Prescribed opioid difficulties, depression and opioid dose among chronic opioid therapy patients.
Prescribed opioid difficulties, depression and opioid dose among chronic opioid therapy patients.
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DOI：
10.1016/j.genhosppsych.2012.06.018
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发表时间：
2012-11
影响因子：
7
通讯作者：
Weisner C
中科院分区：
文献类型：
--
作者：
Merrill JO;Von Korff M;Banta-Green CJ;Sullivan MD;Saunders KW;Campbell CI;Weisner C
慢性阿片类药物治疗急剧增加，与处方阿片类药物有关的并发症也急剧增加。接受不同阿片类药物剂量的患者对阿片类药物引起的问题和担忧知之甚少。我们调查了1883名接受慢性阿片类药物治疗慢性非癌症疼痛的患者。阿片类药物治疗方案的特点，从电子药房记录确定。使用处方阿片类药物困难量表测量患者报告的阿片类药物相关问题和担忧。抑郁症与患者健康问卷进行了评估。处方较高阿片类药物剂量的患者报告了适度较高的疼痛强度和疼痛影响。调整后，高剂量的患者将更高水平的心理社会问题和控制问题归因于处方阿片类药物（p<.0001）。他们也有更高的抑郁水平，更有可能达到临床抑郁症的标准。超过60%接受每日120+ mg（吗啡当量）治疗的患者出现临床抑郁症，其风险（95%CI为1.5 - 4.4）是低剂量方案（每日< 20 mg）患者的2.6倍。较高的阿片类药物剂量与较高的疼痛严重程度和较高水平的患者报告的阿片类药物相关的心理社会问题，控制问题和抑郁症相关。这些发现可能是由于患者选择高剂量治疗或高剂量阿片类药物引起的问题。
Chronic opioid therapy has increased dramatically, as have complications related to prescription opioids. Little is known about the problems and concerns attributed to opioids by patients receiving different opioid doses. We surveyed 1883 patients who were receiving chronic opioid therapy for chronic non-cancer pain. Opioid regimen characteristics were ascertained from electronic pharmacy records. Patient-reported opioid-related problems and concerns were measured using the Prescription Opioid Difficulties Scale. Depression was assessed with the Patient Health Questionnaire. Patients prescribed higher opioid doses reported modestly higher pain intensity and pain impact. After adjustment, patients on higher doses attributed higher levels of psychosocial problems and control concerns to prescribed opioids (p<.0001). They also had higher levels of depression and were more likely to meet criteria for clinical depression. Over 60% of patients receiving 120+ mg daily (morphine equivalent) were clinically depressed, a 2.6-fold higher risk (95% CI of 1.5 to 4.4) than patients on low dose regimens (< 20 mg daily). Higher opioid doses were associated with somewhat higher pain severity and higher levels of patient-reported opioid-related psychosocial problems, control concerns, and depression. These findings may result from patient selection for high dose therapy or problems caused by higher dose opioids.
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影响因子：
--
作者：
Braden, Jennifer Brennan;Russo, Joan;Sullivan, Mark D.
通讯作者：
Sullivan, Mark D.
影响因子：
4.2
作者：
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通讯作者：
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影响因子：
7.4
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影响因子：
3
作者：
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通讯作者：
DEYO, RA
影响因子：
4.4
作者：
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通讯作者：
West, Brady T.