Sex Differences in Opioid Use Disorder Prevalence and Multimorbidity Nationally in the Veterans Health Administration.
Sex Differences in Opioid Use Disorder Prevalence and Multimorbidity Nationally in the Veterans Health Administration.
复制标题
退伍军人健康管理局全国阿片类药物使用障碍患病率和多重发病率的性别差异。
DOI：
10.1080/15504263.2021.1904162
复制
发表时间：
2021-04
影响因子：
2.2
通讯作者：
Rosenheck RA
中科院分区：
文献类型：
--
作者：
Peltier MR;Sofuoglu M;Petrakis IL;Stefanovics E;Rosenheck RA
阿片类药物使用障碍（OUD）是美国退伍军人中的一个重要问题，OUD和过量的比率不断增加，因此对退伍军人健康管理局（VHA）内的服务提供具有重要意义。在OUD患者中，关于共同发生的医学、精神病和疼痛相关诊断，已经开始出现一些性别特异性差异。这种多发病率在OUD男性和女性之间可能有所不同，可能对VHA内的治疗有重要意义，但尚未进行研究。本研究使用的数据集包括在2012财政年度（FY）（2011年10月1日至2012年9月30日）期间接受VHA医疗保健的所有退伍军人，他们在这一年中被诊断为阿片类药物依赖或滥用。在2012财年，对全国范围内诊断为OUD的VHA患者按性别、OUD比例、社会人口学特征、医学、精神病和疼痛相关诊断以及服务使用、精神病和阿片类激动剂处方填写进行了比较。在2012财政年度，48，408名退伍军人被诊断患有OUD，其中5.77%是女性。在这些退伍军人与OUD，很少的社会人口学差异，观察性别之间。女性退伍军人有较高的精神病诊断率，特别是情绪，焦虑和人格障碍，以及较高的疼痛相关诊断率，如头痛和纤维肌痛，而男性退伍军人更有可能并发严重的医疗合并症，包括肝脏疾病，艾滋病毒，癌症，外周血管疾病，糖尿病和相关并发症，以及肾脏疾病。在保健服务利用方面几乎没有差异，妇女报告说，更多地收到抗焦虑/镇静/催眠药、兴奋剂和锂的处方。男性和女性在接受阿片类激动剂药物或心理健康/物质使用治疗方面没有差异。在患有OUD的退伍军人中，跨医学，精神病学和疼痛相关诊断的多发病模式存在显著的性别特异性差异。这些结果表明，需要将OUD视为一种多发病状况，并设计针对此类多发病的干预措施。本研究强调了对患有OUD和相关并发症的女性退伍军人进行性别特异性治疗和预防工作的潜在益处。
Opioid use disorder (OUD) is a significant problem among US veterans with increasing rates of OUD and overdose, and thus has substantial importance for service delivery within the Veterans Health Administration (VHA). Among individuals with OUD, several sex-specific differences have begun to emerge regarding co-occurring medical, psychiatric and pain-related diagnoses. The rates of such multimorbidities are likely to vary between men and women with OUD and may have important implications for treatment within the VHA but have not yet been studied. The present study utilized a data set that included all veterans receiving VHA health care during Fiscal Year (FY) 2012 (October 1, 2011 through September 30, 2012), who were diagnosed during the year with opioid dependence or abuse. VHA patients diagnosed with OUD nationwide in FY 2012 were compared by sex on proportions with OUD, and among those with OUD, on sociodemographic characteristics, medical, psychiatric and pain-related diagnoses, as well as on service use, and psychotropic and opioid agonist prescription fills. During FY 2012, 48,408 veterans were diagnosed with OUD, 5.77% of whom were women. Among those veterans with OUD, few sociodemographic differences were observed between sexes. Female veterans had a higher rate of psychiatric diagnoses, notably mood, anxiety and personality disorders, as well as higher rates of pain-related diagnoses, such as headaches and fibromyalgia, while male veterans were more likely to have concurrent, severe medical co-morbidities, including hepatic disease, HIV, cancers, peripheral vascular disease, diabetes and related complications, and renal disease. There were few differences in health service utilization, with women reporting greater receipt of prescriptions for anxiolytic/sedative/hypnotics, stimulants and lithium. Men and women did not differ in receipt of opioid agonist medications or mental health/substance use treatments. There are substantial sex-specific differences in patterns of multimorbidity among veterans with OUD, spanning medical, psychiatric and pain-related diagnoses. These results illustrate the need to view OUD as a multimorbid condition and design interventions to target such multimorbidities. The present study highlights the potential benefits of sex-specific treatment and prevention efforts among female veterans with OUD and related co-occurring disorders.
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影响因子：
4.2
作者：
Greenfield, Shelly F.;Sugarman, Dawn E.;Fitzmaurice, Garrett M.
通讯作者：
Fitzmaurice, Garrett M.
影响因子：
5.5
作者：
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通讯作者：
Simpson, Tracy L.
影响因子：
4.2
作者：
Hernandez-Avila, CA;Rounsaville, BJ;Kranzler, HR
通讯作者：
Kranzler, HR
影响因子：
7.4
作者：
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通讯作者：
Isenberg, Keith
影响因子：
3
作者：
Finlay, Andrea K.;Binswanger, Ingrid A.;Frayne, Susan
通讯作者：
Frayne, Susan