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评估癌症患者严重处方阿片类药物引起的呼吸抑制或过量风险指数。

Evaluating the Risk Index for Serious Prescription Opioid-Induced Respiratory Depression or Overdose in Patients with Cancer.

机构信息

are with the Skaggs School of Pharmacy & Pharmaceutical Sciences, University of California (UC), San Diego, CA.

is with the Knight Cancer Institute, Oregon Health and Science University, Portland, ORJoseph D. Ma, PharmD a is with the Skaggs School of Pharmacy & Pharmaceutical Sciences, University of California (UC), San Diego, CA.

出版信息

J Pain Palliat Care Pharmacother. 2024 Jun;38(2):131-137. doi: 10.1080/15360288.2024.2348620. Epub 2024 May 9.

Abstract

The Commercially Insured health Plan Risk Index for Overdose or Serious Opioid-induced Respiratory Depression (CIP-RIOSORD) is an evidence-based tool to determine serious opioid-induced respiratory depression (OIRD) or overdose risk. The CIP-RIOSORD total score determines a risk class and estimates the probability for an OIRD event within the next 6 months. We performed a single-center, retrospective analysis to determine CIP-RIOSORD baseline scores and the most common predictive factors in patients with cancer. Patients ( = 160) were split into new consultations ( = 83, Group 1) versus the first documented follow-up consultation ( = 77, Group 2). Most patients were Caucasian women with metastatic gastrointestinal cancer. CIP-RIOSORD scores for Group 1 patients were 14.8 ± 15.2 (mean ± SD, risk class 4). Group 2 patients had higher CIP-RIOSORD scores (16.6 ± 14.9, risk class 4). For Group 1, the most common CIP-RIOSORD predictive factors were use of a long-acting opioid formulation ( = 24, 29%) and daily oral morphine equivalent (OME) ≥100 ( = 20, 24%); for Group 2, predictive factors were use of an antidepressant ( = 34, 44%) and a long-acting opioid formulation ( = 27, 35%). Based on the CIP-RIOSORD, there is a 15% probability of experiencing a serious OIRD event or overdose within the next 6 months.

摘要

商业保险计划的阿片类药物过量或严重阿片类药物引起的呼吸抑制风险指数(CIP-RIOSORD)是一种基于证据的工具,用于确定严重阿片类药物引起的呼吸抑制(OIRD)或过量风险。CIP-RIOSORD 总评分确定风险类别,并估计在接下来的 6 个月内发生 OIRD 事件的概率。我们进行了一项单中心回顾性分析,以确定癌症患者的 CIP-RIOSORD 基线评分和最常见的预测因素。患者(n=160)分为新就诊患者(n=83,第 1 组)和首次记录的随访就诊患者(n=77,第 2 组)。大多数患者为白种人女性,患有转移性胃肠道癌。第 1 组患者的 CIP-RIOSORD 评分为 14.8±15.2(平均值±标准差,风险类别 4)。第 2 组患者的 CIP-RIOSORD 评分更高(16.6±14.9,风险类别 4)。对于第 1 组,最常见的 CIP-RIOSORD 预测因素是使用长效阿片类药物制剂(n=24,29%)和每日口服吗啡当量(OME)≥100(n=20,24%);对于第 2 组,预测因素是使用抗抑郁药(n=34,44%)和长效阿片类药物制剂(n=27,35%)。根据 CIP-RIOSORD,在接下来的 6 个月内发生严重 OIRD 事件或过量的概率为 15%。

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