Medical multimorbidity and drug use among adults in the United States.
Medical multimorbidity and drug use among adults in the United States.
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DOI：
10.1016/j.pmedr.2018.10.007
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发表时间：
2018-12-01
影响因子：
2.8
通讯作者：
Palamar, Joseph J
中科院分区：
文献类型：
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作者：
Han, Benjamin H;Termine, Domenic J;Palamar, Joseph J
患有医学多发性疾病（≥2种慢性疾病）的成人对卫生保健系统提供协调护理提出了挑战。物质使用可以使慢性疾病的管理复杂化，但很少有研究集中在医疗多重疾病和物质使用的交叉点上。这项研究对2012-2014年全国药物使用和健康调查的115，335名成年受访者进行了横断面分析，以估计患有多发性硬化症的成年人中过去一年药物使用的流行率和相关性。在报告0、1和≥2种慢性疾病的个体之间比较了过去一年药物使用的患病率。我们使用多变量logistic回归来确定患有≥2种慢性疾病的成年人过去一年药物使用的相关性。53.1%报告无慢性疾病，29.5%报告1种慢性疾病，17.4%报告≥2种慢性疾病。18.3%的无慢性病患者报告了去年的药物使用，14.8%的患者报告了1种慢性病，11.6%的患者报告了≥2种慢性病。大麻和阿片类镇痛药（非医疗用途）是所有三组中最常用的药物。在调整后的模型中，在患有医学多发性硬化症的成年人中，过去一年使用药物的成年人更有可能是年轻，男性，收入较低，并报告目前吸烟，酒精依赖，过去一年抑郁症，并在过去一年接受心理健康治疗。在这一国家队列中，与没有或有一种慢性疾病的成年人相比，报告使用药物的多发病成年人较少，然而，这一多发病率高的人群可能特别容易受到药物使用的负面影响。
Adults with medical multimorbidity (≥2 chronic conditions) present challenges for health care systems to provide coordinated care. Substance use can complicate the management of chronic medical conditions, but little research has focused on the intersection of medical multimorbidity and substance use. This study uses cross-sectional analysis of 115,335 adult respondents of the 2012-2014 administrations of the National Survey on Drug Use and Health to estimate the prevalence and correlates of past-year drug use among adults with multimorbidity. The prevalence of past-year drug use was compared between individuals reporting 0, 1, and ≥2 chronic medical conditions. We used multivariable logistic regression to determine correlates of past-year drug use among adults with ≥2 chronic medical conditions. 53.1% reported no chronic conditions, 29.5% reported one chronic condition, and 17.4% reported ≥2 chronic conditions. Past-year drug use was reported by 18.3% of those with no chronic conditions, 14.8% with 1 chronic condition, and 11.6% with ≥2 chronic conditions. Cannabis and opioid analgesics (nonmedical use) were the most common drugs used across all three groups. In the adjusted model, among adults with medical multimorbidity, adults with past-year drug use were more likely to be younger, male, have lower income, and report current tobacco use, alcohol dependence, past-year depression, and having received mental health treatment in the past year. In this national cohort, fewer adults with multimorbidity reported substance use compared to adults with no or one chronic condition, however, this population with high multimorbidity may be particularly vulnerable to the negative effects of drug use.