INSERM UMR 1246, SPHERE, Methods in Patient-Centered Outcomes and Health Research, Nantes and Tours Universities, 44000 Nantes, France.
EA 7479 SPURBO, BREST University, 29200 Brest, France.
Int J Environ Res Public Health. 2021 Feb 21;18(4):2097. doi: 10.3390/ijerph18042097.
(1) Background: Chronic non-cancer pain (CNCP) remains a public health challenge around the world. Opioids (PO) have been increasingly used in the treatment of CNCP in the last 20 years. This study aimed to assess the prevalence of opioid misuse and prescribed-opioid use disorder (p-OUD) among patients with CNCP in a pain centre in France, and to analyse risk factors for moderate or severe p-OUD. (2) Method: A cross-sectional study was conducted, including patients consulting for pain management in the pain centre of Brest University Hospital. A self-questionnaire was administered (sociodemographic data, medical data, PO misuse, and p-OUD according the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM 5) criteria). Descriptive, univariate, and multivariate analyses were conducted, together with a principal component analysis, in order to identify factors associated with p-OUD. (3) Results: In total, 115 patients were included, the majority of whom were women, with a mean age of 52 years old [18-82]; 64.3% ( = 74) had a current prescription for opioid analgesics (weak or strong). In this group, 56.7% ( = 42) had no or only mild p-OUD and 43.3% ( = 32) had current moderate or severe p-OUD. Patients with moderate or severe p-OUD were more likely to have a current antidepressant prescription, to have had psychotherapy, to currently use strong opioids and oxycodone, and to report taking more frequent doses than prescribed and feeling dependent. (4) Conclusions: We showed that the prevalence of current moderate/severe p-OUD concerned 43.3% of the patients with a CNCP seeking treatment in a pain centre. According to these results, several measures are relevant in managing p-OUD among patients with CNCP.
(1) 背景：慢性非癌性疼痛（CNCP）仍然是全球公共卫生面临的挑战。在过去的 20 年中，阿片类药物（PO）在 CNCP 的治疗中越来越多地被使用。本研究旨在评估法国一个疼痛中心的 CNCP 患者中阿片类药物滥用和处方阿片类药物使用障碍（p-OUD）的流行率，并分析中重度 p-OUD 的危险因素。(2) 方法：进行了一项横断面研究，纳入了在布雷斯特大学医院疼痛中心就诊的疼痛管理患者。进行了自我问卷调查（社会人口学数据、医疗数据、PO 滥用和根据《精神障碍诊断与统计手册》第 5 版（DSM 5）标准的 p-OUD）。进行了描述性、单变量和多变量分析，以及主成分分析，以确定与 p-OUD 相关的因素。(3) 结果：共纳入 115 例患者，大多数为女性，平均年龄为 52 岁[18-82]；64.3%（=74）目前有阿片类镇痛药（弱或强）处方。在这一组中，56.7%（=42）没有或只有轻度 p-OUD，而 43.3%（=32）有当前中重度 p-OUD。中重度 p-OUD 患者更有可能有当前的抗抑郁药处方、接受过心理治疗、当前使用强阿片类药物和羟考酮，并且报告服用的剂量比规定的更频繁且感到依赖。(4) 结论：我们表明，在疼痛中心寻求治疗的 CNCP 患者中，当前中重度 p-OUD 的患病率为 43.3%。根据这些结果，在管理 CNCP 患者的 p-OUD 时，有几项措施是相关的。
