Kuntheavy Ing Lorenzini, PhD, University Hospitals of Geneva, Division of Clinical Pharmacology and Toxicology, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland, Telephone: +41795535074, Fax: +41223729945, Email:
J Frailty Aging. 2022;11(3):329-334. doi: 10.14283/jfa.2022.35.
Opioid use has much increased in several countries during the last two decades, accompanied by a rise in associated morbidity and mortality, especially in the United States. Data on a possible opioid crisis are scarcer in Europe. We performed a study aiming to assess the frequency of adverse drug reactions (ADR) related to opioids in patients presenting to the emergency unit (EU) of a geriatric tertiary Swiss University Hospital. This particular setting is intended for patients aged 75 and older. Our retrospective, monocentric survey of opioid use and related ADR was conducted over two months in 2018. The main and secondary outcomes were the frequency of EU visits considered due to an opioid ADR and insufficient pain relief, respectively. Current opioid use was identified in 20.3% (n=99) of the 487 included EU visits (mean age 86). An ADR was the suspected cause of the EU visit in 22 opioid users, mainly fall-related injury and gastrointestinal disorders. All these patients had at least one comorbid condition. In 19/22 cases (86%) of ADR, a drug-drug interaction might have been involved. In 12 opioid users (12%), insufficient pain relief was suspected as the cause of the EU visit. In conclusion, one-third of opioid users visiting a geriatric EU consulted for a problem related to its use mainly adverse drug-related reaction (22%) followed by insufficient pain relief (12%).
在过去的二十年中，几个国家的阿片类药物使用量大大增加，随之而来的是相关发病率和死亡率的上升，尤其是在美国。欧洲关于阿片类药物危机的数据则更为稀缺。我们进行了一项研究，旨在评估在瑞士一家老年三级大学医院的急诊部（EU）就诊的患者中与阿片类药物相关的不良反应（ADR）的频率。这种特殊的环境是为 75 岁及以上的患者设置的。我们对 2018 年两个月内的阿片类药物使用和相关 ADR 进行了回顾性、单中心调查。主要和次要结局分别是由于阿片类药物 ADR 和疼痛缓解不足而导致的 EU 就诊的频率。在纳入的 487 次 EU 就诊中，有 20.3%（n=99）的患者正在使用阿片类药物（平均年龄 86 岁）。在 22 名阿片类药物使用者中，ADR 被怀疑是 EU 就诊的原因，主要是跌倒相关损伤和胃肠道疾病。所有这些患者都至少有一种合并症。在 22 例（86%）ADR 中，可能涉及药物相互作用。在 12 名阿片类药物使用者（12%）中，疼痛缓解不足被怀疑是 EU 就诊的原因。总之，三分之一的在老年 EU 就诊的阿片类药物使用者咨询的问题与阿片类药物的使用有关，主要是药物不良反应（22%），其次是疼痛缓解不足（12%）。
