J Pain Palliat Care Pharmacother. 2022 Sep;36(3):178-186. doi: 10.1080/15360288.2022.2105471. Epub 2022 Aug 2.
While improving opioid safety has been a national priority, the coronavirus disease 2019 (COVID-19) pandemic has been associated with increased rates of opioid overdose. The present study characterized outpatient opioid and naloxone prescribing patterns during the COVID-19 pandemic. A retrospective chart review was conducted of adult patients receiving opioid therapy between August 2020 through October 2020 from outpatient clinics within a Texas health system. The primary outcome was naloxone co-prescription during the study period or within the year prior. During the study period, 1,368 patients received an opioid prescription, most of which were prescribed for chronic pain treatment (63.0%). Most opioid prescriptions (91.5%) were written for < 50 MME/day. For prescriptions written for acute pain, 78% were written for ≤ 10 days supply. While 31.1% of patients received gabapentinoid prescriptions, few (7.9%) received benzodiazepine or Z-hypnotic prescriptions. Twenty-two (1.6%) patients were co-prescribed naloxone. In this study, naloxone was rarely prescribed for outpatients receiving opioid prescriptions during the COVID-19 pandemic. Health systems should continue to prioritize adherence to evidence-based clinical guidelines and increase access to naloxone.
虽然提高阿片类药物安全性一直是国家的重点，但 2019 年冠状病毒病（COVID-19）大流行与阿片类药物过量率的增加有关。本研究描述了 COVID-19 大流行期间门诊阿片类药物和纳洛酮处方模式。对 2020 年 8 月至 2020 年 10 月期间从德克萨斯州卫生系统门诊诊所接受阿片类药物治疗的成年患者进行了回顾性图表审查。主要结局是研究期间或前一年纳洛酮共同处方。在研究期间，1368 名患者接受了阿片类药物处方，其中大多数用于治疗慢性疼痛（63.0%）。大多数阿片类药物处方（91.5%）的开具剂量小于 50 MME/天。对于开具的急性疼痛处方，78%的处方开具剂量为 10 天以下。尽管 31.1%的患者开具了加巴喷丁类药物处方，但很少（7.9%）开具了苯二氮䓬类药物或 Z 类催眠药物处方。22 名（1.6%）患者同时开具了纳洛酮处方。在这项研究中，在 COVID-19 大流行期间，接受阿片类药物处方的门诊患者很少开具纳洛酮。卫生系统应继续优先遵守基于证据的临床指南，并增加纳洛酮的获取途径。
