慢性阿片类药物使用者、非慢性阿片类药物使用者和慢性非癌症疼痛非阿片类药物使用者的健康相关生活质量。
Health-Related Quality of Life among Chronic Opioid Users, Nonchronic Opioid Users, and Nonopioid Users with Chronic Noncancer Pain.
机构信息
Division of Pharmaceutical Evaluation and Policy, Department of Pharmacy Practice, University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR.
NIDAT32 Addiction Research Training Program, Psychiatric Research Institute, University of Arkansas for Medical Sciences College of Medicine, Little Rock, AR.
出版信息
Health Serv Res. 2018 Oct;53(5):3329-3349. doi: 10.1111/1475-6773.12836. Epub 2018 Feb 25.
OBJECTIVE
Evaluate the association between opioid therapy and health-related quality of life (HRQoL) in participants with chronic, noncancer pain (CNCP).
DATA SOURCES
Medical Expenditure Panel Survey Longitudinal, Medical Conditions, and Prescription Files.
STUDY DESIGN
Using a retrospective cohort study design, the Mental Health Component (MCS12) and Physical Health Component (PCS12) scores of the Short Form-12 Version 2 were assessed to measure mental and physical HRQoL.
DATA COLLECTION
Chronic, noncancer pain participants were classified as chronic, nonchronic, and nonopioid users. One-to-one propensity score matching was employed to match chronic opioid users to nonchronic opioid users plus nonchronic opioid users and chronic opioid users to nonopioid users.
PRINCIPAL FINDINGS
A total of 5,876 participants were identified. After matching, PCS12 was not significantly different between nonchronic versus nonopioid users (LSM Diff = -0.98, 95% CI: -2.07, 0.10), chronic versus nonopioid users (LSM Diff = -2.24, 95% CI: -4.58, 0.10), or chronic versus nonchronic opioid users (LSM Diff = -2.23, 95% CI: -4.53, 0.05). Similarly, MCS12 was not significantly different between nonchronic versus nonopioid users (LSM Diff = 0.76, 95% CI: -0.46, 1.98), chronic versus nonopioid users (LSM Diff = 1.08, 95% CI: -1.26, 3.42), or chronic versus nonchronic opioid users (LSM Diff = -0.57, 95% CI: -2.90, 1.77).
CONCLUSIONS
Clinicians should evaluate opioid use in participants with CNCP as opioid use is not correlated with better HRQoL.
目的
评估慢性非癌症疼痛（CNCP）患者阿片类药物治疗与健康相关生活质量（HRQoL）之间的关联。
数据来源
医疗支出面板调查纵向、医疗状况和处方档案。
研究设计
采用回顾性队列研究设计，使用 12 项简短健康调查量表精神健康分量表（MCS12）和身体健康分量表（PCS12）评估来衡量精神和身体 HRQoL。
数据收集
将慢性非癌症疼痛参与者分为慢性非阿片类使用者、慢性阿片类使用者和非阿片类使用者。采用 1:1 倾向评分匹配将慢性阿片类使用者与慢性非阿片类使用者加非阿片类使用者进行匹配，将慢性阿片类使用者与非阿片类使用者进行匹配。
主要发现
共确定了 5876 名参与者。匹配后，非慢性组与非阿片类使用者相比，PCS12 无显著差异（LSM 差值=-0.98，95%CI：-2.07，0.10），慢性组与非阿片类使用者相比（LSM 差值=-2.24，95%CI：-4.58，0.10），或慢性组与慢性非阿片类使用者相比（LSM 差值=-2.23，95%CI：-4.53，0.05）。同样，非慢性组与非阿片类使用者相比，MCS12 无显著差异（LSM 差值=0.76，95%CI：-0.46，1.98），慢性组与非阿片类使用者相比（LSM 差值=1.08，95%CI：-1.26，3.42），或慢性组与慢性非阿片类使用者相比（LSM 差值=-0.57，95%CI：-2.90，1.77）。
结论
临床医生在评估 CNCP 患者的阿片类药物使用情况时，应考虑到阿片类药物的使用与更好的 HRQoL 无关。
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