2001年至2019年按年龄和性别划分的阿片类药物处方国际趋势：一项使用来自18个国家和一个特别行政区的基于人群数据库的观察性研究。
International Trends in Opioid Prescribing by Age and Sex from 2001 to 2019: An Observational Study Using Population-Based Databases from 18 Countries and One Special Administrative Region.
作者信息
Chan Adrienne Y L, Bahmanyar Shahram, Beyene Kebede, Bushnell Greta, Carleton Bruce, Chan Amy Hai Yan, Cook Sharon, Crystal Stephen, Furu Kari, Gadzhanova Svetla, García Poza Patricia, Gini Rosa, Giometto Sabrina, Harrison Jeff, Haug Ulrike, Hsu Christine, Hjördísar Jónsdóttir Harpa Lind, Kai Joe, Karlstad Øystein, Kim Ju Hwan, Kubota Kiyoshi, Lai Edward Chia-Cheng, Lee Hyesung, Lau Wallis C Y, Li Kathy H, Lucenteforte Ersilia, Maura Géric, Neumann Anke, Pate Virginia, Pottegård Anton, Qureshi Nadeem, Rasmussen Lotte, Reutfors Johan, Roughead Elizabeth E, Saastamoinen Leena, Sato Tsugumichi, Scholle Oliver, Schuiling-Veninga C C M, Shen Chin-Yao, Shin Ju-Young, Stürmer Til, Taxis Katja, Tuccori Marco, Weng Stephen, Wong Kirstie H T W, Zoega Helga, Man Kenneth K C, Wong Ian C K
机构信息
Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.
Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Special Administrative Region, China Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.
出版信息
CNS Drugs. 2025 Sep 1. doi: 10.1007/s40263-025-01215-2.
OBJECTIVE
To characterize multinational trends and patterns of opioid analgesic prescribing by sex and age.
DESIGN, SETTING, AND PARTICIPANTS: We studied opioid analgesic prescribing from 2001 to 2019 with common protocol using population-based databases from eighteen countries and one special administrative region.
MAIN OUTCOME MEASURES
We measured opioid prescribing by geographical region, sex and age, estimating annual prevalent, incident, and nonincident opioid prescribing per 100 population with a 95% confidence interval (CI) and meta-analyzed the multinational and regional opioid prescribing with a random-effects model. Time trends were reported through average annual absolute changes, estimated using linear mixed models. We further explored the effect of sex and age on prevalent opioid prescribing in the multivariable analysis.
RESULTS
Over 248 million individuals were included. Pooled multinational opioid prescribing prevalence was 9.0% amongst included countries/regions. Opioid prescribing prevalence in 2015 ranged from 2.7% in Japan to 19.7% in Iceland. Average annual absolute changes in opioid prescribing prevalence per year ranged from - 1.53% (95% CI - 2.06, - 1.00; United States Medicaid) to + 1.24% (95% CI 1.02, 1.46; South Korea). Pooled multinational incident opioid prescribing (4.9%; 95% CI 4.1, 5.9) was higher than pooled multinational nonincident opioid prescribing (3.7%; 95% CI 2.9, 4.8). The female sex and older age were associated with higher opioid prescribing. Main limitations of this study include the absence of data from study duration or individuals not covered by the data sources and the lack of information on medication adherence and indication.
CONCLUSIONS
Opioid prescribing remains unbalanced across geographical regions; however, results suggest a tendency to convergence across countries/regions. Differences in opioid prescribing by sex and age were identified.
目的
描述按性别和年龄划分的阿片类镇痛药处方的跨国趋势和模式。
设计、设置和参与者：我们使用来自18个国家和1个特别行政区的基于人群的数据库，通过通用方案研究了2001年至2019年的阿片类镇痛药处方情况。
主要观察指标
我们按地理区域、性别和年龄衡量阿片类药物处方情况，估计每100人口中每年的流行、新发和非新发阿片类药物处方，并使用随机效应模型对跨国和区域阿片类药物处方进行荟萃分析。通过使用线性混合模型估计的平均年度绝对变化来报告时间趋势。我们在多变量分析中进一步探讨了性别和年龄对流行阿片类药物处方的影响。
结果
纳入了超过2.48亿人。在纳入的国家/地区中，汇总的跨国阿片类药物处方患病率为9.0%。2015年阿片类药物处方患病率从日本的2.7%到冰岛的19.7%不等。每年阿片类药物处方患病率的平均年度绝对变化范围从-1.53%（95%置信区间-2.06，-1.00；美国医疗补助计划）到+1.24%（95%置信区间1.02，1.46；韩国）。汇总的跨国新发阿片类药物处方（4.9%；95%置信区间4.1，5.9）高于汇总的跨国非新发阿片类药物处方（3.7%；95%置信区间2.9，4.8）。女性和年龄较大与较高的阿片类药物处方相关。本研究的主要局限性包括缺乏研究期间的数据或未被数据源覆盖的个体的数据，以及缺乏关于药物依从性和适应症的信息。
结论
阿片类药物处方在地理区域上仍然不均衡；然而，结果表明国家/地区之间存在趋同趋势。确定了阿片类药物处方在性别和年龄上的差异。
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