The impact of California wildfires on patient access to prescription opioids.
The impact of California wildfires on patient access to prescription opioids.
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DOI：
10.1016/j.japh.2022.05.012
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发表时间：
2022-11
影响因子：
2.1
通讯作者：
Henry, Stephen G.
中科院分区：
文献类型：
--
作者：
Tseregounis, Iraklis E.;Delcher, Chris;Stewart, Susan L.;Gasper, James J.;Shev, Aaron B.;Crawford, Andrew;Wintemute, Garen;Henry, Stephen G.
长期接受阿片类药物治疗的患者特别容易受到药物供应中断的影响，特别是在野火和其他自然灾害等创伤和混乱事件期间。确定过去高度破坏性的加州野火是否与长期接受阿片类药物治疗的患者中断处方阿片类药物的使用有关，因此身体依赖阿片类药物。使用加州处方药监测项目数据，这项回顾性研究选择了居住在受Camp Fire或Tubbs Fire影响的邮政编码列表地区的长期处方阿片类药物使用发作的患者。将自回归综合移动平均时间序列模型拟合至火灾前数据，以预测火灾后预期值，然后与观察到的火灾后数据进行比较;特别是针对具有早期填充、晚期填充、患者处方者和/或药房变化以及在与患者住所不同的邮政编码制表区域内填充的长期发作的每周比例。在营火之后，在高影响的邮政编码列表区域，早期填充比例（峰值为56%，火灾后第1周），晚期填充比例（峰值为29%，第6周）以及处方者（峰值为37%，第3周）和药房变化（峰值为71%，第1周）的立即显著增加。低影响的邮政编码制表区没有经历类似的中断。塔布斯大火造成的破坏远没有那么严重。对于生活在受Camp Fire影响最严重的地区的患者来说，获得处方阿片类药物的机会受到了极大的干扰。未来的研究应探讨当前州和联邦受控药物处方政策的有效性，以确定需要进行哪些改进，以尽量减少野火和其他自然灾害对药物获取的干扰。
Patients on long-term opioid therapy are particularly vulnerable to disruptions in medication access, especially during traumatic and chaotic events such as wildfires and other natural disasters. To determine if past highly destructive California wildfires were associated with disrupted access to prescription opioids for patients receiving long-term, and therefore physically dependent on, opioid medications. Using California prescription drug monitoring program data, this retrospective study selected patients with long-term prescription opioid use episodes residing in ZIP code tabulation areas impacted by either the Camp Fire or Tubbs Fire. Autoregressive integrated moving average time series models were fit to pre-fire data to forecast post-fire expected values and then compared to observed post-fire data; specifically for weekly proportions of long-term episodes with early fills, late fills, changes in patients’ prescriber and/or pharmacy, and fills within a different ZIP code tabulation area than the patient’s residence. After the Camp Fire, there were significant spikes in the proportions of early fills (peak at 56% of total, week 1 post fire), late fills (peak at 29%, week 6), and immediate significant increases in prescriber (peak at 37%, week 3) and pharmacy changes (peak at 71%, week 1) in high-impact ZIP code tabulation areas. Low-impact ZIP code tabulation areas experienced no similar disruptions. Disruptions due to the Tubbs Fire were far less severe. Access to prescription opioids was greatly disrupted for patients living in areas most impacted by the Camp Fire. Future research should explore effectiveness of current state and federal controlled substance prescribing policies to determine what improvements are needed to minimize disruptions in medication access due to wildfires and other natural disasters.
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影响因子：
3.1
作者：
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通讯作者：
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影响因子：
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