Institute of General Practice and Family Medicine, Universitatsklinikum Bonn, Bonn, Germany.
Department für Versorgungsforschung, Carl von Ossietzky University Oldenburg, Oldenburg, UK.
BMJ Open. 2019 Apr 3;9(4):e026871. doi: 10.1136/bmjopen-2018-026871.
The DSM-5 diagnosis 'opioid use disorder' (OUD) was established to better describe and detect significant impairment or distress related to opioid use. There is no data on rates of OUD in chronic non-cancer pain (CNCP) in European countries. Therefore, our objective was to screen patients in specialised pain centres for signs of OUD.
Cross-sectional questionnaire study.
Four outpatient pain clinics in the area of Bonn, Germany.
n=204 patients participated in the study (response rate: 87.9%). All adult patients with opioid pain therapy >6 months for CNCP were included. Excluded were patients with malignant disease, patients who could not collect their prescription themselves due to age or multimorbidity and patients on opioid-maintenance therapy.
Primary outcome measure was the proportion of patients with mild to severe OUD.
One-fourth (26.5%) of participants were diagnosed with OUD. Moderate to severe disorder was found in 9.3. Young age was the only connected risk factor (OR 0.96 [95% CI 0.94 to 0.99], p: 0.003).
OUD is a relevant diagnosis in patients on long-term opioid therapy for CNCP in the Bonn area. Careful follow-up by the attending physicians is advisable, especially in patients with moderate or severe disorder.
DSM-5 诊断“阿片类药物使用障碍”（OUD）的设立是为了更好地描述和检测与阿片类药物使用相关的显著功能障碍或痛苦。欧洲国家尚无慢性非癌性疼痛（CNCP）中 OUD 的发病率数据。因此，我们的目的是在专门的疼痛中心筛查患者是否存在 OUD 迹象。
横断面问卷调查研究。
德国波恩地区的四个门诊疼痛诊所。
204 名患者参加了这项研究（应答率：87.9%）。所有接受阿片类药物疼痛治疗>6 个月的 CNCP 成年患者均被纳入研究。排除标准为患有恶性肿瘤的患者、因年龄或合并症而无法自行取药的患者、以及接受阿片类药物维持治疗的患者。
主要结局测量是轻度至重度 OUD 患者的比例。
四分之一（26.5%）的参与者被诊断为 OUD。中度至重度障碍的发生率为 9.3%。年龄较轻是唯一相关的危险因素（OR 0.96[95%CI 0.94 至 0.99]，p：0.003）。
在波恩地区，长期接受阿片类药物治疗 CNCP 的患者中，OUD 是一个相关的诊断。建议主治医生进行仔细的随访，尤其是对中度或重度障碍的患者。
