2009 年至 2020 年莫氏手术（Mohs surgery）后获得阿片类药物处方的比率：索赔数据库分析。

Rates of Opioid Prescriptions Obtained After Mohs Surgery: A Claims Database Analysis From 2009 to 2020.

机构信息

Tulane University School of Medicine, New Orleans, Louisiana.

University of South Carolina School of Medicine, Columbia.

出版信息

JAMA Dermatol. 2021 Nov 1;157(11):1299-1305. doi: 10.1001/jamadermatol.2021.3468.

DOI:10.1001/jamadermatol.2021.3468

PMID:34550299

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8459307/

Abstract

IMPORTANCE

To curtail the opioid epidemic, physicians have been advised to limit opioid prescriptions.

OBJECTIVE

To characterize the frequency and changes over time (2009-2020) of opioid prescriptions following Mohs micrographic surgery.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study using Optum Clinformatics DataMart (Optum CDM), a nationally representative insurance claims database, included patients aged 18 years and older who had Mohs micrographic surgery insurance claims in the Optum CDM database from 2009 to 2020. Data were analyzed from November 11, 2020, to March 30, 2021.

EXPOSURES

Opioid prescription following Mohs surgery.

MAIN OUTCOMES AND MEASURES

The primary outcome was the proportion of patients who underwent Mohs surgery and obtained an opioid prescription within 2 days of surgery. Secondary outcomes included type and opioid quantity prescribed.

RESULTS

Among 358 012 patients with Mohs micrographic surgery claims (mean [SD] age, 69 [13] years; 205 609 [57.4%] were men), the proportion of patients obtaining an opioid prescription after Mohs micrographic surgery increased from 2009 (34.6%) to 2011 (39.6%). This proportion then declined each year, reaching a low of 11.7% in 2020 (27.9% absolute decrease from 2011 to 2020). Hydrocodone, codeine, oxycodone, and tramadol were the 4 most commonly prescribed opioids. By 2020, hydrocodone was obtained less (2009: 47.5%; 2011: 67.1%; 2020: 45.4%; 21.7% absolute decrease from 2011 to 2020) and tramadol was obtained more (2009: 1.6%; 2020: 27.9%; 26.3% absolute increase from 2009 to 2020).

CONCLUSIONS AND RELEVANCE

In this cross-sectional study of Mohs micrographic surgery claims, patients obtained fewer postsurgery opioid prescriptions over the study period, suggesting responsiveness of patients and dermatologic surgeons to public health concerns regarding the opioid epidemic. During this decline, prescriptions for hydrocodone decreased and tramadol increased.

摘要

重要性

为了遏制阿片类药物流行，医生被建议限制阿片类药物处方。

目的

描述 Mohs 显微外科手术后阿片类药物处方的频率和随时间的变化（2009-2020 年）。

设计、地点和参与者：这项使用 Optum Clinformatics DataMart（Optum CDM）的横断面研究，Optum CDM 是一个全国性的保险索赔数据库，纳入了 2009 年至 2020 年期间 Optum CDM 数据库中接受 Mohs 显微外科手术保险索赔的年龄在 18 岁及以上的患者。数据分析于 2020 年 11 月 11 日至 2021 年 3 月 30 日进行。

暴露

Mohs 手术后的阿片类药物处方。

主要结果和测量

主要结果是接受 Mohs 手术并在手术后 2 天内获得阿片类药物处方的患者比例。次要结果包括开出的药物类型和阿片类药物数量。

结果

在 358012 名接受 Mohs 显微外科手术的患者中（平均[SD]年龄，69[13]岁；205609[57.4%]为男性），接受 Mohs 显微外科手术后获得阿片类药物处方的患者比例从 2009 年（34.6%）增加到 2011 年（39.6%）。此后每年都有所下降，到 2020 年达到 11.7%的最低点（与 2011 年相比下降 27.9%）。氢可酮、可待因、羟考酮和曲马多是最常开的 4 种阿片类药物。到 2020 年，氢可酮的使用量减少（2009 年：47.5%；2011 年：67.1%；2020 年：45.4%；与 2011 年相比减少 21.7%），而曲马多的使用量增加（2009 年：1.6%；2020 年：27.9%；与 2009 年相比增加 26.3%）。