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新冠疫情封锁措施对英国初级医疗保健环境中阿片类药物的开具趋势和使用的影响:分段线性回归分析。

The impact of the COVID-19 pandemic lockdown measures on the prescribing trends and utilization of opioids in the English primary care setting: segmented-liner regression analysis.

机构信息

Strathclyde Institute of Pharmacy and Biomedical Science (SIPBS), University of Strathclyde, Glasgow, UK.

Pharmaceutical Sciences Department, Fakeeh College for Medical Sciences, Jeddah, Kingdom of Saudi Arabia.

出版信息

Expert Rev Clin Pharmacol. 2022 Jun;15(6):787-793. doi: 10.1080/17512433.2022.2093715. Epub 2022 Jun 27.

Abstract

BACKGROUND

The COVID-19 lockdown has resulted in limited access to most of the conventional chronic pain management services. Subsequently, changes in opioids' utilization could be expected. This study assessed the impact of the first COVID-19 lockdown on opioid utilization using aggregated-level, community dispensing dataset covering the whole English population.

RESEARCH DESIGN AND METHODS

A segmented-linear regression analysis was applied to monthly dispensed opioid prescriptions from March 2019 to March 2021. Opioid utilization was measured using the number of opioids' items dispensed/1000 inhabitants and Defined Daily Dose (DDD)/1000 inhabitants/day during 12-months pre/post the lockdown in March 2020 stratified by strong and weak opioids.

RESULTS

For all opioids' classes, there were nonsignificant changes in the number of opioids' items dispensed/1000 inhabitants trend pre-lockdown, small increases in their level immediately post-lockdown, and a non-significant decline in the trend post-lockdown. Similarly, a non-significant reduction in the DDD/1000 inhabitant/day baseline trend pre-lockdown, nonsignificant immediate increases in the level post-lockdown, and declines in the trend post-lockdown for all opioids' classes were observed.

CONCLUSION

Unexpectedly, opioid utilization does not appear to have been significantly affected by the lockdown measures during the study period. However, patient-level data is needed to determine more accurate estimates of any changes in the opioid prescribing including incident prescribing/use.

摘要

背景

COVID-19 封锁导致大多数常规慢性疼痛管理服务的获取受限。因此,预计阿片类药物的使用会发生变化。本研究使用涵盖整个英国人口的汇总社区配药数据集,评估了第一次 COVID-19 封锁对阿片类药物使用的影响。

研究设计和方法

从 2019 年 3 月至 2021 年 3 月,采用分段线性回归分析每月配给的阿片类药物处方。在 2020 年 3 月封锁前后的 12 个月内,通过配给的阿片类药物数量/每 1000 居民和 DDD/每 1000 居民/天来衡量阿片类药物的利用情况,并根据强阿片类药物和弱阿片类药物进行分层。

结果

对于所有阿片类药物类别,在封锁前,配给的阿片类药物数量/每 1000 居民趋势没有明显变化,封锁后立即略有增加,封锁后趋势没有明显下降。同样,在封锁前,DDD/每 1000 居民/天的基线趋势没有明显下降,封锁后立即略有增加,封锁后趋势下降,所有阿片类药物类别均如此。

结论

出乎意料的是,在研究期间,封锁措施似乎并没有对阿片类药物的使用产生显著影响。然而,需要患者层面的数据来确定阿片类药物处方包括新处方/使用的任何变化的更准确估计。

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