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台湾地区(2008-2018 年)阿片类药物处方的流行情况。

Prevalence of opioid prescriptions in Taiwan (2008-2018).

机构信息

Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan, ROC.

Department of Anesthesiology, National Defense Medical Center, Taipei, Taiwan, ROC.

出版信息

J Chin Med Assoc. 2022 May 1;85(5):603-609. doi: 10.1097/JCMA.0000000000000720. Epub 2022 Mar 30.

Abstract

BACKGROUND

Opioids are effective for severe pain; however, the safety issue is also a primary concern. To better understand the opioid use in Taiwan, we conducted this study.

METHODS

Data on patients with opioid prescriptions, including morphine, fentanyl, pethidine, codeine, oxycodone, hydromorphone, and buprenorphine were collected using the Taiwan National Health Insurance Database (NHID).

RESULTS

Our analysis of opioid prescriptions from 2008 to 2018 in Taiwan indicated that (1) A slow increase in prevalence of opioid prescription was found during the study period. Among the drugs studied, morphine accounted for the majority of the prescriptions written, with a gradual increase annually. Pethidine prescriptions showed a significant and rapid decline over the years; (2) medical centers prescribed the largest number of opioids, followed by regional hospitals, local hospitals, and clinics; (3) the number of prescriptions per year per capita in cancer group was much higher than that in noncancer group. In noncancer group, most of the prescriptions were used in acute pain service (98.7%); and (4) use of opioids increased with age in both cancer and noncancer patients.

CONCLUSION

The total number of opioid prescriptions in Taiwan gradually increased annually, among which morphine was the most commonly used opioid. Cancer patients consumed more opioid prescriptions than noncancer patients and most of the prescriptions in noncancer patients were used in acute pain service. The number of prescriptions increased with the age of the patients in both cancer and noncancer patients. The low prescription rate of opioids in chronic pain in Taiwan is not similar as those in high opioid-consuming countries, such as United States.

摘要

背景

阿片类药物对重度疼痛有效;然而,安全性问题也是主要关注点。为了更好地了解台湾的阿片类药物使用情况,我们进行了这项研究。

方法

使用台湾全民健康保险数据库(NHID)收集了包括吗啡、芬太尼、哌替啶、可待因、羟考酮、氢吗啡酮和丁丙诺啡在内的阿片类药物处方患者的数据。

结果

我们对 2008 年至 2018 年台湾阿片类药物处方的分析表明:(1)在研究期间,阿片类药物处方的流行率呈缓慢上升趋势。在所研究的药物中,吗啡占处方的大部分,且逐年递增。哌替啶处方多年来呈显著快速下降趋势;(2)医学中心开出处方数量最多,其次是区域医院、地区医院和诊所;(3)癌症组每年人均处方数明显高于非癌症组。在非癌症组中,大部分处方用于急性疼痛服务(98.7%);(4)癌症和非癌症患者的阿片类药物使用量均随年龄增长而增加。

结论

台湾的阿片类药物总处方量逐年增加,其中吗啡是最常用的阿片类药物。癌症患者比非癌症患者消耗更多的阿片类药物处方,非癌症患者的大部分处方用于急性疼痛服务。癌症和非癌症患者的处方数量均随患者年龄的增长而增加。台湾慢性疼痛中阿片类药物的低处方率与美国等阿片类药物高消费国家不同。

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