Opioid Prescribing Patterns in the U.S.

美国的阿片类药物处方模式

• 批准号: 7101282
• 负责人: Mark J Pletcher
• 金额: $ 4.4万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-03-01 至 2008-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7101282
• 关键词: analgesia; behavioral /social science research tag; cancer pain; chemotherapy; chronic pain; drug controls; emergency health services; geographic difference; health behavior; health care personnel education; health care personnel performance; health care policy; health care quality; health care service evaluation; health services research tag; health surveys; human data; longitudinal human study; opiate alkaloid; outpatient care; patient care personnel attitude; patient oriented research; self medication; substance abuse epidemiology; substance abuse related behavior

DESCRIPTION (Provided by the Applicant): Prescription opioid abuse has emerged as a major public health problem in the U.S. during the last decade. Nearly five million Americans actively use these medications for non-medical purposes, and nearly one million are physically dependent on them, making pain medicine addiction as common as cocaine addiction in the U.S. This substance abuse epidemic is unique in that the "supply side" of the epidemic is controlled by physicians, who prescribe these addictive but often essential medications for treatment of pain. There is concern, however, that changes in physician prescribing patterns during the last 10 years may be partially responsible for fueling the epidemic. The objective of this research is to understand how physician prescribing patterns have changed during the last decade, with the ultimate goal of improving the quality of physician prescribing and informing public policy. The National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS) offer a unique opportunity to examine changing opioid prescribing patterns by providing extensive cross-sectional data every year on a large, nationally representative sample of all ambulatory care visits to non-federally-employed office-based physicians (NAMCS), hospital-based outpatient departments (NHAMCS-OPD), and emergency departments (NHAMCS-ED). Using NAMCS/NHAMCS data collected on 851,212 unique patient visits during survey years 1993-2002, we plan to analyze: How many ambulatory care visits result in an opioid prescription every year in the U.S. How patient behavior (presenting with pain) and physician behavior (prescribing for pain) contribute to trends in opioid prescribing How choice of analgesic has changed over time (non-opioids vs. opioids, short- vs. long-acting opioids, high abuse potential and brand name formulations) How opioid prescribing differs by clinical setting, physician type, and geographic area/U.S. state Summary and relevance to public health: Addiction to pain medications is a major public health problem in the U.S. that has increased markedly in the last 10 years. The goal of this research is to understand how physician prescribing has changed during this time period, and to generate ideas for how physicians and policymakers, who control the supply of these addictive but essential medications, can slow the epidemic.

描述（由申请人提供）：过去十年中，处方阿片类药物滥用已成为美国的一个主要公共卫生问题。近五百万美国人出于非医疗目的积极使用这些药物，近一百万人在身体上依赖它们，这使得止痛药成瘾在美国与可卡因成瘾一样普遍。这种药物滥用流行病的独特之处在于，流行病的“供应方”是由医生控制的，他们开出这些成瘾但通常是治疗疼痛的基本药物。然而，有人担心，过去 10 年医生处方模式的变化可能是加剧这一流行病的部分原因。 这项研究的目的是了解医生的处方模式在 过去十年，其最终目标是提高医生开药的质量和为公共政策提供信息。国家流动医疗调查 (NAMCS) 和国家医院流动医疗调查 (NHAMCS) 每年提供广泛的横截面数据，涉及对非联邦雇用的办公室医生 (NAMCS)、医院门诊部 (NHAMCS-OPD) 和急诊科的所有流动医疗就诊的大量具有全国代表性的样本，为检查不断变化的阿片类药物处方模式提供了独特的机会 （NHAMCS-ED）。使用 1993 年至 2002 年调查期间收集的 851,212 名独特患者就诊的 NAMCS/NHAMCS 数据，我们计划分析： 在美国，每年有多少次门诊就诊导致开出阿片类药物处方 患者行为（表现疼痛）和医生行为（治疗疼痛处方）如何影响阿片类药物处方趋势 镇痛药的选择如何随时间变化（非阿片类药物与阿片类药物、短效阿片类药物与长效阿片类药物、高滥用潜力和品牌制剂） 阿片类药物处方因临床环境、医生类型和地理区域/美国而异状态 摘要及与公共卫生的相关性：止痛药成瘾是美国的一个主要公共卫生问题，在过去 10 年中这一问题显着增加。这项研究的目的是了解在此期间医生处方发生了怎样的变化，并为控制这些成瘾但必需药物的供应的医生和政策制定者如何减缓这种流行病提出想法。