老年人自我报告的阿片类药物使用与驾驶结果：AAA LongROAD 研究。
Self-Reported Opioid Use and Driving Outcomes among Older Adults: The AAA LongROAD Study.
机构信息
From the Department of Emergency Medicine, University of Colorado School of Medicine, Aurora (MEB, JH); Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora (HH, CD); Department of Emergency Medicine, University of North Carolina School of Medicine, Chapel Hill (TFPM); Bassett Research Institute, Cooperstown, NY (DS); Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY (HFA); Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY (HFA); Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (TJM, GI); Department of Family Medicine and Public Health, University of California-San Diego, La Jolla (LLH); Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (VJ); University of Michigan Transportation Research Institute and the Center for Advancing Transportation Leadership and Safety (ATLAS Center), Ann Arbor (LJM, DWE); Department of Anesthesiology, Columbia University-Vagelos College of Physicians and Surgeons, New York, NY (GI).
出版信息
J Am Board Fam Med. 2020 Jul-Aug;33(4):521-528. doi: 10.3122/jabfm.2020.04.190429.
BACKGROUND
Opioid medications are important therapeutic options to mitigate the harmful effects of pain but can also impair driving ability. We sought to explore opioid use, pain levels, and driving experiences among older drivers.
METHODS
Cognitively intact drivers ages 65 to 79 years were recruited for the multisite AAA Longitudinal Research on Aging Drivers (LongROAD) study (n = 2990). This cross-sectional analysis used data from the baseline questionnaire and "brown-bag" medication review.
RESULTS
Among LongROAD participants (47% male, 88% white, 41% aged 65 to 69 years), 169 (5.7%) reported currently taking an opioid, with a median daily dose of 20 morphine milligram equivalents. Participants did not differ significantly in opioid use by age, gender, race, or ethnicity ( > .05). After adjustment for age, gender, race and ethnicity, participants who were taking opioids (vs not) were significantly more likely to report self-regulated driving reduction and reduced driving ability. However, these effects became nonsignificant when hospitalization, impaired physical function and other factors associated with opioid use were controlled.
CONCLUSIONS
In this study from a large, geographically diverse sample of older adults, there was an association between opioid use and several self-reported measures of driving behavior and ability. However, future work should clarify the effects on driving of opioid use from the effects of the painful medical conditions for which the opioids are being taken. Clinicians should continue to discuss the risks and benefits of opioid medications with patients, including risks related to driving safety.
背景
阿片类药物是减轻疼痛有害影响的重要治疗选择，但也会损害驾驶能力。我们试图探讨老年驾驶员的阿片类药物使用、疼痛程度和驾驶经验。
方法
认知功能正常的 65 至 79 岁驾驶员被招募参加多站点美国汽车协会纵向老龄化驾驶员研究（LongROAD）研究（n=2990）。这项横断面分析使用了基线问卷和“棕色袋子”药物审查的数据。
结果
在 LongROAD 参与者中（47%为男性，88%为白人，41%年龄在 65 至 69 岁之间），有 169 人（5.7%）报告正在服用阿片类药物，中位数日剂量为 20 毫克吗啡等效物。参与者在阿片类药物使用方面在年龄、性别、种族和民族方面没有显著差异（>0.05）。在调整年龄、性别、种族和民族后，服用阿片类药物的参与者（与未服用者相比）更有可能报告自我调节驾驶减少和驾驶能力下降。然而，当控制住院、身体功能受损和与阿片类药物使用相关的其他因素时，这些影响变得无统计学意义。
结论
在这项来自大量地理上多样化的老年人群体的研究中，阿片类药物的使用与几种自我报告的驾驶行为和能力测量指标之间存在关联。然而，未来的工作应该阐明阿片类药物使用对驾驶的影响，以及这些药物所治疗的疼痛性医疗状况的影响。临床医生应继续与患者讨论阿片类药物的风险和益处，包括与驾驶安全相关的风险。
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