Noh Yoojin, Heo Kyu-Nam, Yu Yun Mi, Lee Ju-Yeun, Ah Young-Mi
Pharmacy School, Massachusetts College of Pharmacy and Health Sciences, Worcester, MA, USA.
Research Institute of Pharmaceutical Sciences, College of Pharmacy, Seoul National University, Seoul, Republic of Korea.
Ther Adv Drug Saf. 2022 Apr 30;13:20420986221091001. doi: 10.1177/20420986221091001. eCollection 2022.
The aim of this study was to investigate trends in the prevalence of potentially inappropriate opioid prescribing (PIOP) and identify potential risk factors among Korean noncancer patients.
We conducted a cross-sectional study of annual national patient sample data from the Korean Health Insurance Review and Assessment Service (HIRA-NPS) for the period 2012-2018. Noncancer patients who were prescribed non-injectable opioid analgesics (NIOAs) at least once were included. The proportion of patients with at least one PIOP in terms of concurrent use of benzodiazepines or gabapentinoids, substance use disorder, treatment duration, and dosage was evaluated. Multivariable logistic regression was performed to identify the risk factors associated with PIOP.
Of the 9,772,503 noncancer patients, 1,583,444 (16.2%) were prescribed NIOAs at least once. Among them, 15.7% were exposed to PIOP, and the prevalence was much higher (31.6%) in the elderly group (age: ⩾65 years). The prevalence of PIOP increased 1.1-fold over 7 years (14.8-16.8%) among the total NIOA users and was more pronounced in non-tramadol NIOA users (a 1.5-fold increase, from 13.2% to 19.4%). Multivariable logistic regression indicated that older age, beneficiaries of medical aid or national meritorious service, exposure to polypharmacy, psychological disorder, chronic pain indication, and concomitant sedative use were independently associated with higher odds of PIOP.
We found that the prevalence of PIOP was 15.7% among Korean noncancer patients, and it increased over the 7-year study period. This increasing trend is alarming because it was more drastic with non-tramadol NIOAs compared with that with tramadol. Several patient-level risk factors associated with PIOP would be useful in targeted management strategies for the safe use of opioids.
In Korea, the prevalence of non-injectable opioid analgesic (NIOA) use in noncancer patients steadily increased from 15.3% in 2012 to 17.1% in 2018.Also, the prevalence of potentially inappropriate opioid prescribing (PIOP) increased from 14.8% in 2012 to 16.8% in 2018.The following factors were associated with a markedly increased risk of PIOP: age, beneficiaries of medical aid or national meritorious service, polypharmacy, psychological disorder, chronic pain, and concomitant medications.
本研究旨在调查韩国非癌症患者中潜在不适当阿片类药物处方（PIOP）的流行趋势，并确定潜在风险因素。
我们对韩国健康保险审查和评估服务机构（HIRA-NPS）2012年至2018年期间的年度全国患者样本数据进行了横断面研究。纳入至少接受过一次非注射用阿片类镇痛药（NIOA）处方的非癌症患者。评估了在同时使用苯二氮䓬类药物或加巴喷丁类药物、物质使用障碍、治疗持续时间和剂量方面至少存在一项PIOP的患者比例。进行多变量逻辑回归以确定与PIOP相关的风险因素。
在9772503名非癌症患者中，1583444名（16.2%）至少接受过一次NIOA处方。其中，15.7%的患者暴露于PIOP，老年组（年龄：≥65岁）的患病率更高（31.6%）。在所有NIOA使用者中，PIOP的患病率在7年内增加了1.1倍（从14.8%增至16.8%），在非曲马多NIOA使用者中更为明显（增加了1.5倍，从13.2%增至19.4%）。多变量逻辑回归表明，年龄较大、医疗救助或国家功勋服务受益人、使用多种药物、心理障碍、慢性疼痛适应症以及同时使用镇静剂与PIOP的较高几率独立相关。
我们发现韩国非癌症患者中PIOP的患病率为15.7%，且在7年的研究期内有所增加。这种上升趋势令人担忧，因为与曲马多相比，非曲马多NIOA的情况更为严重。几个与PIOP相关的患者层面风险因素将有助于制定阿片类药物安全使用的针对性管理策略。
在韩国，非癌症患者中使用非注射用阿片类镇痛药（NIOA）的患病率从2012年的15.3%稳步上升至2018年的17.1%。此外，潜在不适当阿片类药物处方（PIOP）的患病率从2012年的14.8%增至2018年的16.8%。以下因素与PIOP风险显著增加相关：年龄、医疗救助或国家功勋服务受益人、使用多种药物、心理障碍、慢性疼痛以及同时服用的药物。
