The Association Between Sustained Poor Quality of Life and Future Opioid Use in Inflammatory Bowel Disease.
The Association Between Sustained Poor Quality of Life and Future Opioid Use in Inflammatory Bowel Disease.
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DOI：
10.1093/ibd/izy040
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发表时间：
2018-06-08
影响因子：
4.9
通讯作者：
Binion DG
中科院分区：
文献类型：
--
作者：
Anderson A;Click B;Ramos-Rivers C;Koutroubakis IE;Hashash JG;Dunn MA;Schwartz M;Swoger J;Barrie A 3rd;Regueiro M;Binion DG
炎症性肠病（IBD）与生活质量差和残疾有关。简短的炎症性肠病问卷 (SIBDQ) 经过验证，可以确定患者在单个时间点的生活质量或随时间的推移的改善情况。很少有研究评估持续较差的生活质量是否与未来的医疗保健利用模式相关。我们对来自前瞻性 IBD 自然史登记处的患者进行了连续 4 年的随访分析。 SIBDQ 在门诊就诊时进行测量。医疗保健利用数据暂时分为 2 年观察期和 2 年随访期。头 2 年平均 SIBDQ 得分 <50 被归类为“生活质量差”。感兴趣的主要结果是计划外医疗保健利用和阿片类药物使用的衡量标准。在总共 447 名参与者（56.1% 为女性、66.1% 为克罗恩病、34.9% 为溃疡性结肠炎）中，有 215 名（48.1%）被归类为生活质量较差。生活质量差与克罗恩病（P < 0.01）、IBD 相关手术史和吸烟显着相关（均 P < 0.01）。在随访期间，生活质量较差的同一患者更有可能出现炎症生物标志物异常、更多的电话和办公室就诊、经历计划外护理以及接触阿片类药物（所有 P < 0.05）。经过多变量分析，生活质量差仍然是未来阿片类药物使用的独立预测因素（比值比：2.2，P = 0.003），并在随访期间缩短首次阿片类药物处方时间（风险比：1.67，P = 0.019）。生活质量持续较差的 IBD 患者使用阿片类药物的风险增加，并且阿片类药物暴露时间缩短。对门诊患者生活质量的常规测量可以深入了解那些有使用麻醉品和医疗保健的风险的人。
Inflammatory bowel disease (IBD) is associated with poor quality of life and disability. The short inflammatory bowel disease questionnaire (SIBDQ) is validated to determine patients quality of life at single time points, or improvement over time. Few studies have evaluated if sustained poor quality of life is associated with future healthcare utilization patterns. We analyzed patients from a prospective IBD natural history registry with 4 consecutive years of follow-up. SIBDQ was measured at outpatient visits. Healthcare utilization data were temporally organized into a 2-year observation period, and 2-year follow-up period. Mean SIBDQ score <50 during the first 2 years was categorized as having “poor quality of life”. Primary outcomes of interest were measures of unplanned healthcare utilization and opioid use. From a total of 447 participants (56.1% female, 66.1% Crohn’s disease, 34.9% ulcerative colitis), 215 (48.1%) were classified as having poor quality of life. Poor quality of life was significantly associated with Crohn’s disease (P < 0.01), history of IBD related surgery, and tobacco use (all P < 0.01). In the follow-up period, the same patients with poor quality of life were more likely to have abnormal biomarkers of inflammation, more telephone calls and office visits, experience unplanned care, and be exposed to opiates (all P < 0.05). After multivariable analysis, poor quality of life remained an independent predictor of future opiate use (odds ratio: 2.2, P = 0.003) and decreased time to first opiate prescription (hazard ratio: 1.67, P = 0.019) in the follow-up period. IBD patients with sustained poor quality of life are at an increased risk of opiate use and decreased time to opiate exposure. Routine measurement of quality of life in the outpatient setting may provide insight into those at risk for narcotic use and healthcare utilization.
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影响因子：
4.9
作者：
Zhang CK;Hewett J;Hemming J;Grant T;Zhao H;Abraham C;Oikonomou I;Kanakia M;Cho JH;Proctor DD
通讯作者：
Proctor DD
影响因子：
3.1
作者：
DROSSMAN, DA;PATRICK, DL;APPELBAUM, MI
通讯作者：
APPELBAUM, MI
影响因子：
3.1
作者：
Anderson, Alyce J. M.;Click, Benjamin;Binion, David G.
通讯作者：
Binion, David G.
影响因子：
120.7
作者：
Detmar, SB;Muller, MJ;Aaronson, NK
通讯作者：
Aaronson, NK
影响因子：
4.9
作者：
Devlen, Jennifer;Beusterien, Kathleen;Moss, Alan C.
通讯作者：
Moss, Alan C.