Characterizations of Opioid Prescribing in Community Health Centers in 2018.
Characterizations of Opioid Prescribing in Community Health Centers in 2018.
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DOI：
10.1177/21501319221074115
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发表时间：
2022-01
影响因子：
3.6
通讯作者：
Muench J
中科院分区：
文献类型：
--
作者：
Huguet N;Hodes T;Bailey SR;Marino M;Hartung DM;Voss R;O'Malley J;Chamine I;Muench J
确定多州社区健康中心 (CHC) 网络中任何处方阿片类药物使用、长期使用和高剂量阿片类药物使用在患者和诊所层面的相关性。我们使用了 2018 年为 15 个州的 610-983 名患者提供服务的 337 个初级保健诊所的电子健康记录数据。主要结果是任何阿片类药物、慢性阿片类药物和高剂量阿片类药物的处方。总体而言，6.5% 的患者服用了阿片类药物；其中，31% 是长期使用者，5% 是高剂量使用者。男性服用阿片类药物的几率低 5%（优势比 [OR] = 0.95；95% 置信区间 = 0.93-0.97），但长期使用者的几率高 16%（OR = 1.16；95% CI = 1.10-1.21），男性为 48% （OR = 1.48；95% CI = 1.36-1.64）高剂量使用者的几率高于女性。农村诊所慢性阿片类药物使用率（比率 = 1.86；95% CI= 1.20、2.88）和高剂量使用者（比率 = 2.95；95% CI= 1.81-4.81）比例较高。我们的研究强调了阿片类药物处方在患者层面和诊所层面因素方面的差异。可能需要有针对性的努力和资源来支持寻求减少高风险阿片类药物处方的农村社区卫生中心。
To identify the patient- and clinic-level correlates of any prescription opioid use, chronic use, and high-dose opioid use in a multi-state network of Community Health Centers (CHCs). We used electronic health record data from 337 primary care clinics serving 610 983 patients across 15 states in 2018. The primary outcomes were prescription of any opioid, chronic opioid, and high-dose opioid. Overall, 6.5% of patients were prescribed an opioid; of these, 31% were chronic users and 5% were high-dose users. Males had 5% lower odds (Odds Ratio [OR] = 0.95; 95% Confidence Interval = 0.93-0.97) of being prescribed an opioid but 16% higher odds (OR = 1.16; 95% CI = 1.10-1.21) of being chronic users and 48% (OR = 1.48; 95% CI = 1.36-1.64) higher odds of being high-dose users than females. Rural clinics had higher rates of chronic opioid (rate ratio = 1.86; 95% CI = 1.20, 2.88) and high-dose users (rate ratio = 2.95; 95% CI = 1.81-4.81). Our study highlights variations in opioid prescribing with regard to patient-level and clinic-level factors. Targeted efforts and resources may be required to support rural CHCs who seek to reduce high-risk opioid prescribing.