Patterns and trends in opioid use among individuals with back pain in the United States
Patterns and trends in opioid use among individuals with back pain in the United States
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DOI：
10.1097/00007632-200404150-00012
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发表时间：
2004-04-15
期刊：
影响因子：
3
通讯作者：
Hey, L
中科院分区：
文献类型：
--
作者：
Luo, XM;Pietrobon, R;Hey, L
研究设计. 1996~1999年医疗费用追踪调查的二次分析研究1996年、1997年、1998年和1999年美国背痛患者中阿片类药物的使用模式，并调查总体和个体阿片类药物使用的趋势。据作者所知，没有研究在国家层面上研究美国背痛患者使用阿片类药物的模式和趋势。根据社会人口学特征和地理区域对背痛患者进行分层。使用简单和多变量logistic回归模型比较不同分层之间阿片类药物的总体使用率。为了调查阿片类药物使用的趋势，计算并比较了每年总体和个体阿片类药物类别的使用率。从1996年到1999年，在不同教育水平、家庭收入和健康保险状况的个人中，阿片类药物的总体使用情况一直存在很大差异。在4年的大部分时间里，还观察到类阿片使用的区域差异。在对协变量进行调整后，健康保险状况和地理区域是1997年至1999年阿片类药物使用的一致预测因素。趋势分析表明，总体阿片类药物使用率在4年期间略有增加。在单个阿片类药物类别中，羟考酮或氢可酮的使用增加，而丙氧芬的使用减少。具有不同社会人口学特征和来自不同地理区域的背痛患者总体阿片类药物使用情况的差异表明有机会改善阿片类药物处方模式。氢可酮和羟考酮使用的增加表明需要更好地评估这些药物在背痛患者中的疗效和安全性。
Study Design. Secondary analysis of Medical Expenditure Panel Survey from 1996 to 1999.Objective. To examine patterns in opioid use in 1996, 1997, 1998, and 1999 among individuals with back pain in the United States and to investigate trends in the use of overall and individual opioid category.Summary of Background Data. To the authors' best knowledge, no study has examined at a national level the patterns and trends in opioid use among individuals with back pain in the United States.Methods. Individuals with back pain were stratified by sociodemographic characteristics and geographic regions. Rates of overall opioid use were compared among different strata by the use of simple and multivariate logistic regression models. To investigate trends in opioid use, use rates of the overall and individual opioid category in each year were calculated and compared.Results. From 1996 to 1999, wide variations in overall opioid use were consistently observed among individuals with different educational levels, family income, and health insurance status. Regional variation in opioid use was also observed for most of the 4 years. After adjustment for covariates, health insurance status and geographic regions were consistent predictors of opioid use from 1997 to 1999. Trend analysis indicated that the rates of overall opioid use increased slightly across the 4-year span. Among individual opioid categories, the use of oxycodone or hydrocodone increased, whereas the use of propoxyphene decreased.Conclusions. The variation in overall opioid use among individuals with back pain with different sociodemographic characteristics and from different geographic regions suggested an opportunity to improve opioid prescribing patterns. The increase in the use of hydrocodone and oxycodone indicated a need to better assess the efficacy and safety associated with these drugs among individuals with back pain.