头颈癌幸存者慢性阿片类药物治疗的趋势
Trends in chronic opioid therapy among survivors of head and neck cancer.
作者信息
Kriplani Anuja, Lavery Jessica A, Mishra Akriti, Korenstein Deborah, Lipitz-Snyderman Allison N, Boudreau Denise M, Moryl Natalie, Gillespie Erin F, Salz Talya
机构信息
Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
出版信息
Head Neck. 2021 Jan;43(1):223-228. doi: 10.1002/hed.26478. Epub 2020 Sep 22.
BACKGROUND
Survivors of head and neck cancer (HNC) have increased risk of opioid misuse.
METHODS
Using Surveillance, Epidemiology and End-Results-Medicare data, we matched adults ≥66 years diagnosed with HNC 2008-2015 with cancer-free controls. We computed odds ratios (OR) for receipt of chronic opioid therapy (COT, claims for ≥90 consecutive days) for HNC survivors compared to controls each year after matching through 2016.
RESULTS
The cohort of HNC survivors declined from 5107 in the first year after diagnosis to 604 in the sixth year after diagnosis. For 5 years, rates of COT among HNC survivors exceeded that of controls. Differences between survivors and controls declined each year (ORs: year 1, 4.36; year 2, 2.60; year 3, 2.18; year 4, 1.85; and year 5, 1.35; all P-values <.05).
CONCLUSIONS
Among older HNC survivors, cancer-associated opioid use in the first years after diagnosis suggests that the benefit of opioids must balance the risk of opioid misuse.
背景
头颈癌（HNC）幸存者存在阿片类药物滥用风险增加的情况。
方法
利用监测、流行病学和最终结果 - 医疗保险数据，我们将2008 - 2015年诊断为HNC的66岁及以上成年人与无癌对照进行匹配。在匹配后的2016年之前，我们计算了HNC幸存者与对照相比每年接受慢性阿片类药物治疗（COT，连续索赔≥90天）的比值比（OR）。
结果
HNC幸存者队列从诊断后第一年的5107人下降到诊断后第六年的604人。在5年时间里，HNC幸存者中的COT率超过了对照组。幸存者与对照组之间的差异逐年下降（OR值：第1年，4.36；第2年，2.60；第3年，2.18；第4年，1.85；第5年，1.35；所有P值<.05）。
结论
在老年HNC幸存者中，诊断后最初几年与癌症相关的阿片类药物使用表明，阿片类药物的益处必须与阿片类药物滥用的风险相平衡。
Zotero 插件