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美国使用阿片类药物的老年疼痛患者(≥50 岁)中疼痛负担与任何受限之间的关联:使用 2020 年医疗支出面板调查的横断面研究。

Association between pain burden and presence of any limitation among older adults (≥50 years of age) with pain who used opioids in the United States: Cross-sectional study using 2020 medical expenditure panel survey.

机构信息

Department of Pharmacy Practice and Science, R. Ken Coit College of Pharmacy, The University of Arizona 1295 N Martin Ave, Tucson, AZ.

出版信息

Medicine (Baltimore). 2023 Aug 18;102(33):e34863. doi: 10.1097/MD.0000000000034863.

Abstract

This study aimed to assess the association between pain burden and presence of any limitation among older adults (≥50 years of age) with pain who used opioids in the United States. This cross-sectional study used 2020 Medical Expenditure Panel Survey data and included all adults aged 50 or older, who were alive for the 2020 calendar year, used an opioid at least once in the calendar year, and reported having pain in the past 4 weeks. Unadjusted and adjusted logistic regression models were developed to assess the association between any limitation (AL) (yes or no), pain burden (extremely, quite a bit, moderately, or little bit) and the control variables among a nationally representative sample of United States adults. A total of 844 of the 27,805 participants included in the dataset were eligible for the study. Of these, 71.2% (95% confidence interval (CI) = 67.2, 75.1%) reported the presence of AL. The adjusted logistic regression analysis showed that having extreme, quite a bit, or moderate pain (vs little pain) was associated with 10.30 (95% CI = 3.87, 27.40), 5.07 (95% CI = 2.77, 9.30), and 2.49 (95% CI = 1.40, 4.45), respectively, times greater odds of having AL. Furthermore, being unemployed (vs employed; adjusted odds ratio (aOR) = 5.26, 95% CI = 2.94, 9.09%), unmarried (vs married; aOR = 1.92, 95% CI = 1.12, 3.33%), having poor overall health (vs good overall health; aOR = 2.08, 95% CI = 1.08, 4.17), and residing in the Midwest (vs West; aOR = 2.04, 95% CI = 1.10, 3.80) were associated with greater odds of having AL. Extreme, quite a bit, and moderate pain burden were significantly associated with greater odds of reporting AL compared to little pain burden. Developing effective pain management strategies that address not only pain relief but also functional improvement among this population is of importance. Future research could then be conducted to determine the most effective pain management strategies that will provide pain relief and improve their functional abilities.

摘要

本研究旨在评估美国使用阿片类药物的老年疼痛患者(≥50 岁)的疼痛负担与任何受限之间的关联。这项横断面研究使用了 2020 年医疗支出面板调查数据,纳入了所有 50 岁或以上、在 2020 日历年仍存活、在日历年至少使用过一次阿片类药物且报告在过去 4 周内有疼痛的成年人。在全国代表性的美国成年人样本中,建立了未经调整和调整后的逻辑回归模型,以评估任何受限(AL)(是或否)、疼痛负担(极度、相当多、中度或轻度)与对照变量之间的关联。在数据集纳入的 27805 名参与者中,共有 844 名符合研究条件。其中,71.2%(95%置信区间[CI] = 67.2,75.1%)报告存在 AL。调整后的逻辑回归分析显示,与轻度疼痛相比,有极度、相当多或中度疼痛(vs 轻度疼痛)的人出现 AL 的可能性分别增加 10.30 倍(95%CI = 3.87,27.40)、5.07 倍(95%CI = 2.77,9.30)和 2.49 倍(95%CI = 1.40,4.45)。此外,失业(vs 就业;调整后的比值比[aOR] = 5.26,95%CI = 2.94,9.09%)、未婚(vs 已婚;aOR = 1.92,95%CI = 1.12,3.33%)、整体健康状况较差(vs 整体健康状况良好;aOR = 2.08,95%CI = 1.08,4.17%)和居住在中西部(vs 西部;aOR = 2.04,95%CI = 1.10,3.80%)与 AL 出现的可能性增加相关。与轻度疼痛负担相比,极度、相当多和中度疼痛负担与报告 AL 的可能性显著增加相关。极度、相当多和中度疼痛负担与报告 AL 的可能性显著增加相关。在这个人群中,制定不仅能缓解疼痛,还能改善功能的有效疼痛管理策略非常重要。然后可以进行进一步的研究,以确定提供疼痛缓解并改善他们的功能能力的最有效疼痛管理策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac5c/10443775/74b64ad829cc/medi-102-e34863-g001.jpg

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