Association of Household Opioid Availability With Opioid Overdose.
Association of Household Opioid Availability With Opioid Overdose.
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DOI：
10.1001/jamanetworkopen.2023.3385
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发表时间：
2023-03-01
影响因子：
13.8
通讯作者：
Weiner, Scott G.
中科院分区：
文献类型：
--
作者：
Hendricks, Michelle A.;El Ibrahimi, Sanae;Ritter, Grant A.;Flores, Diana;Fischer, Michael A.;Weiss, Roger D.;Wright, Dagan A.;Weiner, Scott G.
家庭阿片类药物处方的可获得性和处方特征在个人阿片类药物过量的几率中起什么作用？在这项针对1个 187 140个家庭中1个 691个 856个俄勒冈州成年人的队列研究中，当另一个家庭成员在之前6个月内填满阿片类药物时，与阿片类药物相关的过量服药的几率显著增加。当个人和另一名家庭成员在前6个月都填充了阿片类药物时，这种可能性也增加了。这项队列研究的结果强调了教育个人了解在家庭中保留阿片类药物的风险的重要性。以前研究家庭阿片类药物处方在阿片类药物过量风险中的作用的研究仅限于商业索赔，不包括致命的过量，并且有限地纳入家庭处方特征。需要更广泛的研究来扩大对过量用药风险的理解。评估家庭阿片类药物供应和其他家庭处方因素在个人致命或非致命阿片类药物过量几率中的作用。从2015年1月1日到2018年12月31日，在俄勒冈州综合阿片类药物风险登记数据库中对至少2人家庭的成年人进行了一项回顾性队列研究，评估了患者的结果。数据分析在2020年10月16日至2023年1月26日之间进行。家庭阿片类药物处方可获得性和家庭处方特征。阿片类药物过量是从保险索赔、死亡记录和医院出院数据中获得的。家庭阿片类药物处方的可获得性和个人和家庭的处方特征被建模为6个月的累积时间依赖措施，每月更新。为了评估家庭处方可获得性、家庭处方特征和过量用药之间的关系，开发了多水平Logistic回归模型，调整了人口统计学、临床、家庭和处方特征。样本包括1个 187个 140个家庭中的1 691个 856人，其中大多数是女性(53.2%)、白人(70.7%)、居住在大都市地区(75.8%)、有商业保险(51.8%)、没有Elixhauser合并症(69.5%)、在研究期间没有阿片类药物处方(57.0%)。在研究期间，共观察到28起 747阿片类药物过量事件(每百人月0.0526起)。与没有个人或家庭阿片类药物填充的个人相比，当另一家庭成员在过去6个月内填充阿片类药物时，与阿片类药物相关的过量服药的几率增加了60%(调整后的优势比[AOR]，1.60；95%可信区间，1.54-1.66)，并且当个人和另一家庭成员都在前6个月填充阿片类药物时，与阿片类药物相关的过量用药的几率最高(调整后的优势比，6.25；95%可信区间，6.09-6.40)。在这项对至少有2名成员的家庭中的俄勒冈州成年居民进行的队列研究中，研究结果表明，家庭处方的可获得性与家庭中其他人阿片类药物过量的可能性增加有关，即使他们没有自己的阿片类药物处方。这些发现强调了教育患者正确处理阿片类药物和家庭阿片类药物风险的重要性。这项队列研究检查了与家庭中阿片类药物存在相关的阿片类药物过量的风险。
What role do household opioid prescription availability and prescription characteristics play in an individual’s odds of opioid overdose? In this cohort study of 1 691 856 Oregon adults in 1 187 140 households, the odds of opioid-related overdose increased significantly when another household member had opioid fills in the preceding 6 months. The odds also increased when both the individual and another household member had opioid fills in the preceding 6 months. The findings of this cohort study underscore the importance of educating individuals about the risks of keeping opioids in the household. Previous studies that examined the role of household opioid prescriptions in opioid overdose risk were limited to commercial claims, did not include fatal overdoses, and had limited inclusion of household prescription characteristics. Broader research is needed to expand understanding of the risk of overdose. To assess the role of household opioid availability and other household prescription factors associated with individuals’ odds of fatal or nonfatal opioid overdose. A retrospective cohort study assessing patient outcomes from January 1, 2015, through December 31, 2018, was conducted on adults in the Oregon Comprehensive Opioid Risk Registry database in households of at least 2 members. Data analysis was performed between October 16, 2020, and January 26, 2023. Household opioid prescription availability and household prescription characteristics. Opioid overdoses were captured from insurance claims, death records, and hospital discharge data. Household opioid prescription availability and prescription characteristics for individuals and households were modeled as 6-month cumulative time-dependent measures, updated monthly. To assess the association between household prescription availability, household prescription characteristics, and overdose, multilevel logistic regression models were developed, adjusting for demographic, clinical, household, and prescription characteristics. The sample included 1 691 856 individuals in 1 187 140 households, of which most were women (53.2%), White race (70.7%), living in metropolitan areas (75.8%), and having commercial insurance (51.8%), no Elixhauser comorbidities (69.5%), and no opioid prescription fills in the study period (57.0%). A total of 28 747 opioid overdose events were observed during the study period (0.0526 per 100 person-months). Relative to individuals without personal or household opioid fills, the odds of opioid-related overdose increased by 60% when another household member had an opioid fill in the past 6 months (adjusted odds ratio [aOR], 1.60; 95% CI, 1.54-1.66) and were highest when both the individual and another household member had opioid fills in the preceding 6 months (aOR, 6.25; 95% CI, 6.09-6.40). In this cohort study of adult Oregon residents in households of at least 2 members, the findings suggest that household prescription availability is associated with increased odds of opioid overdose for others in the household, even if they do not have their own opioid prescription. These findings underscore the importance of educating patients about proper opioid disposal and the risks of household opioids. This cohort study examines the risk for opioid overdose associated with the presence of opioids within the household.
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影响因子：
5.5
作者：
Chua KP;Kenney BC;Waljee JF;Brummett CM;Nalliah RP
通讯作者：
Nalliah RP
影响因子：
6
作者：
Burke, Laura G.;Zhou, Xiner;Frakt, Austin B.
通讯作者：
Frakt, Austin B.
影响因子：
39
作者：
Seamans, Marissa J.;Carey, Timothy S.;Brookhart, M. Alan
通讯作者：
Brookhart, M. Alan
影响因子：
4
作者：
Mayhew, Meghan;DeBar, Lynn L.;Von Korff, Michael
通讯作者：
Von Korff, Michael
影响因子：
2.6
作者：
Nam, Young Hee;Bilker, Warren B.;Hennessy, Sean
通讯作者：
Hennessy, Sean