2015 年至 2021 年阿片类药物使用障碍和酒精使用障碍处方药物使用趋势:加拿大一省的全人群研究。
Trend in Prescription Medication Utilization for Opioid Use Disorder and Alcohol Use Disorder From 2015 to 2021: A Population-wide Study in a Canadian Province.
机构信息
From the College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (KA, RH, SE, KK, JF, SA-S, CL); Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (JMB, JS, MWE, GK, EK, CL); and Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada (KL, HP).
出版信息
J Addict Med. 2024;18(6):683-688. doi: 10.1097/ADM.0000000000001348. Epub 2024 Jul 16.
OBJECTIVE
To examine the quarterly incidence and prevalence of medications for opioid use disorder (OUD) and alcohol use disorder (AUD) from 2015 to 2021.
METHODS
A retrospective population-wide observational study in Manitoba, Canada, was conducted using administrative claims data from the Manitoba Centre for Health Policy to examine the incidence and prevalence of OUD (methadone, buprenorphine-naloxone, buprenorphine) or AUD medications (naltrexone, acamprosate, disulfiram) per 10,000 individuals in each quarter between January 1, 2015, and December 31, 2021.
RESULTS
There were 1179 and 451 individuals who received at least one prescription for OUD and AUD, respectively, in the first quarter of 2020. The prevalence of OUD medications more than doubled from 6.3 to 14.3 per 10,000 from January 1, 2015, to December 31, 2021. Likewise, AUD medication prevalence increased almost 10-fold from 0.68 to 6.5 per 10,000 from January 1, 2015, to December 31, 2021, primarily due to naltrexone. The incidence of AUD prescription use increased 8.6-fold from 0.29 to 2.51 per 10,000 during the study period. In contrast, the incidence of opioid agonist therapy declined from 2.1 per 10,000 in the first quarter of 2015 to 0.53 per 10,000 the first quarter of 2016, primarily due to methadone. Whereas methadone incidence declined, buprenorphine-naloxone incidence increased almost 15-fold during the study period.
CONCLUSION
An increase in both AUD medication prevalence and incidence in addition to an increase in buprenorphine-naloxone incidence was observed. These findings reflect an increase in the uptake of medications for treating AUD and OUD following changes to improve coverage and access to these medications.
目的
从 2015 年到 2021 年,调查阿片类药物使用障碍(OUD)和酒精使用障碍(AUD)药物的季度发病率和患病率。
方法
在加拿大马尼托巴省进行了一项回顾性全人群观察性研究,使用马尼托巴省卫生政策中心的行政索赔数据,调查 2015 年 1 月 1 日至 2021 年 12 月 31 日期间,每个季度每 10000 人中 OUD(美沙酮、丁丙诺啡-纳洛酮、丁丙诺啡)或 AUD 药物(纳曲酮、阿坎酸、双硫仑)的发病率和患病率。
结果
2020 年第一季度,分别有 1179 人和 451 人至少开了一张 OUD 和 AUD 的处方。从 2015 年 1 月 1 日至 2021 年 12 月 31 日,OUD 药物的患病率从 6.3 增至 14.3,翻了一番多。同样,AUD 药物的患病率从 2015 年 1 月 1 日的 0.68 增至 12 月 31 日的 6.5,增加了近 10 倍,主要是因为纳曲酮。研究期间,AUD 处方使用率从 0.29 增至 2.51,增加了 8.6 倍。相比之下,阿片类激动剂治疗的发病率从 2015 年第一季度的每 10000 人 2.1 降至 2016 年第一季度的每 10000 人 0.53,主要是因为美沙酮。美沙酮的发病率下降,丁丙诺啡-纳洛酮的发病率在研究期间几乎增加了 15 倍。
结论
观察到 AUD 药物的患病率和发病率增加,以及丁丙诺啡-纳洛酮发病率增加。这些发现反映了在改善这些药物的覆盖范围和可及性之后,AUD 和 OUD 治疗药物的使用增加。