Prescription and Prescriber Specialty Characteristics of Initial Opioid Prescriptions Associated with Chronic Use.
Prescription and Prescriber Specialty Characteristics of Initial Opioid Prescriptions Associated with Chronic Use.
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与长期使用相关的初始阿片类药物处方的处方和处方者专业特征。
DOI：
10.1093/pm/pnaa293
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Baker,Olesya
中科院分区：
文献类型：
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作者：
Weiner,ScottG;Chou,Shih-Chuan;Chang,CindyY;Garner,Chad;ElIbrahimi,Sanae;Hallvik,Sara;Hendricks,Michelle;Baker,Olesya
目的：本研究评估opioid-naïve患者阿片类药物处方的特点，包括处方医师专业及其与慢性用药的关系。2010年1月至2017年11月俄亥俄州处方药监测项目的横断面分析。SettingOhio,美国。研究对象2010年至2012年无阿片类药物处方，2013年1月至2016年11月首次处方的患者。方法慢性使用定义为一年内至少6次阿片类药物处方，首次使用阿片类药物与最后一次使用阿片类药物间隔1年或1年以上，或该年度平均≤30天未使用阿片类药物。结果2013 - 2016年共4252809例opioid-naïve患者首次获得阿片类药物处方；364947例（8.6%）符合慢性用药的定义。慢性使用的患者年龄较大（51.7岁vs 45.6岁），女性更容易（53.6% vs 52.8%），他们的第一次处方有更高的药片量（44.9比30.2），更高的吗啡毫克当量（MME； 355.3比200.0），更可能是缓释制剂（2.9%比0.7%，均p < 0.001）。与内科相比，调整后的慢性用药几率以麻醉科（OR = 1.46）和神经内科（OR = 1.43）最高，眼科（OR = 0.33）和妇科（OR = 0.37）最低。结论：接受阿片类药物处方的opioid-naïve个体中有8.6%发展为慢性使用。这个比率取决于开处方的医生的专业。慢性用药的风险随着初始处方中MME含量的增加和缓释阿片类药物的使用而增加。
ObjectiveThis study evaluated the characteristics of opioid prescriptions, including prescriber specialty, given to opioid-naïve patients and their association with chronic use.DesignCross-sectional analysis of the Ohio prescription drug monitoring program from January 2010 to November 2017.SettingOhio, USA.SubjectsPatients who had no opioid prescriptions from 2010 to 2012 and a first-time prescription from January 2013 to November 2016.MethodsChronic use was defined as at least six opioid prescriptions in one year and either one or more years between the first and last prescription or an average of ≤30 days not covered by an opioid during that year.ResultsA total of 4,252,809 opioid-naïve patients received their first opioid prescription between 2013 and 2016; 364,947 (8.6%) met the definition for chronic use. Those who developed chronic use were older (51.7 vs 45.6 years) and more likely to be female (53.6% vs 52.8%), and their first prescription had higher pill quantities (44.9 vs 30.2), higher morphine milligram equivalents (MME; 355.3 vs 200.0), and was more likely to be an extended-release formulation (2.9% vs 0.7%, allP< 0.001). When compared with internal medicine, the adjusted odds of chronic use were highest with anesthesiology (odds ratio [OR] = 1.46) and neurology (OR = 1.43) and lowest with ophthalmology (OR = 0.33) and gynecology (OR = 0.37).ConclusionsEight point six percent of opioid-naïve individuals who received an opioid prescription developed chronic use. This rate varied depending on the specialty of the provider who wrote the prescription. The risk of chronic use increased with higher MME content of the initial prescription and use of extended-release opioids.