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服用处方阿片类镇痛药患者的亚型及其特征:潜在类别分析

Subtypes in Patients Taking Prescribed Opioid Analgesics and Their Characteristics: A Latent Class Analysis.

作者信息

Rauschert Christian, Seitz Nicki-Nils, Olderbak Sally, Pogarell Oliver, Dreischulte Tobias, Kraus Ludwig

机构信息

Department of Epidemiology and Diagnostics, IFT Institut Für Therapieforschung, Munich, Germany.

Department of Psychology, University of Arizona, Tucson, AZ, United States.

出版信息

Front Psychiatry. 2022 Jul 8;13:918371. doi: 10.3389/fpsyt.2022.918371. eCollection 2022.

Abstract

BACKGROUND

Owing to their pharmacological properties the use of opioid analgesics carries a risk of abuse and dependence, which are associated with a wide range of personal, social, and medical problems. Data-based approaches for identifying distinct patient subtypes at risk for prescription opioid use disorder in Germany are lacking.

OBJECTIVE

This study aimed to identify distinct subgroups of patients using prescribed opioid analgesics at risk for prescription opioid use disorder.

METHODS

Latent class analysis was applied to pooled data from the 2015 and 2021 Epidemiological Survey of Substance Abuse. Participants were aged 18-64 years and self-reported the use of prescribed opioid analgesics in the last year ( = 503). Seven class-defining variables based on behavioral, mental, and physical health characteristics commonly associated with problematic opioid use were used to identify participant subtypes. Statistical tests were performed to examine differences between the participant subtypes on sociodemographic variables and prescription opioid use disorder.

RESULTS

Three classes were extracted, which were labeled as (43.0%, = 203), (10.4%, = 50), and (46.6%, = 250). Individuals within the poor mental health group (23.2%, = 43) and the polysubstance group (31.1%, = 13) showed a higher prevalence of prescription opioid use disorder compared to those of the relatively healthy group.

CONCLUSION

The results add further evidence to the knowledge that patients using prescribed opioid analgesics are not a homogeneous group of individuals whose needs lie in pain management alone. Rather, it becomes clear that these patients differ in their individual risk of a prescription opioid use disorder, and therefore identification of specific risks plays an important role in early prevention.

摘要

背景

由于其药理特性,阿片类镇痛药的使用存在滥用和成瘾风险,这与一系列个人、社会和医疗问题相关。德国缺乏基于数据的方法来识别有处方阿片类药物使用障碍风险的不同患者亚型。

目的

本研究旨在识别使用处方阿片类镇痛药且有处方阿片类药物使用障碍风险的不同患者亚组。

方法

将2015年和2021年药物滥用流行病学调查的汇总数据应用于潜在类别分析。参与者年龄在18 - 64岁之间,自我报告在过去一年中使用过处方阿片类镇痛药(n = 503)。基于与阿片类药物使用问题常见相关的行为、心理和身体健康特征的七个类别定义变量用于识别参与者亚型。进行统计测试以检查参与者亚型在社会人口统计学变量和处方阿片类药物使用障碍方面的差异。

结果

提取出三个类别,分别标记为A(43.0%,n = 203)、B(10.4%,n = 50)和C(46.6%,n = 250)。与相对健康组相比,心理健康状况较差组(23.2%,n = 43)和多物质使用组(31.1%,n = 13)中处方阿片类药物使用障碍的患病率更高。

结论

研究结果进一步证明,使用处方阿片类镇痛药的患者并非仅需疼痛管理的同质个体群体。相反,很明显这些患者在处方阿片类药物使用障碍的个体风险方面存在差异,因此识别特定风险在早期预防中起着重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2155/9304960/c61cf077946f/fpsyt-13-918371-g0001.jpg

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