美国老年疼痛患者中阿尔茨海默病诊断后的门诊阿片类药物处方
Outpatient opioid prescribing by Alzheimer's diagnosis among older adults with pain in United States.
机构信息
Department of Pharmacy Administration, University of Mississippi College of Pharmacy, 235 Faser Hall, Oxford, Mississippi, 38677, USA.
Department of Pharmaceutical Health Outcome and Policy, University of Houston College of Pharmacy, Houston, USA.
出版信息
BMC Geriatr. 2023 Aug 1;23(1):465. doi: 10.1186/s12877-023-04115-6.
OBJECTIVE
To examine opioid prescribing practices for pain in older adults with and without Alzheimer's Disease and Related Dementias (ADRD).
METHODS
This cross-sectional study used National Ambulatory Medical Care Survey data (2014-2016, and 2018). Adults aged ≥ 50 years with pain were analyzed. Prescribing of opioid and concomitant sedative prescriptions (including benzodiazepines, Z-drugs, and barbiturates) were identified by the Multum lexicon code. Multivariable logistic regression evaluated the risk of opioid prescribing or co-prescribing of opioid and sedative associated with ADRD in older adults with pain.
RESULTS
There were 13,299 office visits in older adults with pain, representing 451.75 million visits. Opioid prescribing occurred in 27.19%; 30% involved co-prescribing of opioids and sedatives. ADRD was not associated with opioid prescribing or co-prescribing of opioid and sedative therapy.
CONCLUSIONS
Opioid and sedatives are commonly prescribed in older adults with pain. Longitudinal studies need to understand the etiology and chronicity of opioid use in older patients, specifically with ADRD.
目的
调查患有阿尔茨海默病及相关痴呆症（ADRD）和无 ADRD 的老年疼痛患者的阿片类药物处方实践。
方法
本横断面研究使用了国家门诊医疗调查数据（2014-2016 年和 2018 年）。分析了年龄≥50 岁且有疼痛的成年人。阿片类药物和伴随镇静剂处方（包括苯二氮䓬类、Z 类药物和巴比妥类）的开具通过 Multum 词汇代码确定。多变量逻辑回归评估了阿片类药物处方或阿片类药物和镇静剂联合处方与老年疼痛患者 ADRD 相关的风险。
结果
13299 次老年疼痛患者的门诊就诊，代表了 4.5175 亿次就诊。阿片类药物处方的开具率为 27.19%；30%涉及阿片类药物和镇静剂的联合处方。ADRD 与阿片类药物处方或阿片类药物和镇静剂联合处方无关。
结论
阿片类药物和镇静剂在老年疼痛患者中经常开具。需要进行纵向研究，以了解老年患者，特别是患有 ADRD 的老年患者中阿片类药物使用的病因和慢性病程。
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