for Health Statistics, and Centers for Disease Control and Prevention","year":"2021"},{"key":"bibr14-08971900231189353","unstructured":"Center for Disease Control and Prevention. Wide-ranging online data for epidemiologic research (WONDER). Retrieved from: http:\/\/wonder.cdc.gov. 2020"},{"key":"bibr15-08971900231189353","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7006a4"},{"key":"bibr16-08971900231189353","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2015.04.012"},{"key":"bibr17-08971900231189353","unstructured":"American College of Surgeons. Best practice guidelines for acute pain management in trauma patients. Retrieved from: https:\/\/www.facs.org\/-\/media\/files\/quality-programs\/trauma\/tqip\/acute_pain_guidelines.ashx. 2020."},{"issue":"3","key":"bibr18-08971900231189353","volume":"6","author":"Shanti B","year":"2006","journal-title":"Pract Pain Manag"},{"key":"bibr19-08971900231189353","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2020.12.014"},{"key":"bibr20-08971900231189353","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2019.01.020"},{"key":"bibr21-08971900231189353","unstructured":"Joseph\u2019s Health S. ALTO - alternatives to opiates program. 2017. Available at: https:\/\/www.stjosephshealth.org\/alto. Accessed September 1, 2019."},{"key":"bibr22-08971900231189353","unstructured":"St. Joseph\u2019s Health. St. Joseph\u2019s ALTO\n                      SM\n                      - alternative to opiates. 2017. Available at: https:\/\/www.stjosephshealth.org\/home-page-articles\/item\/1908-alto-alternatives-to-opioids. Accessed September 15, 2019."},{"key":"bibr23-08971900231189353","unstructured":"Drug Enforcement Administration Diversion Control Division. Controlled substance schedules controlled substances alphabetical order. Available at: https:\/\/www.deadiversion.usdoj.gov\/schedules\/orangebook\/c_cs_alpha.pdf. Accessed May 15, 2023."}],"container-title":["Journal of Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08971900231189353","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08971900231189353","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08971900231189353","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:38:13Z","timestamp":1777509493000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08971900231189353"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,12]]},"references-count":23,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1177\/08971900231189353"],"URL":"https:\/\/doi.org\/10.1177\/08971900231189353","relation":{},"ISSN":["0897-1900","1531-1937"],"issn-type":[{"value":"0897-1900","type":"print"},{"value":"1531-1937","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,12]]}}}