Trends in Use of Opioids by Noncancer Pain Type 2000-2005 Among Arkansas Medicaid and HealthCore Enrollees: Results From the TROUP Study
Trends in Use of Opioids by Noncancer Pain Type 2000-2005 Among Arkansas Medicaid and HealthCore Enrollees: Results From the TROUP Study
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DOI：
10.1016/j.jpain.2008.06.002
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发表时间：
2008-11-01
期刊：
影响因子：
4
通讯作者：
Sullivan, Mark D.
中科院分区：
文献类型：
--
作者：
Braden, Jennifer Brennan;Fan, Ming-Yu;Sullivan, Mark D.
近年来，处方阿片类药物用于非癌症疼痛的使用显着增加，但目前尚不清楚最常见的非癌症疼痛状况之间的趋势是否不同。我们研究了2000年至2005年关节炎/关节疼痛、背痛、颈痛和头痛患者的阿片类药物处方趋势，按疼痛诊断的类型和数量，使用来自2家健康保险公司的索赔记录数据：HealthCore商业保险成员（N = 3，768，223）和阿肯色州医疗补助（N = 127，866）。在阿肯色州医疗补助计划的注册者中，头痛、背痛和颈部疼痛的诊断率显著增加，但在健康核心计划的注册者中增幅较小。两组中阿片类药物的使用率都有所增加，长期使用（每年>90天的供应）的增加率是任何使用率的两倍。阿片类药物的使用率在非癌症疼痛条件之间没有很大差异，但长期阿片类药物的使用率随着每一个额外的疼痛诊断而增加一倍。2000年至2005年期间，随着疼痛诊断数量的增加，疼痛类型的平均供应天数和累积年剂量增加，但每日供应剂量保持相对稳定。最大的增加剂量之间的所有疼痛条件中看到短效DEA附表11 opioids.Perspective：这项研究表明，增加使用阿片类药物，特别是长期使用，在非cancerpain超过6年的时间在那些与多种疼痛类型。这些结果似乎反映了处方阿片类药物用于非癌症疼痛的普遍增加，而不是处方实践中的特定条件变化。(C)2008年美国疼痛协会
Use of prescription opioids for noncancer pain has increased significantly in recent years, but it is not known if trends differ among the most common noncancer pain conditions. We examined trends in opioid prescribing for the years 2000 through 2005 for individuals with arthritis/joint pain, back pain, neck pain, and headaches by type and number of pain diagnoses, using data from claims records from 2 health insurers: HealthCore commercially insured members (N = 3,768,223) and Arkansas Medicaid (N = 127,866). Rates of headache, back pain, and neck pain diagnoses increased significantly in Arkansas Medicaid enrollees but more modestly among HealthCore enrollees. Rates of opioid use increased in both groups, with long-term use (>90 days' supply per year) increasing at twice the rate of any use. Rates of opioid use did not differ widely between noncancer pain conditions, but long-term opioid use rates doubled with each additional pain diagnosis. Mean days supply and cumulative yearly dose increased between 2000 and 2005 for ill pain types and with increasing number of pain diagnoses, but dose per day supply remained relatively stable. The greatest increases in dose among all the pain conditions were seen in short-acting DEA Schedule 11 opioids.Perspective: This study demonstrates increased use of opioids, particularly long-term use, in non-cancerpain over a 6-year period among those with multiple pain types. These results appear to reflect a general increase in use of prescription opioids for noncancer pain rather than a condition-specific change in prescribing practices. (C) 2008 by the American Pain Society