Patient-Centric Side Effect Risk Assessment for Medications Used During Aeromedical Evacuations

BACKGROUND: The U.S. Air Force performs more than 6000 aeromedical transport flights annually, both internationally and domestically. Many of these flights include patients requiring pain relief medications. The risk of side effects from such medications administered at altitude is unknown, but understanding these risks is vital when selecting the safest pain management strategies to achieve optimal postflight outcomes.METHODS: Using an evidence-based medication side effect risk assessment model, we compared our patient-centric approach to an aircrew-centric approach using medications approved for use in U.S. Navy aircrew. We then determined the patient-centric side effect risk of medications commonly used during Air Force aeromedical evacuation (AE).RESULTS: The patient-centric approach to medication side effect risk assessment demonstrates that the majority of medications currently approved for use during AE have an acceptable side effect risk for the patient (18/22, 82%). Four approved drugs displayed significantly elevated patient risk, with risk scores between 2.0- and 3.2-fold greater than the statistically determined upper allowable ("acceptable") limit and between 1.2- and 2.0-fold above the upper control ("tolerable") limit.DISCUSSION: Our results suggest that pain management strategies during AE should be tailored individually to minimize the risk associated with pain medications administered en route.Huntsberger SA, Butler WP, Chapleau RR. Patient-centric side effect risk assessment for medications used during aeromedical evacuations. Aerosp Med Hum Perform. 2017; 88(4):423-426.