オピオイドの処方に関する傾向と要因 (2017年から2023年)
Wenyu Song1,2, Kenneth J Mukamal2,3, Joji Suzuki2,4
1Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States.
Pain
|September 2, 2025
まとめ
オピオイドの処方率は2017年から2023年の間に全体的に減少したが,2020年には急激な低下と回復を含む明確な段階を示した. 高用量オピオイドの処方には 患者と提供者の要因が影響した.
科学分野:
- 公衆衛生
- 医療情報学
- 薬理学について
背景:
- オピオイドの乱用が 過剰摂取による死亡に寄与しています
- 時間的な処方パターンを理解することは 介入に不可欠です
- 電子医療記録は,傾向分析のための貴重なデータを提供します.
研究 の 目的:
- 大規模な米国保健システムにおける7年間の (2017年-2023) オピオイド処方傾向を分析する.
- 月々のオピオイド処方率の 異なる段階とパターンを特定する
- 設定,人口統計,および遭遇タイプ,および高用量処方箋との関連による処方箋の変動を調査する.
主な方法:
- 13の病院の1,019,706人の患者からの電子医療記録の分析.
- 3,877,281人のオピオイドの処方箋の調査で 18,225人の処方箋の提供者が確認された.
- 月間処方率の統計分析,傾向と段階を特定するためのセグメンテッド回帰を含む.
主要な成果:
- 2017年1月から2023年12月までの月間オピオイド処方率の全体的な減少が観察されました (月平均0.70%).
- 段階的な減少 (2020年1月~2020年1月),急激な減少と反発 (2020年2月~7月),再度の段階的な減少 (2020年8月~2023年12月) という4つの段階が特定されました.
- 患者の特徴と提供者の専門性により,環境,人口,および遭遇の種類によって,高いモルヒンミリグラム相当の用量に関連した処方における有意な変動が認められた.
結論:
- オピオイドの処方傾向は複雑で,外部要因の影響によるダイナミックな変化を示しています (例えば2020年).
- サブグループ分析では,高用量オピオイドの処方に関連する格差と特定のリスク要因が明らかになりました.
- オピオイドの処方に関するガイドラインを策定する際には,微妙な多要素アプローチが必要であることを強調しています.
関連する概念動画
Opioid Analgesics: Synthetic and Semisynthetic Opioids
421
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
421
Opioid Analgesics: Morphine and Other Natural Cogeners
361
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
361
Analgesia and Pain Management
788
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
788
Prescription, Nonprescription and Orphan Drugs
842
Prescription drugs require a prescription from a medical practitioner and can only be obtained from a pharmacy. They have many applications, including treating pain, anxiety, and hypertension.
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
842
Opioid Receptors: Overview
1.8K
Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
1.8K
Issues And Trends In Healthcare Delivery System
5.8K
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
5.8K


