A Preliminary Study of Stress, Mental Health, and Pain Related to the COVID-19 Pandemic and Odds of Persistent Prescription Opioid Use.
A Preliminary Study of Stress, Mental Health, and Pain Related to the COVID-19 Pandemic and Odds of Persistent Prescription Opioid Use.
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DOI：
10.1007/s11606-022-07940-4
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发表时间：
2023-03
影响因子：
5.7
通讯作者：
Ahmedani, Brian
中科院分区：
文献类型：
--
作者：
Scherrer, Jeffrey F.;Miller-Matero, Lisa R.;Sullivan, Mark D.;Chrusciel, Timothy;Salas, Joanne;Davidson, Whitney;Zabel, Celeste;Wilson, Lauren;Lustman, Patrick;Ahmedani, Brian
COVID-19大流行与阿片类药物处方增加有关。目前尚不清楚感知到的COVID-19相关压力是否与长期使用阿片类药物的可能性增加有关。确定在6个月的观察期内，与COVID-19相关的更大压力和大流行引起的疼痛恶化是否与LTOT相关。纵向队列。来自两个中西部医疗保健系统的患者（n=477），患有任何急性或慢性非癌症疼痛，开始新的30-90天处方阿片类药物使用期，被邀请参加处方阿片类药物和抑郁途径队列研究，这是一项关于疼痛、阿片类药物使用和心理健康结局的纵向调查研究。基线和6个月的随访评估用于衡量感知的COVID-19压力因素、大流行使疼痛恶化的感知以及持续使用阿片类药物的几率之间的关联，即，在6个月随访时仍为处方阿片类药物使用者。多变量模型控制人口统计学，阿片类药物剂量和疼痛特征，心理健康措施和社会支持的变化。参与者平均年龄为53.9（±11.4）岁，67.1%为白色人种，70.9%为女性。最常被认同的COVID-19压力源是“担心自己/他人的健康”（85. 7%），最少被认同的是“因大流行而加剧的疼痛”（26. 2%）。调整所有协变量后，“大流行引起的疼痛恶化”（OR=2.88; 95%CI：1.33-6.22）、疼痛干扰的变化（OR=1.20; 95%CI：1.04-1.38）和生命衰竭的变化（OR=0.90; 95%CI：0.82-0.99）仍与持续使用阿片类药物显著相关。将疼痛恶化归因于COVID-19大流行的患者更有可能是持续的阿片类药物使用者。进一步的研究是必要的，以确定这种关联的机制。临床医生可以考虑在大流行的背景下讨论疼痛，以确定持续使用阿片类药物的高风险患者。在线版本包含补充材料，可通过10.1007/s11606-022-07940-4获得。
The COVID-19 pandemic has been associated with increased opioid prescribing. It is not known if perceived COVID-19 related stress is associated with increased odds of long-term opioid use. To determine if greater COVID-19-related stress and worsening pain attributed to the pandemic was associated with LTOT over a 6-month observation period. Longitudinal cohort. Patients (n=477) from two midwestern health care systems, with any acute or chronic non-cancer pain, starting a new period of 30–90-day prescription opioid use, were invited to participate in the Prescription Opioids and Depression Pathways Cohort Study, a longitudinal survey study of pain, opioid use, and mental health outcomes. Baseline and 6-month follow-up assessments were used to measure the association between perceived COVID-19 stressors, the perception that pain was made worse by the pandemic and the odds of persistent opioid use, i.e., remaining a prescription opioid user at 6-month follow-up. Multivariate models controlled for demographics, opioid dose, and change in pain characteristics, mental health measures, and social support. Participants were, on average, 53.9 (±11.4) years of age, 67.1% White race, and 70.9% female. The most frequently endorsed COVID-19 stressor was “worry about health of self/others” (85.7% endorsed) and the least endorsed was “worsened pain due to pandemic” (26.2%). After adjusting for all covariates, “worsened pain due to pandemic” (OR=2.88; 95%CI: 1.33–6.22), change in pain interference (OR=1.20; 95%CI: 1.04–1.38), and change in vital exhaustion (OR=0.90; 95%CI: 0.82–0.99) remained significantly associated with persistent opioid use. Patients who attribute worsening pain to the COVID-19 pandemic are more likely to be persistent opioid users. Further research is warranted to identify mechanisms underlying this association. Clinicians may consider discussing pain in the context of the pandemic to identify patients at high risk for persistent opioid use. The online version contains supplementary material available at 10.1007/s11606-022-07940-4.
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影响因子：
1.5
作者：
Licciardone, John C.
通讯作者：
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影响因子：
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作者：
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DOI：
10.1093/pm/pnaa446
发表时间：
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期刊：
Pain medicine (Malden, Mass.)
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DOI：
10.3122/jabfm.2021.s1.200352
发表时间：
2021-02-01
影响因子：
2.9
作者：
Licciardone, John C.
通讯作者：
Licciardone, John C.