University of Pittsburgh, School of Social Work, 4200 Forbes Ave. #2006, Pittsburgh, PA 15260, USA; University of Pittsburgh, School of Medicine, Department of Psychiatry, 3811 O'Hara St, Pittsburgh, PA 15213, USA.
University of Pittsburgh, School of Social Work, 4200 Forbes Ave. #2006, Pittsburgh, PA 15260, USA.
Res Social Adm Pharm. 2017 Nov;13(6):1055-1061. doi: 10.1016/j.sapharm.2016.11.005. Epub 2016 Nov 15.
Community pharmacists are well-positioned to address the US opioid medication crisis, which has created a need to detect misuse risk in order to provide optimal patient care.
This study sought to identify community pharmacy patient subgroups at risk for opioid medication misuse.
This study was a cross-sectional survey that examined behavioral, mental, and physical health characteristics among patients filling opioid pain medications. A convenience sample of adult patients filling opioid pain medications who were not receiving cancer treatment were screened in 2 urban and 2 rural community pharmacies in southwestern Pennsylvania. Patient subgroups were identified using latent class analysis. Latent class regression analysis was used to examine the association between subgroup membership and misuse.
A total of 333 patients completed the survey (response rate 71.4%). Latent class analysis results showed that a 3-class solution best fit the data, which were labeled: mental health (8.4%, n = 28), poor health (79.6%, n = 265), and hazardous alcohol use (12%, n = 40). Individuals within the mental health subgroup had an increased risk for opioid medication misuse (Odds Ratio = 6.23, 95% CI = 5.13-7.33).
These findings demonstrate heterogeneity of this population receiving prescribed opioids and the potential to identify subgroups with high misuse risk. These findings also support routine screening of patients filling opioid medications and suggest the need for evidence-based patient-centered intervention development.
社区药剂师在美国阿片类药物危机中处于有利地位，可以发现药物滥用风险，从而为患者提供最佳的护理。
本研究旨在确定有阿片类药物滥用风险的社区药房患者亚组。
这是一项横断面调查，研究了正在服用阿片类止痛药的患者的行为、精神和身体健康特征。在宾夕法尼亚州西南部的 2 家城市和 2 家农村社区药房，对正在服用阿片类止痛药且未接受癌症治疗的成年患者进行了便利抽样筛选。使用潜在类别分析确定患者亚组。使用潜在类别回归分析来检查亚组成员与药物滥用之间的关联。
共有 333 名患者完成了调查（应答率为 71.4%）。潜在类别分析结果表明，3 类解决方案最适合数据，分别为：心理健康（8.4%，n=28）、健康状况不佳（79.6%，n=265）和危险饮酒（12%，n=40）。心理健康亚组的个体阿片类药物滥用风险增加（优势比=6.23，95%置信区间=5.13-7.33）。
这些发现表明，接受处方阿片类药物的人群存在异质性，并且有可能确定高滥用风险的亚组。这些发现还支持对服用阿片类药物的患者进行常规筛查，并表明需要制定基于证据的以患者为中心的干预措施。
