Berner Todd, Thomson Heather, Hartry Ann, Puenpatom R Amy, Ben-Joseph Rami, Szeinbach Sheryl L
P T. 2011 Mar;36(3):139-44.
Our goal was to examine the daily average consumption (DACON) of oxycodone controlled-release tablets (OxyContin CR)and oxymorphone extended-release tablets (Opana ER) in patients with low back pain.
An observational, retrospective cohort study enrolled patients with multiple prescriptions for oxycodone CR or oxymorphone ER tablets. These patients also had International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for low back pain. Pharmacy prescription medication claims data were obtained from a large commercially insured health plan in the U.S. Mean daily consumption was calculated for a 90-day period.
We used descriptive statistics to evaluate patient demographics and health plan characteristics. Univariate analyses were used to examine the data as observed. A generalized linear model with a gamma distribution and log-link function provided a sensitivity measure, adjusting for heterogeneity among patients and the skewed nature of the DACON variable.
A total of 4,023 patients received oxycodone CR, and 374 patients received oxymorphone ER. The mean age of patients (standard deviation, SD) was 49.0 (11.6) years for oxycodone CR and 47.3 (10.6) years for oxymorphone ER. DACON of oxycodone CR was 3.2 tablets per day, and DACON of oxymorphone ER was 2.7 tablets per day (P < 0.01). Utilization of maximum-strength tablets of oxycodone CR 80 mg was 3.9 tablets per day, which was significantly higher, by one tablet per day, than the utilization of equipotent oxymorphone ER maximum-strength tablets of 40 mg at 2.9 tablets per day (P < 0.01).
The use of oxycodone CR, measured as mean daily consumption over a 90-day period, was significantly higher than that for oxymorphone ER in these patients, a finding that could have financial implications for health care systems.
我们的目标是研究腰痛患者口服羟考酮控释片（奥施康定）和羟吗啡酮缓释片（奥帕纳）的日平均用量（DACON）。
一项观察性回顾性队列研究纳入了多次开具羟考酮控释片或羟吗啡酮缓释片处方的患者。这些患者还具有国际疾病分类第九版临床修订本（ICD-9-CM）中腰痛的编码。药房处方用药索赔数据来自美国一家大型商业保险健康计划。计算90天期间的日平均用量。
我们使用描述性统计来评估患者人口统计学和健康计划特征。使用单因素分析来观察数据。具有伽马分布和对数链接函数的广义线性模型提供了一种敏感性测量方法，对患者之间的异质性和DACON变量的偏态性质进行了调整。
共有4023例患者接受了羟考酮控释片治疗，374例患者接受了羟吗啡酮缓释片治疗。羟考酮控释片组患者的平均年龄（标准差，SD）为49.0（11.6）岁，羟吗啡酮缓释片组为47.3（10.6）岁。羟考酮控释片的DACON为每日3.2片，羟吗啡酮缓释片的DACON为每日2.7片（P<0.01）。羟考酮控释片80mg最大剂量片剂的用量为每日3.9片，比等效的40mg羟吗啡酮缓释片最大剂量片剂每日2.9片的用量显著高1片/日（P<0.01）。
在这些患者中，以90天期间的日平均用量衡量，羟考酮控释片的使用量显著高于羟吗啡酮缓释片，这一发现可能对医疗保健系统产生财务影响。
