Stephenson Judith J, Cepeda M Soledad, Zhang Jie, Dinh Jade, Hall Kelsey, Esposito Daina B, Kern David M
Scientific Affairs, HealthCore, Inc, Wilmington, DE, USA.
Epidemiology, Janssen Research and Development, Titusville, NJ, USA.
J Pain Res. 2020 Apr 3;13:689-701. doi: 10.2147/JPR.S232409. eCollection 2020.
BACKGROUND/RATIONALE: Little is known about the reasons for visiting multiple doctors/pharmacies, known as doctor/pharmacy shopping, to obtain opioids.
To investigate patients' self-reported reasons for doctor/pharmacy shopping and assess whether doctor/pharmacy shopping behavior can be used as a surrogate measure of opioid abuse/misuse.
We conducted a cross-sectional web-based survey among adult patients with ≥2 pharmacy claims for immediate-release or extended-release/long-acting opioids between 7/1/2015 and 12/31/2016, identified from a large United States (US) commercial claims database. Patients were classified into no, mild, moderate, or severe shopping categories based on their claims. Reasons for doctor/pharmacy shopping and opioid abuse/misuse were determined from patient responses to the Prescription Opioid Misuse and Abuse Questionnaire.
A random sample of 10,081 patients was invited to participate in the survey and 1085 (11%) completed surveys. The most frequently reported reasons for doctor/pharmacy shopping were convenience, availability, price, and multiple morbidities requiring pain management. Among patients in the no, minimal, moderate, and severe shopping categories, only 7.8%, 8.5%, 11.8% and 12.6% reported opioid abuse/misuse, respectively.
In this commercially-insured population, patient-reported reasons for doctor/pharmacy shopping do not suggest opioid abuse/misuse. Less than 15% of patients with shopping behavior in the past 3 months reported any reasons attributable to opioid abuse/misuse, indicating that shopping behavior in this population may not be a good surrogate for abuse/misuse.
背景/基本原理：对于为获取阿片类药物而拜访多位医生/药店（即所谓的“医生/药店购物”行为）的原因，我们知之甚少。
调查患者自述的医生/药店购物原因，并评估医生/药店购物行为是否可作为阿片类药物滥用/误用的替代指标。
我们从美国一个大型商业理赔数据库中识别出在2015年7月1日至2016年12月31日期间有≥2次速释或缓释/长效阿片类药物药店理赔记录的成年患者，开展了一项基于网络的横断面调查。根据患者的理赔记录，将其分为无、轻度、中度或重度购物类别。通过患者对处方阿片类药物滥用和误用问卷的回答，确定医生/药店购物原因以及阿片类药物滥用/误用情况。
随机抽取10,081名患者邀请其参与调查，1085名（11%）患者完成了调查。最常报告的医生/药店购物原因是便利性、可获取性、价格以及多种疾病需要疼痛管理。在无、轻度、中度和重度购物类别患者中，分别只有7.8%、8.5%、11.8%和12.6%的患者报告有阿片类药物滥用/误用情况。
在这个商业保险人群中，患者自述的医生/药店购物原因并不表明存在阿片类药物滥用/误用。在过去3个月有购物行为的患者中，不到15%的患者报告了任何可归因于阿片类药物滥用/误用的原因，这表明该人群中的购物行为可能不是滥用/误用的良好替代指标。
