CHRONIC OPIOID THERAPY-ASSOCIATED PRODUCTIVITY LOSSES IN US WORKING OLDER ADULTS

美国老年工作人员与慢性阿片类药物治疗相关的生产力下降

基本信息

  • 批准号:
    10025587
  • 负责人:
  • 金额:
    $ 7.86万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2019
  • 资助国家:
    美国
  • 起止时间:
    2019-09-30 至 2022-08-31
  • 项目状态:
    已结题

项目摘要

Abstract The most pervasive chronic condition, chronic non-cancer pain (CNCP), is prevalent in up to nearly 40% of working-aged older adults. Despite lack of robust evidence regarding the efficacy and effectiveness of opioids for CNCP, and currently-available effective non-opioid treatments, many patients still receive opioid therapy. Older adults are more likely to use prescription opioids than middle aged adults, and many adults with CNCP who were initiated on opioids acutely, transition into chronic opioid therapy (COT) with adverse health consequences. Our previous research has shown this transition, with the associated adverse health consequences, can be predicted using a set of modifiable factors including opioid regimen characteristics. Adding co-prescribed benzodiazepines to the opioid regimen can further increase these risks. Also, the labor force is aging and 40% of adults 55 years and older are working or looking for work. Health related factors of working-age older adults can burden both the employer and employee beyond the direct medical costs associated with treating a condition. The purpose of this proposal is to quantify the productivity losses associated with a transition to COT, with or without concurrent benzodiazepine therapy, among a growing segment of the US workforce, working-aged older adults. A retrospective cohort design based on Truven Health MarketScan® Commercial Claims and Encounters Database linked with Heath and Productivity Management (HPM) data will be used to (1) identify leading predictors of transitioning from acute to COT among working-aged older adults (ages 50–64) without cancer, (2) evaluate the productivity losses associated with transitioning from acute to COT in working-aged older adults without cancer, and (3) evaluate the productivity losses associated with co-prescribing of a benzodiazepine to COT in working-aged older adults without cancer. By providing estimates for losses in productivity associated with COT, stakeholders including patients, health care providers, health care payers, and employers can better quantify the value of maintaining a healthy workforce and justify increased spending on early risk mitigation efforts. With this research we strive to reduce the impact of prescription drug misuse burden in working-age older Americans through evaluation of safe and effective use of medications, particularly opioids.
摘要 最普遍的慢性病,慢性非癌性疼痛(CNCP),是流行在高达近40%的 工作年龄的老年人。尽管缺乏关于阿片类药物疗效和有效性的有力证据, 对于CNCP和目前可用的有效非阿片类药物治疗,许多患者仍接受阿片类药物治疗。 老年人比中年人更有可能使用处方阿片类药物, 急性开始阿片类药物治疗,过渡到慢性阿片类药物治疗(COT), 后果我们之前的研究已经表明了这种转变,以及相关的不利健康 可以使用一组可修改的因素(包括阿片类药物方案特征)来预测结果。 在阿片类药物治疗方案中添加联合处方的苯二氮卓类药物可能会进一步增加这些风险。此外,劳动力 人口老龄化,40%的55岁及以上的成年人正在工作或寻找工作。健康相关因素 工作年龄的老年人除了直接的医疗费用外,还会给雇主和雇员带来负担 与治疗疾病有关本提案的目的是量化生产力损失 与过渡到COT相关,伴随或不伴随苯二氮卓类药物治疗, 美国劳动力的一部分,工作年龄的老年人。基于Truven的回顾性队列设计 与健康和生产力相关的Health MarketScan®商业索赔和遭遇数据库 管理(HPM)数据将用于(1)确定从急性过渡到COT的主要预测因素 在无癌症的工作年龄老年人(50-64岁)中,(2)评估与癌症相关的生产力损失 在无癌症的工作年龄老年人中从急性过渡到COT,以及(3)评估 在工作年龄的老年人中与COT联合处方苯二氮卓类药物相关的生产力损失 没有癌症通过提供与COT相关的生产力损失估计,利益相关者包括 患者、医疗保健提供者、医疗保健支付者和雇主可以更好地量化维持 健康的劳动力队伍,并证明有理由增加早期风险缓解工作的支出。通过这项研究,我们努力 通过评估以下因素,减少处方药滥用对工作年龄的美国老年人的影响: 安全有效地使用药物,特别是阿片类药物。

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