Bernstein Charles N, Fisk John D, Walld Randy, Bolton James M, Sareen Jitender, Patten Scott B, Singer Alexander, Lix Lisa M, Hitchon Carol A, El-Gabalawy Renée, Katz Alan, Graff Lesley A, Marrie Ruth Ann
Rady Faculty of Health Sciences, Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada.
Inflamm Bowel Dis. 2025 Feb 10;31(2):386-393. doi: 10.1093/ibd/izae188.
Little is known about patterns of opioid prescribing in inflammatory bowel disease (IBD), but pain is common in persons with IBD. We estimated the incidence and prevalence of opioid use in adults with IBD and an unaffected reference cohort and assessed factors that modified opioid use.
Using population-based health administrative data from Manitoba, Canada, we identified 5233 persons with incident IBD and 26 150 persons without IBD matched 5:1 on sex, birth year, and region from 1997 to 2016. New and prevalent opioid prescription dispensations were quantified, and patterns related to duration of use were identified. Generalized linear models were used to test the association between IBD, psychiatric comorbidity, and opioid use adjusting for sociodemographic characteristics, physical comorbidities, and healthcare use.
Opioids were dispensed to 27% of persons with IBD and to 12.9% of the unaffected reference cohort. The unadjusted crude incidence per 1000 person-years of opioid use was nearly twice as high for the IBD cohort (88.63; 95% CI, 82.73-91.99) vs the reference cohort (45.02; 95% CI, 43.49-45.82; relative risk 1.97; 95% CI, 1.86-2.08). The incidence rate per 1000 person-years was highest in those 18-44 years at diagnosis (98.01; 95% CI, 91.45-104.57). The relative increase in opioid use by persons with IBD compared to reference cohort was lower among persons with psychiatric comorbidity relative to the increased opioid use among persons with IBD and reference cohort without psychiatric comorbidity.
The use of opioids is more common in people with IBD than in people without IBD. This does not appear to be driven by psychiatric comorbidity.
关于炎症性肠病（IBD）患者阿片类药物的处方模式，我们了解得很少，但疼痛在IBD患者中很常见。我们估计了IBD成年患者和未受影响的对照队列中阿片类药物使用的发病率和患病率，并评估了影响阿片类药物使用的因素。
利用加拿大曼尼托巴省基于人群的卫生行政数据，我们从1997年至2016年确定了5233例IBD新发患者和26150例无IBD患者，后者在性别、出生年份和地区方面按5:1进行匹配。对新开具和长期使用的阿片类药物处方进行了量化，并确定了与使用持续时间相关的模式。使用广义线性模型来检验IBD、精神疾病合并症与阿片类药物使用之间的关联，并对社会人口学特征、身体合并症和医疗保健使用情况进行了调整。
27%的IBD患者使用了阿片类药物，而未受影响的对照队列中这一比例为12.9%。IBD队列每1000人年阿片类药物使用的未调整粗发病率几乎是对照队列的两倍（88.63；95%置信区间，82.73 - 91.99），而对照队列的发病率为45.02；95%置信区间，43.49 - 45.82；相对风险1.97；95%置信区间，1.86 - 2.08）。诊断时年龄在18 - 44岁的人群中，每1000人年的发病率最高（98.01；95%置信区间，91.45 - 104.57）。与对照队列相比，IBD患者中阿片类药物使用的相对增加在有精神疾病合并症的患者中低于没有精神疾病合并症的IBD患者和对照队列中阿片类药物使用的增加。
IBD患者中阿片类药物的使用比非IBD患者更常见。这似乎不是由精神疾病合并症导致的。
