Evaluation of Compensatory Prescribing After Opioid-Restricting Legislation.
Evaluation of Compensatory Prescribing After Opioid-Restricting Legislation.
复制标题
阿片类药物限制立法后补偿性处方的评估。
DOI：
10.1007/s11606-022-07941-3
复制
发表时间：
2023
影响因子：
5.7
通讯作者：
Barrett,TylerW
中科院分区：
文献类型：
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作者：
Reese,ThomasJ;Nelson,ScottD;Marcovitz,David;Shotwell,Matthew;Edwards,DavidA;Wright,Adam;Barrett,TylerW
方法我们使用横断面研究设计来比较范德比尔特大学医学中心实施的全州立法（“TN Together”）前后的处方模式。分析中包括阿片类镇痛药、非阿片类镇痛药和苯二氮卓类药物的门诊处方。非阿片类镇痛药包括最近 CDC 指南中强调的药物：非甾体类抗炎药、对乙酰氨基酚、加巴喷丁、普瑞巴林、去甲替林、阿米替林和度洛西汀。 3 使用多变量逻辑回归，将2017年11月3日至2018年6月30日之间的处方视为对照，并与2018年7月1日至2019年7月1日之间的处方进行比较。我们估算缺失数据并使用 Wald 型方法进行假设检验，I 类错误率为 5%。由 R（R 核心团队，2020）进行分析，并根据加强流行病学观察研究报告（STROBE）指南报告结果。 4 结果 在符合纳入标准的 563,418 个处方中，来自立法后时期的处方略多（60.7%）。处方主要针对白人（80.0%）和女性（57.8%）患者。医生签署了大多数处方（54.3%），大多数处方来自出院（33.2%）或就诊（24%）。患者队列之间没有显着差异。
METHODSWe used a cross-sectional study design to compare prescribing patterns before and after statewide legislation (“TN Together”) that was implemented at Vanderbilt University Medical Center. Outpatient prescriptions for opioid analgesics, nonopioid analgesics, and benzodiazepines were included in the analysis. Nonopioid analgesics included those highlighted by a recent CDC guideline: nonsteroidal anti-inflammatory drugs, acetaminophen, gabapentin, pregabalin, nortriptyline, amitriptyline, and duloxetine. 3 Prescriptions between November 3, 2017, and June 30, 2018, were considered control and compared with prescriptions between July 1, 2018, and July 1, 2019, using multivariable logistic regression. We imputed missing data and used Wald-type methods for hypothesis testing with a type I error rate of 5%. Analyses were conducted with R (R Core Team, 2020), and results were reported according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline. 4RESULTSOf the 563,418 prescriptions that met the inclusion criteria, slightly more were from the post-legislation period (60.7%). Prescriptions were primarily for White (80.0%) and female (57.8%) patients. Physicians signed most prescriptions (54.3%), and most prescriptions were from a hospital discharge (33.2%) or office visit (24%). There were no significant differences between the patient cohorts.