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与处方止痛药滥用相关的因素:全州范围内数据分析。

Factors associated with prescription pain reliever misuse: An analysis of statewide data.

出版信息

J Am Pharm Assoc (2003). 2019 Jul-Aug;59(4):498-505. doi: 10.1016/j.japh.2019.03.009. Epub 2019 May 9.

Abstract

OBJECTIVES

Characterize the individual-level risk factors associated with recent prescription pain reliever misuse (PPRM).

DESIGN

A multivariable logistic regression was developed with 21 covariates.

SETTING AND PARTICIPANTS

The 2015 Ohio Medicaid Assessment Survey (OMAS) was analyzed. The 2015 OMAS was a complex-designed representative survey of all adult Ohioans, regardless of Medicaid status (n = 42,876).

OUTCOME MEASURES

The main outcome was PPRM within the past year ("yes" vs. "no").

RESULTS

An estimated 2.75% of adults in Ohio reported PPRM in the past year (approximately 242,232 individuals). The regression model identified 11 covariates with significantly higher odds of PPRM within the past year. The 5 covariates with the largest, significant effect sizes were binge drinking habits (adjusted odds ratio [AOR] for binge drinking in the past month: 2.35, 95% CI 1.97-2.81; AOR for drinking in the past month but no bingeing: 1.43, 95% CI 1.22-1.67), did not get medical examination, medical supplies, mental health care, or eyeglasses in the past year because of cost (AOR 1.74, 95% CI 1.44-2.11), no insurance (AOR 1.67, 95% CI 1.15-2.45), emergency room visits in the past year (AOR 1.66, 95% CI 1.42-1.93), and had problems paying medical bills in the past year (AOR 1.52, 95% CI 1.29-1.80).

CONCLUSION

In this cross-sectional study of 42,847 adult Ohioans, the covariates associated with PPRM in the past year were identified and quantified. The significant covariates can be broadly grouped into substance use history, poor health care access, demographic characteristics, and chronic health conditions. The single covariate with the largest effect size was binge drinking in the past month; those individuals were more than twice as likely to have endorsed PPRM in the past year compared with those who did not drink at all in the past month.

摘要

目的

描述与近期处方止痛药滥用(PPRM)相关的个体水平风险因素。

设计

采用多变量逻辑回归方法,共纳入 21 个协变量。

地点和参与者

分析了 2015 年俄亥俄州医疗补助评估调查(OMAS)的数据。2015 年 OMAS 是一项针对所有成年俄亥俄州人的复杂设计代表性调查,无论其医疗补助状况如何(n=42876)。

结局测量

主要结局为过去 1 年内的 PPRM(“是”与“否”)。

结果

俄亥俄州约有 2.75%的成年人在过去 1 年内报告有 PPRM(约 242232 人)。回归模型确定了 11 个与过去 1 年内 PPRM 发生风险显著相关的协变量。5 个影响最大的协变量为过去 1 个月内有 binge drinking 习惯(过去 1 个月内 binge drinking 的调整后比值比 [AOR]:2.35,95%置信区间 [CI]:1.97-2.81;过去 1 个月内饮酒但没有 binge drinking 的 AOR:1.43,95% CI:1.22-1.67)、过去 1 年因费用问题未接受体检、医疗用品、心理健康护理或配眼镜(AOR 1.74,95% CI:1.44-2.11)、没有保险(AOR 1.67,95% CI:1.15-2.45)、过去 1 年内急诊就诊(AOR 1.66,95% CI:1.42-1.93)以及过去 1 年内有医疗费用支付问题(AOR 1.52,95% CI:1.29-1.80)。

结论

在这项对俄亥俄州 42847 名成年成年人的横断面研究中,确定并量化了与过去 1 年内 PPRM 相关的协变量。显著的协变量可以大致分为药物使用史、医疗保健机会不足、人口统计学特征和慢性健康状况。影响最大的单个协变量是过去 1 个月内 binge drinking;与过去 1 个月内完全不饮酒的人相比,过去 1 年内报告有 PPRM 的可能性高出两倍以上。

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