Anesthesiology.
Medical Outcomes, Pfizer Inc., Jericho, Vermont.
Pain Med. 2017 Sep 1;18(9):1706-1714. doi: 10.1093/pm/pnw231.
To evaluate current opioid prescribing patterns nationally and regionally across several northern New England states and compare with prescription data on an institutional level over a two-year period, between 2013 and 2014.
DESIGN, SETTING, AND SUBJECTS: The IMS Health National Prescription Audit (NPA) database was used to obtain prescription data from US retail pharmacies between 2013 and 2014.
Our study compared noninjectable opioid dispensing between two time periods: January-June 2013 and July-December 2014. Opioid prescription data were obtained nationally and in New Hampshire, Vermont, Maine, and Massachusetts. Institutional prescription data were supplied by Dartmouth Hitchcock Medical Center (DHMC) and University of Vermont Medical Center (UVMC) pharmacies.
There was a 3.4% ( P = 0.81) decrease in opioid prescriptions filled nationally. Among New England states, opioid prescribing decreased in Maine (-5.20%, P = 0.72), Massachusetts (-4.4%, P = 0.78), and Vermont (-2.2%, P = 0.89) but increased in New Hampshire by 1.3% ( P = 0.94). Examination of local institutional opioid utilization revealed a 13.6% decline in prescriptions filled at UVMC, and only a 0.4% decrease at DHMC.
The review of opioid prescriptions filled in 2013-14 suggests that national opioid utilization may be reaching a plateau. Initiatives such as prescription monitoring programs, prescriber opioid education, addiction treatment programs, public addiction awareness, and availability of medical cannabis may play a role in interstate variability of opioid use. National and regional data served as a benchmark for local institutional comparison, laying groundwork for efforts to explore areas where opioids can be prescribed more judiciously.
评估当前新英格兰北部几个州的全国和地区范围内的阿片类药物处方模式，并与 2013 年至 2014 年期间两年内机构层面的处方数据进行比较。
设计、地点和对象：使用 IMS Health National Prescription Audit（NPA）数据库从美国零售药店获取 2013 年至 2014 年的处方数据。
我们的研究比较了两个时间段内的非注射类阿片类药物配药情况：2013 年 1 月至 6 月和 2013 年 7 月至 12 月。获得了全国范围内和新罕布什尔州、佛蒙特州、缅因州和马萨诸塞州的阿片类药物处方数据。机构处方数据由达特茅斯-希区柯克医疗中心（DHMC）和佛蒙特大学医疗中心（UVMC）药房提供。
全国范围内的阿片类药物处方数量减少了 3.4%（P=0.81）。在新英格兰各州中，缅因州（-5.20%，P=0.72）、马萨诸塞州（-4.4%，P=0.78）和佛蒙特州（-2.2%，P=0.89）的阿片类药物处方减少，但新罕布什尔州增加了 1.3%（P=0.94）。对当地机构阿片类药物使用情况的检查显示，UVMC 配药处方减少了 13.6%，而 DHMC 仅减少了 0.4%。
对 2013-14 年阿片类药物处方的审查表明，全国范围内的阿片类药物使用可能已经达到了一个平台期。处方监测计划、处方医生阿片类药物教育、成瘾治疗计划、公共成瘾意识以及医用大麻的可用性等举措可能在阿片类药物使用的州际差异中发挥作用。国家和地区数据为当地机构比较提供了基准，为探索更明智地开具阿片类药物的领域奠定了基础。
