Department of Family and Community Medicine, UC Davis School of Medicine, Sacramento, California, USA.
J Womens Health (Larchmt). 2021 Jan;30(1):29-35. doi: 10.1089/jwh.2019.8234. Epub 2020 Jun 17.
Surveillance data suggest that women are prescribed more opioid analgesics than men. It remains unclear whether these sex-related differences solely reflect the associations with other characteristics more prevalent among women (., adverse socioeconomic and health status-related factors, and more contact with the health system). We examined the factors associated with opioid prescriptions and sex in a large, nationally representative U.S. sample. This observational analysis of the 2005-2015 Medical Expenditure Panel Survey included all adults aged ≥18 years with prescription and health service utilization data ( = 106,233). Negative binomial regressions examined associations between sex and number of opioid prescriptions. Analyses sequentially adjusted for sociodemographics, health status-related factors, and nonnarcotic prescriptions. Overall, 9,387 women (16.2%) and 5,679 men (11.7%) received opioid prescriptions (female/male incidence rate ratio [IRR] = 1.35 (95% confidence interval [CI] = 1.24-1.44). The IRR was lower with adjustment for sociodemographics (1.23 [95% CI = 1.14-1.31]) and additional adjustment for health status-related factors (1.12 [95% CI = 1.05-1.19]). With further adjustment for number of nonnarcotic prescriptions, the IRR was not significant (0.97 [95% CI = 0.91-1.03). In this nationally representative sample, women received higher rates of prescription opioids, consistent with prior surveillance data. However, this relationship was attenuated with adjustment for sociodemographic and health status-related factors, and nonsignificant with adjustment for higher rates of nonnarcotic prescriptions among women. Higher opioid prescription rates in women may simply be reflective of these other factors, and the overall greater use of health care among women.
监测数据表明，女性开具的阿片类镇痛药处方多于男性。目前尚不清楚这些与性别相关的差异是否仅反映了与女性更为普遍的其他特征相关的关联（例如，不利的社会经济和健康状况相关因素，以及与医疗系统的更多接触）。我们在美国一个大型、具有代表性的样本中研究了与阿片类药物处方和性别的相关因素。这项对 2005-2015 年医疗支出调查的观察性分析纳入了所有有处方和医疗服务利用数据的年龄≥18 岁的成年人（ = 106,233）。负二项回归分析了性别与阿片类药物处方数量之间的关联。分析依次调整了社会人口统计学、健康状况相关因素和非麻醉性处方。总的来说，9387 名女性（16.2%）和 5679 名男性（11.7%）收到了阿片类药物处方（女性/男性发病率比[IRR] = 1.35（95%置信区间[CI] = 1.24-1.44）。调整社会人口统计学因素后，IRR 降低至 1.23（95% CI = 1.14-1.31），进一步调整健康状况相关因素后，IRR 降至 1.12（95% CI = 1.05-1.19）。进一步调整非麻醉性处方数量后，IRR 不再显著（0.97 [95% CI = 0.91-1.03）。在这个具有全国代表性的样本中，女性开具的处方阿片类药物比例较高，与之前的监测数据一致。然而，调整社会人口统计学和健康状况相关因素后，这种关系减弱，而调整女性非麻醉性处方比例后，这种关系不再显著。女性开具更高比例的阿片类药物处方可能仅仅反映了这些其他因素，以及女性整体上更多地利用医疗保健。
