Association of Rheumatoid Arthritis with Opioid Pain Medication Overuse among Persons Exposed to the 9/11 World Trade Center Disaster.
Association of Rheumatoid Arthritis with Opioid Pain Medication Overuse among Persons Exposed to the 9/11 World Trade Center Disaster.
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DOI：
10.3390/ijerph20054166
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发表时间：
2023-02-25
影响因子：
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通讯作者：
Li, Jiehui
中科院分区：
文献类型：
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作者：
Dhanya, Ananya Sarker;Yung, Janette;Cone, James E;Li, Jiehui
我们研究了9/11后类风湿性关节炎（RA）诊断与世界贸易中心健康登记处（WTCHR）注册者中阿片类止痛药过度使用的相关性。阿片类药物过度使用被定义为自我报告的处方阿片类药物的摄入量高于最近两次WTcourt调查之一（2015-2016，2020-2021）中过去12个月的指示剂量或更频繁。通过自我报告确定9/11后RA，随后在登记者的医生发布医疗记录或医疗记录审查后进行验证。我们排除了那些自我报告的未经医生验证的RA患者，以及那些在过去12个月内没有报告服用阿片类止痛药的患者。进行多变量对数二项回归，以检查9/11后RA诊断与阿片类止痛药过度使用之间的关系，调整社会人口学特征和9/11相关的创伤后应激障碍（PTSD）症状。在10，196名研究入组者中，46人证实了9/11后的RA。9/11后RA患者大多为女性（69.6% vs. 37.7%），非西班牙裔白色患者较少（58.7% vs. 73.2%），与未发生9/11后RA的患者相比，受教育程度较高的患者较少（76.1% vs. 84.4%）。阿片类止痛药过度使用与9/11后RA诊断显著相关（校正风险比：2.13，95% CI：1.44-3.17）。需要更多的研究来更好地了解WTC暴露的RA患者中处方阿片类药物的使用和管理。
We examined the association of post-9/11 rheumatoid arthritis (RA) diagnosis with opioid pain medication overuse among enrollees in the World Trade Center Health Registry (WTCHR). Opioid overuse was defined as the self-reported intake of prescribed opioids at a higher dosage or more often than directed in the last 12 months on one of the two most recent WTCHR surveys (2015–2016, 2020–2021). Post-9/11 RA was ascertained through self-reports and subsequently validated following medical record release by the enrollees’ physicians or medical records review. We excluded those with self-reported RA that was not validated by their physicians and those who did not report being prescribed opioid pain medication in the last 12 months. Multivariable log-binomial regression was conducted to examine the relationship between post-9/11 RA diagnosis and opioid pain medication overuse, adjusting for sociodemographic characteristics and 9/11-related posttraumatic stress disorder (PTSD) symptoms. Of the 10,196 study enrollees, 46 had confirmed post-9/11 RA. The post-9/11 RA patients were mostly females (69.6% vs. 37.7%), less frequently non-Hispanic White (58.7% vs. 73.2%) individuals, and less often had attained a higher level of education (76.1% vs. 84.4%) compared to those without post-9/11 RA. Opioid pain medication overuse was significantly associated with a post-9/11 RA diagnosis (Adjusted Risk Ratio: 2.13, 95% CI: 1.44–3.17). More research is needed to better understand the use and management of prescribed opioids among WTC-exposed individuals with RA.