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使用Cerner真实世界数据™数据库量化美国印第安人和阿拉斯加原住民中阿片类药物使用障碍和非致命性阿片类药物过量的负担。

Quantifying the Burden of Opioid Use Disorder and Non-fatal Opioid Overdose in American Indian and Alaskan Native Populations Using the Cerner Real-World Data™ Database.

作者信息

Qeadan Fares, Madden Erin F, English Kevin, Venner Kamilla L, Tingey Benjamin, Egbert Jamie, Hipol Feli Anne S

机构信息

Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, USA.

Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA.

出版信息

J Racial Ethn Health Disparities. 2024 Aug 14. doi: 10.1007/s40615-024-02084-z.

DOI:10.1007/s40615-024-02084-z
PMID:39143452
Abstract

OBJECTIVE

This study evaluated the prevalence and incidence of opioid use disorder (OUD), rates of opioid overdose (OD), and rates of non-fatal (NF) OD in American Indian/Alaskan Native (AI/AN) populations.

METHODS

We used de-identified patient data from Oracle Cerner Real-World Data™. Rates were estimated over time, and stratified by sex, age, marital status, insurance, and region. Mann-Kendall trend tests and Theil-Sen slopes assessed changes over time for each group while autoregressive modeling assessed differences between groups.

RESULTS

The study identified trends in OUD and OD among 700,225 AI/AN patients aged 12 and above. Between 2012 and 2022, there was a significant upward trend in both OUD and OD rates (p < 0.05) , with OUD diagnosed in 1.75% and OD in 0.38% of the population. The Western region of the US exhibited the highest rates of OUD and OD. The 35-49 age group showed the highest rates of OUD, while the 12-34 age group had the highest rates of OD. Marital status analysis revealed higher rates of OUD and OD among separated, widowed, or single patients. Additionally, individuals with Medicare or Medicaid insurance demonstrated the highest rates of OUD and OD.

CONCLUSION

Results show that rates of OUD, OD, and NF OD continue to rise among AI/AN individuals, with some regional and demographic variation. Our study provides foundational estimates of key AI/AN populations bearing greater burdens of opioid-related morbidity that federal, state, and tribal organizations can use to direct and develop targeted resources that can improve the health and well-being of AI/AN communities.

摘要

目的

本研究评估了美国印第安人/阿拉斯加原住民(AI/AN)人群中阿片类物质使用障碍(OUD)的患病率和发病率、阿片类物质过量(OD)率以及非致命(NF)OD率。

方法

我们使用了来自甲骨文Cerner真实世界数据™的去识别化患者数据。对一段时间内的比率进行了估计,并按性别、年龄、婚姻状况、保险和地区进行了分层。Mann-Kendall趋势检验和Theil-Sen斜率评估了每组随时间的变化,而自回归模型评估了组间差异。

结果

该研究确定了700225名12岁及以上AI/AN患者中OUD和OD的趋势。2012年至2022年期间,OUD和OD率均呈显著上升趋势(p<0.05),人群中OUD诊断率为1.75%,OD率为0.38%。美国西部地区的OUD和OD率最高。35 - 49岁年龄组的OUD率最高,而12 - 34岁年龄组的OD率最高。婚姻状况分析显示,分居、丧偶或单身患者的OUD和OD率更高。此外,拥有医疗保险或医疗补助保险的个体的OUD和OD率最高。

结论

结果表明,AI/AN个体中OUD、OD和NF OD率持续上升,存在一些地区和人口统计学差异。我们的研究提供了关键AI/AN人群的基础估计数据,这些人群承受着更大的阿片类物质相关发病负担,联邦、州和部落组织可利用这些数据来指导和开发有针对性的资源,以改善AI/AN社区的健康和福祉。

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本文引用的文献

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Acute Pain and Development of Opioid Use Disorder: Patient Risk Factors.急性疼痛与阿片类药物使用障碍的发展:患者风险因素。
Curr Pain Headache Rep. 2023 Sep;27(9):437-444. doi: 10.1007/s11916-023-01127-0. Epub 2023 Jul 1.
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Characteristics of Nonfatal Opioid Overdose in Emergency Department Patients Surviving to Discharge or Hospital Admission.急诊科存活至出院或住院的非致命阿片类药物过量患者的特征。
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What is the prevalence of and trend in opioid use disorder in the United States from 2010 to 2019? Using multiplier approaches to estimate prevalence for an unknown population size.
2010年至2019年期间,美国阿片类药物使用障碍的患病率及趋势如何?采用乘数法估算未知人口规模的患病率。
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Epidemiological trends in opioid-only and opioid/polysubstance-related death rates among American Indian/Alaska Native populations from 1999 to 2019: a retrospective longitudinal ecological study.1999 年至 2019 年美国印第安人/阿拉斯加原住民人群中仅阿片类药物和阿片类药物/多种物质相关死亡率的流行病学趋势:一项回顾性纵向生态学研究。
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Cerner real-world data (CRWD) - A de-identified multicenter electronic health records database.erner真实世界数据(CRWD)——一个经过去标识化处理的多中心电子健康记录数据库。
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A trend analysis of the prevalence of opioid misuse, social support, and suicide attempt among American Indian/Alaska native high school students in New Mexico: 2009-2019 Youth Risk Resiliency Survey (YRRS).新墨西哥州美国印第安/阿拉斯加原住民高中生阿片类药物滥用、社会支持及自杀未遂患病率的趋势分析:2009 - 2019年青少年风险复原力调查(YRRS)
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Racial/ethnic differences in prescription opioid misuse and heroin use among a national sample, 1999-2018.1999-2018 年全国样本中处方阿片类药物滥用和海洛因使用的种族/民族差异。
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Factors mediating pain-related risk for opioid use disorder.介导阿片类药物使用障碍相关疼痛风险的因素。
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