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加拿大不列颠哥伦比亚省牙医为儿童开具镇痛药的情况。

Dentists’ Prescribing of Analgesics for Children in British Columbia, Canada.

作者信息

Etminan Mahyar, Nouri M Reza, Sodhi Mohit, Carleton Bruce C

出版信息

J Can Dent Assoc. 2017 Aug;83:h5.

Abstract

OBJECTIVE

Recently, there has been great interest in the use, abuse and over-prescribing of opioid analgesics for children. However, there is a paucity of evidence on patterns of prescribing of both narcotic and non-narcotic analgesics for children by dentists.

METHODS

We used a population-wide prescription drug database (PharmaNet) in British Columbia, Canada, to examine prescribing and dispensing of analgesics surrounding dental procedures. We examined all drugs prescribed for children by dentists between 1997 and 2013, as we had access to data on drug doses and days of medication supply. We also examined trends in the use of various narcotic and non-narcotic analgesics and benzodiazepines.

RESULTS

In total, 268 691 children were prescribed at least 1 study drug by a dentist. Codeine was the most frequently prescribed: 50% of children received codeine for more than 3 days. Duration of use of codeine was greatest among children ≥12 years, the longest duration of use being 5 days.

CONCLUSIONS

Our study reveals that codeine prescription by dentists increased over the 16-year study period. Codeine is prescribed by dentists for 50% of children; prescriptions are for too long a duration to avoid potential morphine accumulation and are not in line with current treatment guidelines.

摘要

目的

最近,人们对儿童使用、滥用和过度开具阿片类镇痛药极为关注。然而,关于牙医为儿童开具麻醉性和非麻醉性镇痛药的处方模式,证据却很匮乏。

方法

我们使用了加拿大不列颠哥伦比亚省的一个全人群处方药数据库(PharmaNet),来研究围绕牙科手术的镇痛药处方和配药情况。我们研究了1997年至2013年间牙医为儿童开具的所有药物,因为我们能够获取药物剂量和用药天数的数据。我们还研究了各种麻醉性和非麻醉性镇痛药以及苯二氮䓬类药物的使用趋势。

结果

总计有268691名儿童至少被牙医开具了1种研究药物。可待因是最常被开具的药物:50%的儿童接受可待因治疗超过3天。≥12岁儿童使用可待因的时间最长,最长使用时间为5天。

结论

我们的研究表明,在16年的研究期间,牙医开具可待因处方的情况有所增加。50%的儿童由牙医开具可待因处方;处方用药时间过长,无法避免潜在的吗啡蓄积,且不符合当前的治疗指南。

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