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美国涉及药物的住院治疗中的多重药物使用障碍诊断:2016年全国住院患者样本的结果。

Multiple drug use disorder diagnoses among drug-involved hospitalizations in the United States: Results from the 2016 National Inpatient Sample.

作者信息

Zhu He, Wu Li-Tzy

机构信息

China Center for Health Development Studies, Peking University, Beijing, China.

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA; Department of Medicine, Division of General Internal Medicine, Duke University Medical Center, Durham, NC, USA; Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA; Center for Child and Family Policy, Sanford School of Public Policy, Duke University, Durham, NC, USA.

出版信息

Drug Alcohol Depend. 2020 Aug 1;213:108113. doi: 10.1016/j.drugalcdep.2020.108113. Epub 2020 Jun 12.

Abstract

BACKGROUND

Having more than one drug use disorders (DUDs) is an increasing public health concern, but it has been understudied. The goal of this study is to investigate the prevalence and patterns of coexisting DUD diagnoses among inpatient hospitalizations due to DUD in the United States.

METHODS

Data were from the 2016 National Inpatient Sample and included hospitalizations with a principal DUD diagnosis for patients aged ≥18 years (i.e., drug-involved hospitalizations, unweighted n = 31,707). The DUD diagnosis profile was categorized into three groups: single, two, and three or more DUD diagnoses. Generalized ordered logit models were used to examine correlates of DUD diagnosis groups.

RESULTS

Among drug-involved hospitalizations, approximately 50.1 % had multiple coexisting DUD diagnoses (2 DUD diagnoses, 32.1 %; ≥3 DUD diagnoses, 18.0 %). Particularly, opioid use disorder accounted for 58.6 % of drug-involved hospitalizations. Among specific opioid-involved hospitalizations, about 51.2 % had multiple DUD diagnoses. The most common secondary DUD diagnoses among opioid-involved hospitalizations included cocaine (21.7 %), cannabis (18.5 %), and sedatives (18.1 %). Adjusted analyses showed that being aged 18-25 years (vs. ≥ 26), living in areas with the lowest quartile of household income (vs. highest), and having a secondary diagnosis of mental disorders or tobacco/alcohol use disorder were associated with increased odds of having multiple DUD diagnoses in the total sample and in the opioid subsample.

CONCLUSIONS

Findings suggest that healthcare providers should increase the awareness of multiple DUDs while treating patients with DUD, especially those with opioid use disorder. More research is needed to better characterize treatment needs for patients with multiple DUDs.

摘要

背景

患有不止一种药物使用障碍(DUDs)是一个日益受到关注的公共卫生问题,但对其研究不足。本研究的目的是调查美国因药物使用障碍而住院的患者中并存药物使用障碍诊断的患病率和模式。

方法

数据来自2016年全国住院患者样本,包括年龄≥18岁且主要诊断为药物使用障碍的住院患者(即涉及药物的住院患者,未加权n = 31,707)。药物使用障碍诊断概况分为三组:单一、两种以及三种或更多种药物使用障碍诊断。使用广义有序logit模型来检验药物使用障碍诊断组的相关因素。

结果

在涉及药物的住院患者中,约50.1%存在多种并存的药物使用障碍诊断(两种药物使用障碍诊断,占32.1%;≥3种药物使用障碍诊断,占18.0%)。特别是,阿片类药物使用障碍占涉及药物住院患者的58.6%。在特定的涉及阿片类药物的住院患者中,约51.2%有多种药物使用障碍诊断。涉及阿片类药物的住院患者中最常见的继发性药物使用障碍诊断包括可卡因(21.7%)、大麻(18.5%)和镇静剂(18.1%)。校正分析表明,年龄在18 - 25岁(vs.≥26岁)、生活在家庭收入最低四分位数地区(vs.最高)以及患有精神障碍或烟草/酒精使用障碍的继发性诊断与总样本和阿片类药物子样本中存在多种药物使用障碍诊断的几率增加相关。

结论

研究结果表明,医疗保健提供者在治疗药物使用障碍患者,尤其是阿片类药物使用障碍患者时,应提高对多种药物使用障碍的认识。需要更多研究来更好地描述多种药物使用障碍患者的治疗需求。

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