Opioid Prescribing Patterns Before Fatal Opioid Overdose
Opioid Prescribing Patterns Before Fatal Opioid Overdose
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DOI：
10.1016/j.amepre.2019.09.022
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发表时间：
2020-02-01
影响因子：
5.5
通讯作者：
Pho, Mai T.
中科院分区：
文献类型：
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作者：
Abbasi, Ali B.;Salisbury-Afshar, Elizabeth;Pho, Mai T.
简介：尽管自 2010 年以来阿片类药物处方有所减少，但涉及非法阿片类药物的过量死亡人数持续上升。本研究探讨了死于处方药和非法阿片类药物过量的死者在致命过量服用之前的处方模式。方法：这项回顾性队列研究于 2019 年进行，纳入了 2016 年死于阿片类药物相关过量的所有 1,893 名伊利诺伊州居民。每位死者都与任何现有的处方监测计划记录相关联，计算之前 52 周的每周吗啡毫克当量结果：在 1,893 例致命阿片类药物过量中，309 例涉及任何处方阿片类药物，1,461 例涉及非法阿片类药物，但不涉及处方阿片类药物。黑人居民因非法阿片类药物导致的死亡率为 23/100,000，而白人居民为 10.5/100,000。在生命的最后一年，76% 的处方阿片类药物死者服用了任何阿片类药物处方，每个死者总共 10.7 个处方，而非法阿片类药物死者的这一比例为 36%，每个死者总共 2.6 个处方。在生命的最后一周，33% 的处方阿片类死者服用了阿片类药物处方，每个死者总共 0.42 个处方，而非法阿片类死者的这一比例为 4%，每个死者总共 0.05 个处方。结论：仅凭处方模式可能不足以识别阿片类药物过量高风险的患者，特别是对于那些使用非法阿片类药物的患者。旨在减少阿片类药物过量的干预措施应考虑到与非法和处方阿片类药物过量死亡相关的不同阿片类药物处方模式，并围绕阿片类药物过量流行的当地特征进行设计。 (C) 2019 年美国预防医学杂志。由爱思唯尔公司出版。保留所有权利。
Introduction: Although opioid prescribing has decreased since 2010, overdose deaths involving illicit opioids have continued to rise. This study explores prescribing patterns before fatal overdose of decedents who died of prescription and illicit opioid overdoses.Methods: This retrospective cohort study was conducted in 2019 and included all 1,893 Illinois residents who died of an opioid-related overdose in 2016. Each decedent was linked to any existing Prescription Monitoring Program records, calculating weekly morphine milligram equivalents for 52 weeks before overdose.Results: Among the 1,893 fatal opioid overdoses, 309 involved any prescription opioid and 1,461 involved illicit opioids without the involvement of prescription opioids. The death rate because of illicit opioids was 23/100,000 among black residents versus 10.5/100,000 among whites. During the last year of life, 76% of prescription opioid decedents filled any opioid prescription totaling 10.7 prescriptions per decedent, compared with 36% of illicit opioid decedents totaling 2.6 prescriptions per decedent. During the last week of life, 33% of prescription opioid decedents filled an opioid prescription totaling 0.42 prescriptions per decedent, compared with 4% of illicit opioid decedents totaling 0.05 prescriptions per decedent.Conclusions: Prescribing patterns alone may not be sufficient to identify patients who are at high risk for opioid overdose, especially for those using illicit opioids. Interventions aimed at reducing opioid overdoses should take into account different patterns of opioid prescribing associated with illicit and prescription opioid overdose deaths and be designed around the local characteristics of the opioid overdose epidemic. (C) 2019 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.