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匈牙利的阿片类药物使用情况:门诊和医院护理部门的全国及区域分析

Opioid Utilisation in Hungary: National and Regional Analysis in Ambulatory and Hospital Care Sector.

作者信息

Dewi Ni Made Amelia Ratnata, Matuz Mária, Szok Délia, Engi Zsófia, Soós Gyöngyvér, Csenki Melinda, Csüllög Emese, Balog Attila, Csupor Dezső, Viola Réka, Benkő Ria

机构信息

Institute of Clinical Pharmacy, Faculty of Pharmacy, University of Szeged, 6725 Szeged, Hungary.

Pharmacy Study Program, Faculty of Medicine and Health Sciences, University of Mataram, Mataram 83115, Indonesia.

出版信息

J Clin Med. 2025 Jan 29;14(3):897. doi: 10.3390/jcm14030897.

Abstract

: Opioid consumption analysis in Hungary, particularly through ambulatory and hospital sales data, including regional information, is lacking. This study examines opioid use in both sectors, explores regional variations, and identifies influencing factors. A cross-sectional analysis was conducted using sales data from ambulatory and hospital care, quantifying opioid consumption in defined daily doses (DDD) per 1000 inhabitants (DID) and per day, or DDD per 100 patient days (DHPD) at national and regional levels. Correlations between opioid utilisation and regional variables were assessed using Spearman's rank test. Total opioid use has risen from 4.73 DID in 2012 to 6.75 DID in 2021, with weak and oral opioids being the most used. Ambulatory care experienced significant increases in weak (61.48%) and oral opioid use (60.01%). Hospital care experienced a decline in DID and stagnation in DHPD. Tramadol combinations grew notably in ambulatory care, with tramadol-paracetamol rising from 0.37 DID to 2.17 DID (484.61% increase) and tramadol-dexketoprofen from 0.12 DID to 0.91 DID (650.27% increase). Interregional differences showed a maximum to minimum ratio of 1.79 in ambulatory and 3.03 in hospital care in 2021. Positive correlations were found between opioid use and geriatric population percentage (r = 0.475; = 0.035) and, also, unemployment rate (r = 0.546; = 0.014). A moderate negative correlation was observed between the number of general practitioners (r = -0.458; = 0.043) and ambulatory care opioid use. Opioid use is increasing in Hungarian ambulatory care while remaining steady in the hospital sector. Regional variations are possibly linked to demographic and economic factors in ambulatory care.

摘要

匈牙利缺乏对阿片类药物消费的分析,尤其是通过门诊和医院销售数据进行的分析,包括区域信息。本研究考察了两个部门的阿片类药物使用情况,探讨了区域差异,并确定了影响因素。利用门诊和医院护理的销售数据进行了横断面分析,在国家和区域层面按每1000居民每日限定剂量(DDD)和每日每100患者日的DDD来量化阿片类药物消费。使用Spearman秩检验评估阿片类药物使用与区域变量之间的相关性。阿片类药物的总使用量已从2012年的4.73 DDD上升至2021年的6.75 DDD,其中弱阿片类药物和口服阿片类药物使用最为广泛。门诊护理中弱阿片类药物(61.48%)和口服阿片类药物的使用量显著增加(60.01%)。医院护理的DDD有所下降,每100患者日的DDD停滞不前。曲马多复方制剂在门诊护理中显著增长,曲马多-对乙酰氨基酚从0.37 DDD升至2.17 DDD(增长484.61%),曲马多-右酮洛芬从0.12 DDD升至0.91 DDD(增长650.27%)。2021年,区域间差异在门诊护理中最高与最低之比为1.79,在医院护理中为3.03。发现阿片类药物使用与老年人口百分比(r = 0.475;P = 0.035)以及失业率(r = 0.546;P = 0.014)之间存在正相关。观察到全科医生数量与门诊护理阿片类药物使用之间存在中度负相关(r = -0.458;P = 0.043)。匈牙利门诊护理中的阿片类药物使用正在增加,而医院部门则保持稳定。区域差异可能与门诊护理中的人口和经济因素有关。

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