Differential patterns of opioid use: Defining persistent opioid use in a prescription database
Differential patterns of opioid use: Defining persistent opioid use in a prescription database
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DOI：
10.1002/j.1532-2149.2011.00018.x
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发表时间：
2012-03-01
影响因子：
3.6
通讯作者：
Fredheim, O. M. S.
中科院分区：
文献类型：
--
作者：
Svendsen, K.;Skurtveit, S.;Fredheim, O. M. S.
目的：本研究的目的是根据处方数据库的数据制定定义，以识别具有不同临床持续阿片类药物使用模式的人。方法：本研究基于挪威处方数据库的数据，使用2005-2008年间所有配发的阿片类药物处方。使用以下患者标准制定了持续使用阿片类药物的三个定义：分配阿片类药物数量的不同水平、处方数量和分配处方的年份中的季度数。这三种定义都有一些典型的患者特征。严格定义描述了使用阿片类药物以实现治疗范围内持续血药浓度的典型患者，中间定义描述了典型患者每天但不是全天候使用阿片类药物，广义定义描述了典型患者在大部分时间使用阿片类药物。结果：截至2007年12月31日，挪威(4,681,134名居民)持续使用阿片类药物的时点患病率分别为0.16%(n=7663)、0.50%(n=23498)和1.08%(n=50791)。在3年的研究结束时，符合严格、中等和宽泛定义标准的患者在任一定义内的保留率分别为83%、84%和68%。结论：在三种定义确定的患者群体中，观察到较高的保留率，表明建议的定义可以识别长期持续使用阿片类药物的患者。
Aim: The aim of this study was to develop definitions to identify persons with clinically different patterns of persistent opioid use based on data from prescription databases.Methods: The study is based on data from the Norwegian Prescription Database using all dispensed opioid prescriptions during 2005-2008. Three definitions of persistent opioid use were developed using the following patient criteria: different levels of dispensed opioid amounts, number of prescriptions and the number of quarters out of the year in which prescriptions were dispensed. The three definitions each have some typical patient characteristics attached to them. The strict definition describes a typical patient using opioids to achieve a continuous serum concentration in the therapeutic range, the intermediate definition represents a typical patient using opioids daily but not around the clock and the wide definition describes a typical patient who uses opioids most of the days. To study whether the definitions accurately represent long-term use, the patient population was followed for 3 years, and the retention rate within each definition was measured.Results: The point prevalence of persistent opioid use in Norway (4,681,134 inhabitants) as defined by the strict, intermediate and wide definitions was 0.16% (n = 7663), 0.50% (n = 23,498) and 1.08% (n = 50,791), respectively, as of 31 December 2007. At the end of the 3-year study period, the retention within any of the definitions was 83%, 84% and 68% for patients who met the criteria of the strict, intermediate and wide definitions, respectively.Conclusion: In the patient populations identified by the three definitions, a high rate of retention was observed, indicating that the proposed definitions can identify patients with long-term persistent use of opioids.