Kim Kyubeom, Lee Hyesung, Shin Ju-Young
School of Pharmacy, Sungkyunkwan University , Suwon, Korea.
J Psychoactive Drugs. 2020 Apr-Jun;52(2):153-161. doi: 10.1080/02791072.2019.1612125. Epub 2019 May 11.
Our study assessed the trends and patterns of tramadol prescriptions and possible correlations of a person being prescribed tramadol using the Korean National Health Insurance Service Sample Cohort from 2003 to 2013. The study population consisted of patients who were prescribed tramadol, opioids, or nonsteroidal anti-inflammatory drugs (NSAIDs) in an outpatient setting. From 2003 to 2013, the number of tramadol users increased from 2,476 (19.9% of the study population in 2003) to 124,592 (33.3% of the 2013 study population). The absolute change in the proportion of study patients prescribed tramadol (%) was +13.4%, a relative change (%) of +67.3%. In contrast, absolute changes in the number of opioid and NSAID users were -4.78% and -8.65%, respectively, which were relative changes of -73.5% and -11.8%, respectively. Of the studied pain types, arthritis and back pain were the most prominent diagnoses in tramadol users. Notable correlations for tramadol prescriptions, when compared with NSAIDs, were rural area (adjusted odds ratio (aOR): 1.64; 95% CI 1.61-1.66), co-prescription of a benzodiazepine (aOR 2.01; 95% CI 1.97-2.05), and tertiary hospital (aOR: 3.08, 95% CI 3.00-3.17).
我们的研究利用2003年至2013年韩国国民健康保险服务样本队列，评估了曲马多处方的趋势和模式，以及开具曲马多处方的人与其他因素之间可能存在的相关性。研究人群包括在门诊环境中开具曲马多、阿片类药物或非甾体抗炎药（NSAIDs）处方的患者。2003年至2013年，曲马多使用者数量从2476人（占2003年研究人群的19.9%）增至124592人（占2013年研究人群的33.3%）。开具曲马多处方的研究患者比例的绝对变化为+13.4%，相对变化为+67.3%。相比之下，阿片类药物和NSAIDs使用者数量的绝对变化分别为-4.78%和-8.65%，相对变化分别为-73.5%和-11.8%。在研究的疼痛类型中，关节炎和背痛是曲马多使用者中最突出的诊断结果。与NSAIDs相比，曲马多处方的显著相关因素包括农村地区（调整优势比（aOR）：1.64；95%置信区间1.61-1.66）、苯二氮卓类药物的联合处方（aOR 2.01；95%置信区间1.97-2.05）以及三级医院（aOR：3.08，95%置信区间3.00-3.17）。
