南卡罗来纳州青少年（12-18 岁）高危阿片类镇痛药配给：2010-2017 年。
High-risk opioid analgesic dispensing to adolescents 12-18 years old in South Carolina: 2010-2017.
机构信息
Department of Pediatrics, College of Medicine, The Medical University of South Carolina, Charleston, South Carolina, USA.
Department of Psychiatry and Behavioral Services, College of Medicine, The Medical University of South Carolina, Charleston, South Carolina, USA.
出版信息
Pharmacoepidemiol Drug Saf. 2022 Mar;31(3):353-360. doi: 10.1002/pds.5389. Epub 2021 Dec 9.
PURPOSE
To evaluate "high-risk" opioid dispensing to adolescents, including daily morphine milligram equivalents (MME) above recommended amounts, the percentage of extended-release opioid prescriptions dispensed to opioid-naïve adolescents, and concurrent use of opioids and benzodiazepines, and to evaluate changes in those rates over time.
METHODS
Retrospective cohort study of one state's prescription drug monitoring program data (2010-2017), evaluating adolescents 12-18 years old dispensed opioid analgesic prescriptions. Outcomes of interest were the quarterly frequencies of the high-risk measures. We utilized generalized linear regression to determine whether the rate of the outcomes changed over time.
RESULTS
The quarterly percentage of adolescents ages 12-18 years old dispensed an opioid who received ≥90 daily MME declined from 4.1% in the first quarter (Q1) of 2010 to 3.4% in the final quarter (Q4) of 2017 (p < 0.0001). The frequency of adolescents dispensed ≥50 daily MME changed little over time. In 2010, the percentage of adolescents receiving an extended-release opioid who were opioid naïve was 60.7%, declining to 50.6% by Q4 of 2017 (p > 0.10 overall change 2010-2017). The percentage of adolescent opioid days overlapping with benzodiazepine days was 1.6% in Q1 of 2010, declining to 1.1% by Q4 of 2017 (p < 0.001).
CONCLUSIONS
Among persons 12-18 years old dispensed an opioid analgesic, receipt of ≥90 daily MME declined during the years 2010-2017, as did the percentage of adolescent opioid days that overlapped with benzodiazepines. More than half of the individuals who received extended-release opioid analgesics were identified as opioid naïve and, counter to guidelines, received products intended for opioid-tolerant individuals.
目的
评估向青少年开具“高危”类阿片类药物的情况，包括开具超出推荐剂量的日吗啡毫克当量（MME）、向阿片类药物初治青少年开具的延长释放类阿片药物处方的比例，以及同时使用阿片类药物和苯二氮䓬类药物的情况，并评估这些比例随时间的变化。
方法
回顾性队列研究分析了一个州的处方药物监测计划数据（2010-2017 年），评估了 12-18 岁接受阿片类镇痛药处方的青少年。感兴趣的结果是高危措施的季度频率。我们利用广义线性回归来确定结果的发生率是否随时间而变化。
结果
2010 年第一季度（Q1），接受 90 日吗啡毫克当量（MME）的青少年比例为 4.1%，到 2017 年第四季度（Q4）下降至 3.4%（p<0.0001），接受 90 日吗啡毫克当量（MME）的青少年比例呈下降趋势。接受 50 日吗啡毫克当量（MME）的青少年频率随时间变化不大。2010 年，接受延长释放类阿片药物且阿片类药物初治的青少年比例为 60.7%，到 2017 年 Q4 下降至 50.6%（总体变化 2010-2017 年，p>0.10）。2010 年 Q1 接受阿片类药物的青少年中，与苯二氮䓬类药物重叠的天数比例为 1.6%，到 2017 年 Q4 下降至 1.1%（p<0.001）。
结论
在接受阿片类药物镇痛剂的 12-18 岁人群中，2010-2017 年期间，接受 90 日吗啡毫克当量（MME）的比例下降，与苯二氮䓬类药物重叠的阿片类药物天数比例也下降。超过一半接受延长释放类阿片类药物镇痛剂的人被认定为阿片类药物初治，并且违反了指南，使用了旨在用于阿片类药物耐受个体的产品。
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