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与美国妊娠临近女性阿片类药物处方相关的因素。

Factors associated with opioid prescriptions among women proximal to pregnancy in the United States.

机构信息

Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA.

Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Kentucky, Lexington, KY, USA.

出版信息

Res Social Adm Pharm. 2021 Aug;17(8):1483-1488. doi: 10.1016/j.sapharm.2020.11.008. Epub 2020 Nov 17.

Abstract

BACKGROUND

Pregnant women are a vulnerable population exposed to opioids in the United States.

OBJECTIVE

To examine trends and factors associated with opioid prescribing to women proximal to pregnancy.

METHODS

The 2011 to 2015 Medical Expenditure Panel Survey (MEPS) was used to identify participants (n = 3020) with self-reported pregnancy or pregnancy-relevant events aged between 18 and 44 years old. To investigate factors associated with opioid prescriptions, we categorized participants into two subgroups: having one or more opioid prescription or having none during the observational period. We used survey multivariable logistic regression to identify factors associated with opioid prescribing accounting for the complex survey design in MEPS.

RESULTS

From 2011 to 2015, the prevalence of opioid prescribing among study participants was 31%. Opioids were more likely to be prescribed to women who had psychiatric conditions (odds ratio, 1,76, 95%CI: 1.27-2.44, p < 0.001). Other significant factors included being non-Hispanic white or black, living in the South, active tobacco users, and those with lower Physical Component Summary Scores.

CONCLUSION

Receipt of an opioid prescription in the perinatal period is associated with maternal psychiatric disorders in the United States. Study findings add new data to the literature on opioid use among pregnant women and provide evidence for healthcare providers and policy makers to tailor treatment and educational programs to avoid opioid overuse among pregnant women.

摘要

背景

在美国,孕妇是接触阿片类药物的脆弱人群。

目的

调查与孕妇临近妊娠期间开具阿片类药物相关的趋势和因素。

方法

使用 2011 年至 2015 年的医疗支出面板调查(MEPS)来确定自我报告怀孕或与怀孕相关事件的参与者(n=3020),年龄在 18 至 44 岁之间。为了调查与阿片类药物处方相关的因素,我们将参与者分为两个亚组:在观察期间有一个或多个阿片类药物处方或没有处方。我们使用调查多变量逻辑回归来确定与阿片类药物处方相关的因素,同时考虑 MEPS 中的复杂调查设计。

结果

从 2011 年到 2015 年,研究参与者中开具阿片类药物的比例为 31%。阿片类药物更有可能开给有精神疾病的女性(优势比,1.76;95%置信区间:1.27-2.44;p<0.001)。其他显著因素包括非西班牙裔白人或黑人、居住在南部、主动吸烟以及身体成分综合评分较低的女性。

结论

在美国,围产期接受阿片类药物处方与产妇精神障碍有关。研究结果为关于孕妇阿片类药物使用的文献增添了新数据,并为医疗保健提供者和政策制定者提供了证据,以制定治疗和教育计划,避免孕妇阿片类药物过度使用。

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