Shoji Tomokazu, Akazawa Manabu, Nakagomi Nonoka, Kobayashi Miwako, Kitta Fumihiko, Inose Ryo, Muraki Yuichi, Iijima Tetsuya, Suzuki Takaaki
Department of Pharmacy, University of Yamanashi Hospital, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan.
Department of Public Health and Epidemiology, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Tokyo 204-8588, Japan.
Biol Pharm Bull. 2025;48(3):279-285. doi: 10.1248/bpb.b24-00584.
Trends in opioid use for patients with cancer in Japan remain unclear. This study investigated the prescription trends of strong and weak opioids in Japan and the prescription trends among patients with or without support from a palliative care team. Open data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) and administrative claims data from the University of Yamanashi Hospital from fiscal years 2015 to 2021 were used. Opioid consumption was reported using the defined daily dose (DDD) per 1000 inhabitants per day (DID) and DDD per 100 bed-days. The NDB open data showed a decrease from 0.3111 to 0.2271 in the DID for inpatients (p = 0.0001) and an increase from 0.5971 to 0.8597 in the DID for outpatients (p = 0.0003). Consumption of tramadol, a weak opioid, increased in both inpatient and outpatient settings. In University of Yamanashi Hospital, the annual percentage of opioid consumption changed little among strong opioids (98.1-97.1%) and weak opioids (1.8-2.8%) for patients supported by a palliative care team (p = 0.2842), but changed more noticeably among strong opioids (86.6-69.6%) and weak opioids (13.3-30.3%) for patients without support from a palliative care team (p < 0.001). Opioid prescription patterns in Japan changed during the 7-year study period, which indicated shifts in the types of opioids used. Additionally, the trend in opioid prescriptions was characterized by the presence or absence of palliative care team support.
日本癌症患者阿片类药物的使用趋势尚不清楚。本研究调查了日本强效和弱效阿片类药物的处方趋势，以及有无姑息治疗团队支持的患者的处方趋势。使用了来自日本全国健康保险理赔和特定健康检查数据库（NDB）的公开数据以及山梨大学医院2015财年至2021财年的行政理赔数据。阿片类药物的消费量以每千居民每天的限定日剂量（DDD）和每100床日的DDD来报告。NDB公开数据显示，住院患者的每千居民每天限定日剂量（DID）从0.3111降至0.2271（p = 0.0001），门诊患者的DID从0.5971增至0.8597（p = 0.0003）。弱效阿片类药物曲马多在住院和门诊环境中的消费量均有所增加。在山梨大学医院，有姑息治疗团队支持的患者中，强效阿片类药物（98.1 - 97.1%）和弱效阿片类药物（1.8 - 2.8%）的年度阿片类药物消费百分比变化不大（p = 0.2842），但在没有姑息治疗团队支持的患者中，强效阿片类药物（86.6 - 69.6%）和弱效阿片类药物（13.3 - 30.3%）的变化更为明显（p < 0.001）。在7年的研究期间，日本的阿片类药物处方模式发生了变化，这表明所使用的阿片类药物类型有所转变。此外，阿片类药物处方趋势的特点是有无姑息治疗团队的支持。
