Gaps in the Use of Long-Acting Opioids Within Intervals of Consecutive Days Among Cancer Outpatients Using Electronic Pill Caps.
Gaps in the Use of Long-Acting Opioids Within Intervals of Consecutive Days Among Cancer Outpatients Using Electronic Pill Caps.
复制标题
使用电子药帽的癌症门诊患者连续几天使用长效阿片类药物的差距。
DOI：
10.1093/pm/pnaa273
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Knafl,GeorgeJ
中科院分区：
文献类型：
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作者：
Meghani,SalimahH;Persico,AmeliaL;Fudin,Jeffrey;Knafl,GeorgeJ
本研究描述了个体癌症患者不使用缓释或长效（ER/LA）阿片类药物，包括阿片类药物剂量之间的间隔期。设计对使用电子药丸帽监测的处方ER/LA阿片类药物的三个月观察性研究的二次分析。设置大西洋中部地区一个大型卫生系统的两个门诊肿瘤诊所。入选者是基于自我认定的非裔美国人和白人，至少18岁，诊断为实体瘤或多发性骨髓瘤。对于目前的分析，额外的纳入标准是处方口服ER/LA阿片类药物治疗癌症疼痛，需要24小时服用。MethodsThe电子监测期为每个研究参与者被划分为天之间的间隔天与一个或多个开口（使用药物事件监测系统）表示连续几天和一段时间内ER/LA阿片样物质不使用的比率。三分之二的癌症患者在一定程度上未使用处方的ER/LA阿片类药物，四分之一的患者在31.5-87.5%的电子监测期间未使用。连续5天或以上、6天或以上和7天或以上不使用的发生率分别为37.6%、34.9%和30.3%。ConclusionsAbout one of three ambulatory cancer patients in this study had substantial gap between days of ER/LA opioid use，potentially lead in risk of overdosage depending on prescribed ER/LA opioid type，dose，以及阿片样物质停止和以先前剂量恢复的时间长度。这种现象在阿片类药物安全性讨论中几乎没有受到关注。
ObjectiveThis study describes individual cancer patients’ nonuse of extended-release or long-acting (ER/LA) opioids, including periods of gap between opioid doses taken.DesignSecondary analysis of a three-month observational study of prescribed ER/LA opioids monitored using electronic pill caps.SettingTwo outpatient oncology clinics of a large health system in the Mid-Atlantic region.ParticipantsInclusion was based on self-identified African Americans and whites, at least 18 years old, diagnosed with solid tumors or multiple myeloma. For the current analysis, the additional inclusion criterion was prescription of an oral ER/LA opioid for cancer pain to be taken around the clock.MethodsThe electronic monitoring period for each study participant was partitioned into intervals ofdays between dayswith one or more openings (using medication event monitoring systems) representing rates of ER/LA opioid nonuse over consecutive days and over time.ResultsOf the sample (N = 109), two-thirds of the cancer patients had some nonuse of prescribed ER/LA opioids, with one in four having nonuse during 31.5–87.5% of their electronic-monitoring periods. Nonuse over periods of five or more, six or more, and seven or more consecutive days occurred for 37.6%, 34.9%, and 30.3% of the participants, respectively.ConclusionsAbout one in three ambulatory cancer patients in this study had substantial gaps between days of ER/LA opioid use, potentially resulting in risk of overdose depending upon the prescribed ER/LA opioid type, dose, and length of the time the opioid was stopped and resumed at the previous dose. This phenomenon has received little to no attention in the opioid safety discourse.