Jung Monica, Xia Ting, Ilomäki Jenni, Pearce Christopher, Aitken Angela, Nielsen Suzanne
Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia.
Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia.
Pain Med. 2024 Aug 6;25(12):748-57. doi: 10.1093/pm/pnae071.
To examine the predictors of persistent opioid use ('persistence') in people initiating opioids for non-cancer pain in Australian primary care.
A retrospective cohort study.
Australian primary care.
People prescribed opioid analgesics between 2018-2022, identified through the Population Level Analysis and Reporting (POLAR) database.
Persistence was defined as receiving opioid prescriptions for at least 90 days with a gap of less than 60 days between subsequent prescriptions. Multivariable logistic regression was used to examine the predictors of persistent opioid use.
The sample consisted of 343,023 people initiating opioids for non-cancer pain; of these, 16,527 (4.8%) developed persistent opioid use. Predictors of persistence included older age (≥75 vs 15-44 years: Adjusted odds ratio: 1.67, 95% CI: 1.58-1.78), concessional beneficiary status (1.78, 1.71-1.86), diagnosis of substance use disorder (1.44, 1.22-1.71) and chronic pain (2.05, 1.85-2.27), initiation of opioid therapy with buprenorphine (1.95, 1.73-2.20) and long-acting opioids (2.07, 1.90-2.25), provision of higher quantity of opioids prescribed at initiation (total OME of ≥ 750mg vs < 100mg: 7.75, 6.89-8.72), provision of repeat/refill opioid prescriptions at initiation (2.94, 2.77-3.12), and prescription of gabapentinoids (1.59, 1.50-1.68), benzodiazepines (1.43, 1.38-1.50) and z-drugs (e.g., zopiclone, zolpidem; 1.61, 1.46-1.78).
These findings add to the limited evidence of individual-level factors associated with persistent opioid use. Further research is needed to understand the clinical outcomes of persistent opioid use in people with these risk factors to support the safe and effective prescribing of opioids.
研究澳大利亚初级医疗中开始使用阿片类药物治疗非癌性疼痛患者持续使用阿片类药物（“持续性”）的预测因素。
一项回顾性队列研究。
澳大利亚初级医疗。
通过人口水平分析与报告（POLAR）数据库确定的2018年至2022年间开具阿片类镇痛药处方的患者。
持续性定义为接受阿片类药物处方至少90天，且后续处方之间的间隔少于60天。采用多变量逻辑回归分析持续使用阿片类药物的预测因素。
样本包括343,023名开始使用阿片类药物治疗非癌性疼痛的患者；其中，16,527名（4.8%）出现持续使用阿片类药物的情况。持续性的预测因素包括年龄较大（≥75岁与15 - 44岁相比：调整比值比：1.67，95%置信区间：1.58 - 1.78）、享有优惠受益地位（1.78，1.71 - 1.86）、物质使用障碍诊断（1.44，1.22 - 1.71）和慢性疼痛（2.05，1.85 - 2.27），开始使用丁丙诺啡（1.95，1.73 - 2.20）和长效阿片类药物（2.07，1.90 - 2.25）进行阿片类药物治疗，开始时开具的阿片类药物剂量较高（总口服吗啡当量≥750mg与<100mg相比：7.75，6.89 - 8.72），开始时提供重复/续方阿片类药物处方（2.94，2.77 - 3.12），以及开具加巴喷丁类药物（1.59，1.
