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在瑞典一所大学附属三级疼痛诊所就诊的慢性非癌性疼痛人群中,长期阿片类药物治疗的流行率:一项横断面研究。

Prevalence of Long-Term Opioid Therapy in a Chronic Non-Cancer Pain Population Attending a University-Based Tertiary Pain Clinic in Sweden: A Cross-Sectional Study.

机构信息

Department of Neurosurgery and Pain Rehabilitation, Skåne University Hospital, Lund; Lund University, Department of Clinical Sciences Malmö, Center for Primary Health Care Research, Malmö, Sweden.

出版信息

J Rehabil Med. 2022 Apr 29;54:jrm00270. doi: 10.2340/jrm.v54.1981.

Abstract

BACKGROUND

Opioid therapy is a common treatment for chronic pain, despite accumulating evidence regarding harm and a lack of data to support the efficacy of long-term treatment. The prevalence of opioid therapy in Swedish patients with chronic non-cancer pain is unknown. The aim of this study was to assess a short-term period prevalence of prescribed opioid-use and long-term opioid therapy in a population with complex chronic non-cancer pain.

METHODS

The study population comprised 1,613 patients with chronic non-cancer pain referred to a university-based tertiary pain clinic in Sweden during 2015-17. Data from a 360-day period prior to consultation were extracted from the Swedish Quality Registry for Pain Rehabilitation (SQRP) and Swedish Prescribed Drug Register (SPDR). Milligram morphine equivalents per day (MME/day) for dispensed opioids were analysed for a 90-day period preceding consultation, and long-term opioid therapy was determined for the entire 360-day period.

RESULTS

The 90-day prevalence was 38% (95% confidence interval (95% CI) 36.0-40.8%) and 360-day prevalence was 22.3% (n=360, 95% CI 20.4-24.4%).

CONCLUSION

Prescribing rates of opioids in a Swedish population with complex non-cancer chronic pain were high; 2 in 5 patients were dispensed an opioid within a 90-day period prior to consultation.

摘要

背景

尽管有越来越多的证据表明阿片类药物治疗存在危害,且缺乏长期治疗有效的数据,但阿片类药物治疗仍然是慢性疼痛的常见治疗方法。瑞典慢性非癌症疼痛患者接受阿片类药物治疗的流行程度尚不清楚。本研究旨在评估复杂慢性非癌症疼痛人群中短期规定阿片类药物使用和长期阿片类药物治疗的流行率。

方法

研究人群包括 2015-17 年期间在瑞典一所大学附属三级疼痛诊所就诊的 1613 名慢性非癌症疼痛患者。从瑞典疼痛康复质量登记处(SQRP)和瑞典处方药物登记处(SPDR)中提取了咨询前 360 天的数据。在咨询前的 90 天内,对开具的阿片类药物的每日吗啡等效剂量(MME/day)进行了分析,在整个 360 天内确定了长期阿片类药物治疗。

结果

90 天的患病率为 38%(95%置信区间(95%CI)为 36.0-40.8%),360 天的患病率为 22.3%(n=360,95%CI 为 20.4-24.4%)。

结论

在瑞典复杂非癌症慢性疼痛人群中,开具阿片类药物的比率较高;在咨询前的 90 天内,有 2/5 的患者开具了阿片类药物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ba9/9131196/f67d041c2946/JRM-54-1981-g001.jpg

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