高风险阿片类药物处方趋势：2010 年至 2018 年的药物监测计划数据。
High-Risk Opioid Prescribing Trends: Prescription Drug Monitoring Program Data From 2010 to 2018.
机构信息
Division of General Internal Medicine, Department of Medicine (Drs Ball, Moran, and Mauldin, Ms Zhang, and Mr Marsden), Department of Health Administration and Policy, College of Health Professions (Dr Simpson), and Department of Psychiatry and Behavioral Sciences (Dr McCauley), Medical University of South Carolina, Charleston, South Carolina; and Blue Cross Blue Shield of South Carolina, Columbia, South Carolina (Mr Heidari).
出版信息
J Public Health Manag Pract. 2021;27(4):379-384. doi: 10.1097/PHH.0000000000001203.
OBJECTIVE
Deaths due to opioids have continued to increase in South Carolina, with 816 opioid-involved overdose deaths reported in 2018, a 9% increase from the prior year. The objective of the current study is to examine longitudinal trends (quarter [Q] 1 2010 through Q4 2018) of opioid prescribing volume and high-risk opioid prescribing behaviors in South Carolina using comprehensive dispensing data available in the South Carolina Prescription Drug Monitoring Program (SC PDMP).
DESIGN
Retrospective analyses of SC PDMP data were performed using general linear models to assess quarterly time trends and change in rate of each outcome Q1 2010 through Q4 2018.
PARTICIPANTS
Opioid analgesic prescription fills from SC state residents between Q1 2010 and Q4 2018.
MAIN OUTCOME MEASURES
High-risk prescribing behaviors included (1) opioid prescribing rate; (2) percentage of patients receiving opioids dispensed 90 or more average morphine milligram equivalents daily; (3) percentage of opioid prescribed days with overlapping opioid and benzodiazepine prescriptions; (4) rate per 100 000 residents of multiple provider episodes; and (5) percentage of patients prescribed extended release opioids who were opioid naive.
RESULTS
A total of 33 027 461 opioid prescriptions were filled by SC state residents within the time period of Q1 2010 through Q4 2018. A 41% decrease in the quarterly prescribing rate of opioids occurred from Q1 2010 to Q4 2018. The decrease in overall opioid prescribing was mirrored by significant decreases in all 4 high-risk prescribing behaviors.
CONCLUSION
PDMPs may represent the most complete data regarding the dispensing of opioid prescriptions and as such be valuable tools to inform and monitor the supply of licit opioids. Our results indicate that public health policy, legislative action, and multiple clinical interventions aimed at reducing high rates of opioid prescribing across the health care ecosystem appear to be succeeding in the state of South Carolina.
目的
南卡罗来纳州的阿片类药物死亡人数持续增加，2018 年报告有 816 例阿片类药物过量死亡，比前一年增加了 9%。本研究的目的是利用南卡罗来纳州处方药物监测计划（SC PDMP）中提供的综合配药数据，检查南卡罗来纳州 2010 年第一季度（Q1）至 2018 年第四季度（Q4）期间的阿片类药物处方量和高危阿片类药物处方行为的纵向趋势。
设计
使用一般线性模型对 SC PDMP 数据进行回顾性分析，以评估 2010 年第一季度至 2018 年第四季度每个结果的季度时间趋势和变化率。
参与者
来自南卡罗来纳州居民的阿片类镇痛药处方配药，时间为 2010 年第一季度至 2018 年第四季度。
主要观察指标
高危处方行为包括：（1）阿片类药物处方率；（2）每天接受 90 或更多平均吗啡毫克当量的阿片类药物患者的百分比；（3）阿片类药物和苯二氮䓬类药物处方重叠的处方天数百分比；（4）每 10 万居民中多提供者事件的发生率；（5）服用缓释阿片类药物的患者中阿片类药物初治患者的百分比。
结果
在 2010 年第一季度至 2018 年第四季度期间，南卡罗来纳州居民共配药 33027461 份阿片类药物处方。从 2010 年第一季度到 2018 年第四季度，阿片类药物的季度处方率下降了 41%。整体阿片类药物处方量的下降与所有 4 种高危处方行为的显著下降相一致。
结论
PDMP 可能是关于阿片类药物处方配药的最完整数据，因此是一种有价值的工具，可以为整个医疗保健系统提供信息并监测合法阿片类药物的供应。我们的结果表明，旨在降低整个医疗保健系统中阿片类药物高处方率的公共卫生政策、立法行动和多种临床干预措施似乎正在南卡罗来纳州取得成功。
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