J Am Dent Assoc. 2018 Jul;149(7):619-627.e1. doi: 10.1016/j.adaj.2018.02.025. Epub 2018 Apr 12.
Multiple or high dosage opioid prescriptions increase the risk of experiencing drug misuse and overdose. The authors examine index (first) and follow-up opioid prescriptions for 1 year among privately insured dental patients in the United States from 2010 through 2015.
The authors used the 2010 through 2015 Truven Health MarketScan Research databases and the Prescription Drug Monitoring Program Training Technical Assistance Center conversion data set. The authors analyzed index prescriptions, repeat prescriptions over 1 year, same-day multiple prescriptions, and concurrent prescriptions among dental patients. Descriptive analyses were conducted for days' supply, quantity of opioids, daily morphine milligram equivalent (MME) dose, and total MME dose.
Approximately 17.27% of all index prescriptions were dental related. The percentage of dental-related index prescriptions for age groups 11 through 18 years and 19 through 25 years was 23.51% and 23.41%, respectively. Approximately 80.87% of repeat prescriptions within 30 days of dental-related index prescriptions were dental related. In 39.07% of dental-related same-day multiple prescription incidents, the daily dose was greater than or equal to 50 MME. Approximately 58.28% of dental-related concurrent prescriptions were dispensed when an existing dental-related opioid prescription was available.
Dental-related index prescriptions were highest for the age groups 11 through 18 years and 19 through 25 years. The frequency of dental-related repeat prescriptions was the highest within 30 days of a dental-related index prescription.
Low dosages of opioids and the use of prescription drug monitoring programs before prescribing opioids may reduce the potential for drug misuse or overdose.
多剂量或高剂量阿片类药物处方会增加药物滥用和过量用药的风险。作者在美国私人保险牙科患者中,从 2010 年至 2015 年,检查了索引(首次)和后续 1 年的阿片类药物处方。
作者使用了 2010 年至 2015 年的 Truven Health MarketScan 研究数据库和处方药物监测计划培训技术援助中心转换数据集。作者分析了牙科患者的索引处方、1 年内重复处方、同日多处方和同时处方。进行了天数供应、阿片类药物数量、每日吗啡毫克当量(MME)剂量和总 MME 剂量的描述性分析。
所有索引处方中约有 17.27%是与牙科相关的。11 至 18 岁和 19 至 25 岁年龄组的牙科相关索引处方的百分比分别为 23.51%和 23.41%。在牙科相关索引处方后 30 天内,约 80.87%的重复处方与牙科相关。在 39.07%的牙科相关同日多处方事件中,每日剂量大于或等于 50 MME。在 58.28%的牙科相关同时处方中,当存在现有的牙科相关阿片类药物处方时,会配发药物。
11 至 18 岁和 19 至 25 岁年龄组的牙科相关索引处方最高。在牙科相关索引处方后 30 天内,牙科相关重复处方的频率最高。
在开阿片类药物处方之前,使用低剂量的阿片类药物和处方药物监测计划,可能会降低药物滥用或过量用药的可能性。