Oregon State University, Oregon Health & Science University, Portland, OR, USA.
Oregon Health & Science University, Portland, OR, USA.
J Prim Care Community Health. 2023 Jan-Dec;14:21501319221147378. doi: 10.1177/21501319221147378.
When prescribed with opioids, sedative-hypnotics substantially increase the risk of overdose. The objective of this paper was to describe characteristics and trends in opioid sedative-hypnotic co-prescribing in a network of safety-net clinics serving low-income, publicly insured, and uninsured individuals.
This retrospective longitudinal analysis of prescription orders examined opioid sedative-hypnotic co-prescribing rates between 2009 and 2018 in the OCHIN network of safety-net community health centers. Sedative-hypnotics included benzodiazepine and non-benzodiazepine sedatives (eg, zolpidem). Co-prescribing patterns were assessed overall and across patient demographic and co-morbidity characteristics.
From 2009 to 2018, 240 587 patients had ≥1 opioid prescriptions. Most were White (65%), female (59%), and had Medicaid insurance (43%). One in 4 were chronic opioid users (25%). During this period, 55 332 (23%) were co-prescribed a sedative-hypnotic. The prevalence of co-prescribing was highest for females (26% vs 19% for males), non-Hispanic Whites (28% vs 13% for Hispanic to 20% for unknown), those over 44 years of age (25% vs 20% for <44 years), Medicare insurance (30% vs 21% for uninsured to 22% for other/unknown), and among those on chronic opioid therapy (40%). Co-prescribing peaked in 2010 (32%) and declined steadily through 2018 (20%). Trends were similar across demographic subgroups. Co-prescribed sedative-hypnotics remained elevated for those with chronic opioid use (27%), non-Hispanic Whites (24%), females (23%), and those with Medicare (23%) or commercial insurance (22%).
Co-prescribed sedative-hypnotic use has declined steadily since 2010 across all demographic subgroups in the OCHIN population. Concurrent use remains elevated in several population subgroups.
开具阿片类药物和镇静催眠药物处方会显著增加用药过量的风险。本文的目的是描述在为低收入、公共保险和无保险人群服务的安全网诊所网络中，阿片类药物和镇静催眠药物联合使用的特征和趋势。
本回顾性纵向分析研究了 2009 年至 2018 年在 OCHIN 安全网社区卫生中心网络中开具的阿片类药物和镇静催眠药物联合使用的处方比例。镇静催眠药物包括苯二氮䓬类和非苯二氮䓬类镇静剂（如唑吡坦）。总体上以及根据患者人口统计学和合并症特征评估联合用药模式。
2009 年至 2018 年，240587 名患者至少有 1 份阿片类药物处方。大多数为白人（65%）、女性（59%），并拥有医疗补助保险（43%）。四分之一的患者为慢性阿片类药物使用者（25%）。在此期间，55332 名（23%）患者同时开具了镇静催眠药物。女性（26%比男性 19%）、非西班牙裔白人（28%比西班牙裔 13%到 20%的未知族裔）、44 岁以上（25%比 44 岁以下 20%）、医疗保险（30%比无保险 21%到其他/未知 22%）和慢性阿片类药物使用者（40%）的联合用药率最高。联合用药的比例在 2010 年达到峰值（32%），并从 2010 年到 2018 年稳步下降（20%）。各亚组的趋势相似。在慢性阿片类药物使用者（27%）、非西班牙裔白人（24%）、女性（23%）、医疗保险（23%）或商业保险（22%）中，联合使用的镇静催眠药物仍然居高不下。
自 2010 年以来，OCHIN 人群中所有亚组的联合使用镇静催眠药物的比例稳步下降。在几个人群亚组中，同时使用的情况仍然较高。
