Dental Opioid Prescriptions and Overdose Risk in Patients and Their Families.
Dental Opioid Prescriptions and Overdose Risk in Patients and Their Families.
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DOI：
10.1016/j.amepre.2021.02.008
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发表时间：
2021-08
影响因子：
5.5
通讯作者：
Nalliah RP
中科院分区：
文献类型：
--
作者：
Chua KP;Kenney BC;Waljee JF;Brummett CM;Nalliah RP
目前尚不清楚牙科阿片类药物处方是否与患者或其家人的阿片类药物过量有关，后者可能接触到患者的阿片类药物。 2020 年 7 月至 10 月期间，对 2011 年至 2018 年 IBM MarketScan 牙科、商业和医疗补助多州数据库进行了分析。进行了两项分析。在患者分析中，确定了 13-64 岁私人和公共保险患者的牙科手术。暴露量≥1“初始处方”（手术后 3 天内配发的阿片类药物处方）。使用逻辑回归评估暴露与手术后 90 天内≥1 次用药过量之间的关联。在家庭分析中，确定了家庭计划中私人保险患者的程序。使用逻辑回归评估家庭成员在 90 天内暴露与≥1 次用药过量之间的关联。在这两项分析中，计算了暴露的平均边际效应，代表了所有手术与不手术与≥1个初始处方相关时结果概率的变化。患者分析包括 8,544,098 例手术。当 ≥1 个初始处方发生或未发生时，90 天用药过量风险分别为每 10,000 次手术 5.8 例和 2.2 例（平均边际效应 = 1.5，95% CI = 1.2、1.8）。家庭分析包括 3,461,469 例手术。当 ≥1 种初始处方发生或未发生时，家庭成员 90 天用药过量风险分别为每 10,000 例手术 1.7 例和 1.0 例（平均边际效应 = 0.4，95% CI = 0.1，0.7）。研究结果进一步强调了避免不必要的牙科阿片类药物处方的重要性。
It is unknown whether dental opioid prescriptions are associated with opioid overdose in patients or their family members, the latter of which may have access to patients’ opioids. During July–October 2020, the 2011–2018 IBM MarketScan Dental, Commercial, and Medicaid Multi-State Databases were analyzed. Two analyses were conducted. In the patient analysis, dental procedures for privately and publicly insured patients aged 13–64 years were identified. The exposure was ≥1 “initial prescription” (dispensed opioid prescription within 3 days of the procedure). The association between the exposure and ≥1 overdose within 90 days of the procedure was evaluated using logistic regression. In the family analysis, procedures for privately insured patients in family plans were identified. The association between the exposure and ≥1 overdose in a family member within 90 days was evaluated using logistic regression. In both analyses, the average marginal effect of the exposure was calculated, representing the change in the probability of the outcome if all versus no procedures were associated with ≥1 initial prescription. The patient analysis included 8,544,098 procedures. When ≥1 initial prescription did and did not occur, the 90-day risk of overdose was 5.8 versus 2.2 per 10,000 procedures (average marginal effect=1.5, 95% CI=1.2, 1.8). The family analysis included 3,461,469 procedures. When ≥1 initial prescription did and did not occur, the 90-day risk of overdose in a family member was 1.7 versus 1.0 per 10,000 procedures (average marginal effect=0.4, 95% CI=0.1, 0.7). Findings further highlight the importance of avoiding unnecessary dental opioid prescribing.
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影响因子：
13.8
作者：
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通讯作者：
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DOI：
10.1001/jama.2016.1464
发表时间：
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期刊：
JAMA
影响因子：
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通讯作者：
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DOI：
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发表时间：
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影响因子：
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作者：
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作者：
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