Race and Gender Are Associated with Opioid Dose Reduction Among Patients on Chronic Opioid Therapy
Race and Gender Are Associated with Opioid Dose Reduction Among Patients on Chronic Opioid Therapy
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DOI：
10.1093/pm/pny137
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发表时间：
2019-08-01
期刊：
影响因子：
3.1
通讯作者：
Starrels, Joanna L.
中科院分区：
文献类型：
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作者：
Buonora, Michele;Perez, Hector R.;Starrels, Joanna L.
目标。在慢性疼痛患者中，高阿片类药物剂量或同时使用苯二氮卓类药物会增加使用阿片类药物的风险。这项研究检查了这些临床因素，或种族和性别的社会人口学因素，是否与阿片类药物剂量减少有关。设计和布景。使用电子病历数据，对2007年至2012年期间在纽约布朗克斯一个大型学术医疗保健系统中开出慢性阿片类药物治疗的门诊患者进行了一项回溯性队列研究。纳入的患者在一年的“基准期”内被开出稳定剂量的慢性阿片类药物治疗，并且没有患癌症。方法：研究方法。主要结果是两年内阿片类药物剂量减少(从基线减少30%)。多变量Logistic回归检验了两个临床变量(每日阿片类药物基线剂量和同时开出的苯二氮卓类药物处方)和两个社会人口学变量(种族/民族和性别)与阿片类药物剂量减少的关系。结果。在1097名患者中，463名(42.2%)的阿片类药物剂量减少。与阿片类药物剂量相比，高阿片剂量(>；=100吗啡毫克当量[MME])与阿片类药物剂量减少的几率较低相关
Objective. Among patients with chronic pain, risk of opioid use is elevated with high opioid dose or concurrent benzodiazepine use. This study examined whether these clinical factors, or sociodemographic factors of race and gender, are associated with opioid dose reduction. Design and Setting. A retrospective cohort study of outpatients prescribed chronic opioid therapy between 2007 and 2012 within a large, academic health care system in Bronx, New York, using electronic medical record data. Included patients were prescribed a stable dose of chronic opioid therapy over a one-year "baseline period" and did not have cancer. Methods. The primary outcome was opioid dose reduction (>= 30% reduction from baseline) within two years. Multivariable logistic regression tested the associations of two clinical variables (baseline daily opioid dose and concurrent benzodiazepine prescription) and two sociodemographic variables (race/ethnicity and gender) with opioid dose reduction. Results. Of 1,097 patients, 463 (42.2%) had opioid dose reduction. High opioid dose (>= 100 morphine-milligram equivalents [MME]) was associated with lower odds of opioid dose reduction compared with an opioid dose