Valladales-Restrepo Luis Fernando, Rubio-Londoño Santiago, Poveda-Martinez Luisa Fernanda, Machado-Alba Jorge Enrique
Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Calle 105 # 14-140, 660003, Pereira, Risaralda, Colombia.
Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia.
Drugs Real World Outcomes. 2022 Sep;9(3):487-501. doi: 10.1007/s40801-022-00318-2. Epub 2022 Jul 11.
Analgesics provide multiple clinical benefits but they are not without risks.
The aim of this study was to compare the outpatient prescribing pattern of analgesics between cities and municipalities in Colombia and to identify the variables associated with prescribing opioid analgesics.
This was a cross-sectional study that identified the prescription of analgesics for outpatient use from a population database of 8.5 million Colombians. A descriptive, bivariate, and multivariate analysis was performed.
A total of 573,248 patients were identified who had received prescriptions for an analgesic. Mean age was 46.5 ± 23.6 years and 65.7% were females. The most commonly prescribed analgesics were non-opioid analgesics, antispasmodics, and opioid analgesics. The average milligram equivalent of morphine was higher in capital cities than in municipalities. Age ≥ 65 years (odds ratio [OR] 2.60, 95% confidence interval [CI] 2.54-2.67), male sex (OR 1.09, 95% CI 1.07-1.11), dispensing in cities (OR 2.25, 95% CI 2.20-2.30) and experiencing chronic pain (OR 13.25, 95% CI 10.89-16.14) were associated with an increased risk of receiving an opioid analgesic.
Differences were found in the prescription of analgesics between capital cities and municipalities. The use of opioids does not appear to be in line with the recommendations for clinical practice, and they were mainly prescribed for elderly males with chronic non-oncological pain and for residents of capital cities.
镇痛药具有多种临床益处，但并非没有风险。
本研究旨在比较哥伦比亚各城市和直辖市门诊镇痛药的处方模式，并确定与开具阿片类镇痛药相关的变量。
这是一项横断面研究，从一个850万哥伦比亚人的人口数据库中确定门诊使用的镇痛药处方。进行了描述性、双变量和多变量分析。
共识别出573248名接受过镇痛药处方的患者。平均年龄为46.5±23.6岁，65.7%为女性。最常开具的镇痛药是非阿片类镇痛药、解痉药和阿片类镇痛药。首都城市的吗啡平均毫克当量高于直辖市。年龄≥65岁（比值比[OR]2.60，95%置信区间[CI]2.54 - 2.67）、男性（OR 1.09，95%CI 1.07 - 1.11）、在城市配药（OR 2.25，95%CI 2.20 - 2.30）以及患有慢性疼痛（OR 13.25，95%CI 10.89 - 16.14）与接受阿片类镇痛药的风险增加相关。
首都城市和直辖市在镇痛药处方方面存在差异。阿片类药物的使用似乎不符合临床实践建议，且主要开具给患有慢性非肿瘤性疼痛的老年男性和首都城市居民。
