Correlates of indicators of potential extra-medical opioid use in people prescribed opioids for chronic non-cancer pain.
Correlates of indicators of potential extra-medical opioid use in people prescribed opioids for chronic non-cancer pain.
复制标题
服用阿片类药物治疗慢性非癌性疼痛的患者中潜在的非医疗阿片类药物使用指标的相关性。
DOI：
10.1111/dar.13021
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发表时间：
2020
影响因子：
3.8
通讯作者：
Campbell,Gabrielle
中科院分区：
文献类型：
--
作者：
SantoJr,Thomas;Larance,Briony;Bruno,Raimondo;Gisev,Natasa;Nielsen,Suzanne;Degenhardt,Louisa;Campbell,Gabrielle
简介和目的阿片类药物相关治疗行为（ORBIT）量表是衡量潜在的非医疗阿片类药物使用的最新指标。潜在的医疗外使用阿片类药物的指标是处方阿片类药物的人之间的不同做法，这可能使他们面临伤害风险。本研究旨在研究慢性非癌性疼痛（CNCP）处方阿片类药物患者潜在的医疗外阿片类药物使用指标的相关性。设计和方法疼痛和阿片类药物治疗（POINT）研究是一项前瞻性队列研究，研究对象是澳大利亚使用阿片类药物治疗CNCP的患者。仅因阿片类药物依赖而开阿片类药物处方的人被排除在外。本横断面研究利用逻辑回归来确定与报告任何潜在的医疗外阿片类药物使用指标相关的特征。结果在1505名参与者中，38%报告至少有一项潜在的额外医疗阿片类药物使用指标，最常见的是要求增加处方阿片类药物剂量（21%）和早期处方更新（12%）。潜在的医疗外阿片类药物使用指标与年龄较小（校正优势比[AOR] = 0.98； 95%可信区间[CI] = 0.92, 0.99）、男性（AOR = 1.53; 95% CI = 1.15, 2.04）、终生阿片类药物使用障碍（AOR = 1.87; 95% CI = 1.31, 2.66）和终生非法药物使用障碍（AOR = 1.72; 95% CI = 1.18, 2.52）相关。讨论与结论：超过三分之一的POINT队列报告了一个或多个潜在的医疗外阿片类药物使用指标。终生物质使用障碍与这些不同的实践有关，突出了临床监测和患者教育对这一患者群体的重要性。需要进行纵向研究，以调查潜在的医疗外阿片类药物使用指标是否能预测这一人群的阿片类药物使用障碍。
Introduction and AimsThe opioid‐related behaviours in treatment (ORBIT) scale are a measure of recent indicators of potential extra‐medical opioid use. Indicators of potential extra‐medical opioid use are divergent practices among people prescribed opioids that may place them at risk of harm. This study aimed to examine the correlates of indicators of potential extra‐medical opioid use in people prescribed opioids for chronic non‐cancer pain (CNCP).Design and MethodsThe Pain and Opioids IN Treatment (POINT) study is a prospective cohort study of people prescribed opioids for CNCP in Australia. People prescribed opioids solely for opioid dependence were excluded. This cross‐sectional study utilised logistic regression to determine the characteristics associated with reporting any indicators of potential extra‐medical opioid use.ResultsOf the 1505 participants, 38% reported at least one indicator of potential extra‐medical opioid use, most commonly asking for an increase in prescribed opioid dose (21%) and early prescription renewal (12%). Indicators of potential extra‐medical opioid use were associated with younger age (adjusted odds ratio [AOR] = 0.98; 95% confidence interval [CI] = 0.92, 0.99), male sex (AOR = 1.53; 95% CI = 1.15, 2.04), lifetime pharmaceutical opioid use disorder (AOR = 1.87; 95% CI = 1.31, 2.66) and lifetime illicit drug use disorder (AOR = 1.72; 95% CI = 1.18, 2.52).Discussion and ConclusionsOver one‐third of the POINT cohort reported one or more indicators of potential extra‐medical opioid use. Lifetime substance use disorders were associated these divergent practices, highlighting the importance of clinical monitoring and patient education for this patient group. Longitudinal studies are needed to investigate whether indicators of potential extra‐medical opioid use predict opioid use disorders in this population.