Opioid Prescribing After Nonfatal Overdose and Association With Repeated Overdose A Cohort Study
Opioid Prescribing After Nonfatal Overdose and Association With Repeated Overdose A Cohort Study
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DOI：
10.7326/m15-0038
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发表时间：
2016-01-05
影响因子：
39.2
通讯作者：
Wharam, J. Frank
中科院分区：
文献类型：
--
作者：
Larochelle, Marc R.;Liebschutz, Jane M.;Wharam, J. Frank
背景：非致命性阿片类药物过量是识别和治疗物质使用障碍的一个机会，但过量后的治疗模式尚不清楚。目的：确定阿片类药物过量后处方阿片类药物的剂量及其与重复过量服用的关系。设计：回顾性队列研究。背景：美国一家大型健康保险公司。参与者：2848 名年龄在 18 至 64 岁之间、服用非致命性阿片类药物的商业保险患者2000 年 5 月至 2012 年 12 月期间，在长期阿片类药物治疗非癌性疼痛期间服用过量。测量：使用《国际疾病分类》第九次修订版、临床修改、急诊科或住院索赔的代码来确定非致命性阿片类药物过量。主要结果是从过量用药前 60 天到用药过量后 730 天期间每天分配的阿片类药物的吗啡当量剂量 (MED)。我们将剂量分为大剂量（>= 100 mg MED）、中剂量（50 至
Background: Nonfatal opioid overdose is an opportunity to identify and treat substance use disorders, but treatment patterns after the overdose are unknown.Objective: To determine prescribed opioid dosage after an opioid overdose and its association with repeated overdose.Design: Retrospective cohort study.Setting: A large U.S. health insurer.Participants: 2848 commercially insured patients aged 18 to 64 years who had a nonfatal opioid overdose during long-term opioid therapy for noncancer pain between May 2000 and December 2012.Measurements: Nonfatal opioid overdose was identified using International Classification of Diseases, Ninth Revision, Clinical Modification, codes from emergency department or inpatient claims. The primary outcome was daily morphine-equivalent dosage (MED) of opioids dispensed from 60 days before to up to 730 days after the index overdose. We categorized dosages as large (>= 100 mg MED), moderate (50 to