Trajectories and correlates of opioid prescription receipt among patients experiencing interpersonal violence.
Trajectories and correlates of opioid prescription receipt among patients experiencing interpersonal violence.
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经历人际暴力的患者中阿片类药物处方收据的轨迹和相关性。
DOI：
10.1371/journal.pone.0273846
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
作者：
人际暴力增加了对阿片类药物使用有害影响的脆弱性。阿片类药物处方的增加是阿片类药物危机的主要原因;然而，我们对有人际暴力史的人的处方模式和风险因素的理解仍然难以捉摸。本研究旨在确定在大型医疗保健系统内经历人际暴力的患者中阿片类药物处方接受的5年纵向模式以及与处方模式相关的社会人口统计学和临床特征。这项二次分析检查了2004年1月至2019年8月期间转诊接受人际暴力服务的一组患者（N = 1，587）的电子健康记录数据。潜在类别增长分析用于估计5年期间阿片类药物处方接收的轨迹。计算标准化差异，以评估不同类别之间社会人口统计学和临床特征的变化。我们的队列中处方阿片类药物接受率（73.3%）和基础共病的患病率较高，包括慢性疼痛（54.6%），物质使用障碍（39.0%）和精神健康诊断（76.9%）。出现了六种处方阿片类药物接受类别，其特征是在研究期开始和结束时接受任何处方阿片类药物的概率（高、中、低、从不）以及概率随时间的变化（增加、减少、稳定）。处方阿片类药物可能性最高的班级也有最高的男性比例，慢性疼痛诊断，物质使用障碍和心理健康诊断。黑人、非西班牙裔和西班牙裔患者更有可能接受少量或无处方阿片类药物治疗。这些发现强调了在提供疼痛管理和提供创伤知情、去污名化和纳入常规护理的治疗时监测协同共病的重要性。
Interpersonal violence increases vulnerability to the deleterious effects of opioid use. Increased opioid prescription receipt is a major contributor to the opioid crisis; however, our understanding of prescription patterns and risk factors among those with a history of interpersonal violence remains elusive. This study sought to identify 5-year longitudinal patterns of opioid prescription receipt among patients experiencing interpersonal violence within a large healthcare system and sociodemographic and clinical characteristics associated with prescription patterns. This secondary analysis examined electronic health record data from January 2004–August 2019 for a cohort of patients (N = 1,587) referred for interpersonal violence services. Latent class growth analysis was used to estimate trajectories of opioid prescription receipt over a 5-year period. Standardized differences were calculated to assess variation in sociodemographic and clinical characteristics between classes. Our cohort had a high prevalence of prescription opioid receipt (73.3%) and underlying co-morbidities, including chronic pain (54.6%), substance use disorders (39.0%), and mental health diagnoses (76.9%). Six prescription opioid receipt classes emerged, characterized by probability of any prescription opioid receipt at the start and end of the study period (high, medium, low, never) and change in probability over time (increasing, decreasing, stable). Classes with the highest probability of prescription opioids also had the highest proportions of males, chronic pain diagnoses, substance use disorders, and mental health diagnoses. Black, non-Hispanic and Hispanic patients were more likely to be in low or no prescription opioid receipt classes. These findings highlight the importance of monitoring for synergistic co-morbidities when providing pain management and offering treatment that is trauma-informed, destigmatizing, and integrated into routine care.
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