Effects of Opioid Prescribing Cap Laws on Opioid and Other Pain Treatments Among Persons with Chronic Pain.
Effects of Opioid Prescribing Cap Laws on Opioid and Other Pain Treatments Among Persons with Chronic Pain.
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阿片类药物处方上限法对慢性疼痛患者阿片类药物和其他疼痛治疗的影响。
DOI：
10.1007/s11606-022-07796-8
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发表时间：
2023
影响因子：
5.7
通讯作者：
McGinty,EmmaE
中科院分区：
文献类型：
--
作者：
McCourt,AlexanderD;Tormohlen,KaylaN;Schmid,Ian;Stone,ElizabethM;Stuart,ElizabethA;Davis,CoreyS;Bicket,MarkC;McGinty,EmmaE
背景许多州都通过了限制阿片类药物处方数量或持续时间的法律。这些限制通常集中在急性疼痛的处方上，但对于那些被诊断为慢性疼痛的人来说，可能会产生意想不到的后果，包括减少阿片类药物的处方，而不是适当的非阿片类药物治疗。目的评估国家阿片类药物处方上限法律对慢性疼痛患者阿片类药物和非阿片类药物治疗的影响。接受治疗的州包括32个州，它们在2017年至2019年期间实施了处方上限法。人口总数为480,856名成年人，他们从2013年至2019年持续参加医疗和药房保险，并在2013年至2016年间被诊断为患有慢性疼痛。主要衡量标准：每个州的慢性疼痛患者中，拥有至少一种阿片类药物处方和特定持续时间或剂量处方的比例，平均阿片类药物处方数量，平均阿片类药物处方持续时间和剂量，至少一种非阿片类慢性疼痛处方的比例，此类处方的平均数量，至少一种慢性疼痛程序的比例，在慢性疼痛诊断患者中，限制阿片类药物处方的州法律与阿片类药物处方、非阿片类药物处方或非阿片类药物慢性疼痛程序的改变无关。结论这些发现不支持国家阿片类药物处方上限法律与慢性非癌症疼痛治疗的变化之间的联系。
BackgroundMany states have adopted laws that limit the amount or duration of opioid prescriptions. These limits often focus on prescriptions for acute pain, but there may be unintended consequences for those diagnosed with chronic pain, including reduced opioid prescribing without substitution of appropriate non-opioid treatments.ObjectiveTo evaluate the effects of state opioid prescribing cap laws on opioid and non-opioid treatment among those diagnosed with chronic pain.DesignWe used a difference-in-differences approach that accounts for staggered policy adoption. Treated states included 32 states that implemented a prescribing cap law between 2017 and 2019.PopulationA total of 480,856 adults in the USA who were continuously enrolled in medical and pharmacy coverage from 2013 to 2019 and diagnosed with a chronic pain condition between 2013 and 2016.Main MeasuresAmong individuals with chronic pain in each state: proportion with at least one opioid prescription and with prescriptions of a specific duration or dose, average number of opioid prescriptions, average opioid prescription duration and dose, proportion with at least one non-opioid chronic pain prescription, average number of such prescriptions, proportion with at least one chronic pain procedure, and average number of such procedures.Key ResultsState laws limiting opioid prescriptions were not associated with changes in opioid prescribing, non-opioid medication prescribing, or non-opioid chronic pain procedures among patients with chronic pain diagnoses.ConclusionsThese findings do not support an association between state opioid prescribing cap laws and changes in the treatment of chronic non-cancer pain.
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