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接受阿片类药物使用障碍治疗药物的患者与因疼痛管理而接受低剂量和高剂量阿片类药物治疗的患者的临床和心理健康特征。

Clinical and mental health characteristics among patients receiving medications for opioid use disorder treatment versus patients receiving low- and high-dose opioids when referred for pain management.

作者信息

Yang Jie, Giummarra Melita, Picco Louisa, Arnold Carolyn, Nielsen Suzanne

机构信息

Monash Addiction Research Centre, Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria 3199, Australia.

Caulfield Pain Management and Research Centre, Caulfield Hospital, Melbourne, Victoria 3162, Australia.

出版信息

Pain Med. 2025 May 1;26(5):237-247. doi: 10.1093/pm/pnaf011.

Abstract

OBJECTIVE

To examine the demographic and clinical characteristics of patients attending pain management services who were receiving opioid agonist treatment (ie, methadone or buprenorphine for the treatment of opioid use disorder) in comparison with those taking prescription opioid analgesics in oral morphine equivalent daily doses at low (<40 mg) and high doses (>100 mg) in a national database from the electronic Persistent Pain Outcomes Collaboration (ePPOC) in Australia.

DESIGN

A cross-sectional study.

SETTING

Australian pain services.

SUBJECTS

Adult patients referred to Australian pain service clinics between 2016 and 2021.

METHODS

Multinomial and bivariate logistic regression models were conducted to compare the demographic and clinical characteristics of patients on opioid agonist treatment and those taking other prescription opioid analgesics.

RESULTS

Among 42 182 participants, most were female (56.8%), with a mean age of 51.7 years. People on opioid agonist treatment (n = 1016) and high-dose opioids (n = 7122) were similar in that they both had more severe mental health symptoms and longer pain duration than the low-dose group (n = 20 517). Compared with the high-dose group, people on opioid agonist treatment had reduced odds of reporting more severe pain intensity but increased odds of having multimorbidity, more severe anxiety, and pain catastrophizing thoughts.

CONCLUSIONS

These findings highlight the need for mental health treatment and the necessity of tailored multidisciplinary pain management for people in opioid agonist treatment.

摘要

目的

在澳大利亚电子持续性疼痛结局协作组(ePPOC)的全国数据库中,研究接受阿片类激动剂治疗(即使用美沙酮或丁丙诺啡治疗阿片类物质使用障碍)的疼痛管理服务患者与服用低剂量(<40毫克)和高剂量(>100毫克)口服吗啡当量每日剂量的处方阿片类镇痛药患者的人口统计学和临床特征。

设计

横断面研究。

地点

澳大利亚疼痛服务机构。

研究对象

2016年至2021年间转诊至澳大利亚疼痛服务诊所的成年患者。

方法

采用多项和二元逻辑回归模型比较接受阿片类激动剂治疗的患者与服用其他处方阿片类镇痛药患者 的人口统计学和临床特征。

结果

在42182名参与者中,大多数为女性(56.8%),平均年龄为51.7岁。接受阿片类激动剂治疗的患者(n = 1016)和高剂量阿片类药物治疗的患者(n = 7122)有相似之处,即他们的心理健康症状都比低剂量组(n = 20517)更严重,疼痛持续时间更长。与高剂量组相比,接受阿片类激动剂治疗的患者报告更严重疼痛强度的几率降低,但患多种疾病、更严重焦虑和疼痛灾难化思维的几率增加。

结论

这些发现凸显了心理健康治疗的必要性,以及为接受阿片类激动剂治疗的患者提供量身定制的多学科疼痛管理的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aec0/12046219/380cbc1feaca/pnaf011f1.jpg

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