慢性腰痛におけるオピオイド処方と併発症の差異:人種,民族,社会経済的地位の影響
Boss Povieng1, Alvyn Hernandez Reyes2, Yanyu Zhang3
1Department of Physical Medicine and Rehabilitation, Rush University Medical Center, Chicago, Illinois. ORCID: https://orcid.org/0000-0002-4039-9242.
Journal of opioid management
|September 4, 2025
まとめ
慢性腰痛 (CLBP) の患者は オピオイドの使用率が高く,特に人種的少数派や社会経済的困難を抱える人はそうである. これは痛みの管理と 治療の負担の格差を強調しています
科学分野:
- 痛みの治療
- 医療サービス研究
- 健康 の 格差
背景:
- 慢性腰痛 (CLBP) は数百万人に影響を与えます 治療の負担は人口統計学的に大きく異なります
- 人種,社会経済的地位 (SES) と併発症の相互作用を理解することは,公平なCLBP管理に不可欠です.
- オピオイドと非オピオイドの治療パターンは,様々な患者集団で検査する必要があります.
研究 の 目的:
- CLBP患者における人種,併発症,治療負担 (オピオイド/ノンオピオイド),社会経済的地位 (SES) の関連性を調査する.
- CLBPにおける痛み管理戦略に影響を与える人口統計学的および臨床的要因を特定する.
主な方法:
- 4193人のCLBP患者と4193人の対照群を対象とした症例対照試験です.
- オピオイド薬と非オピオイド薬の処方頻度と非医薬品介入の分析
- 共同疾患,人種,SESの特徴の評価,困難度指数を含む.
主要な成果:
- 黒人またはアフリカ系アメリカ人および非白人ヒスパニックまたはラテン系患者は,白人非ヒスパニック患者と比較して,より高い困難を報告しました.
- オピオイドの使用は,CLBPグループで著しく高かったが,併発症の増加と関連したポジティブな傾向があった.
- 苦悩は併発症や治療の増加と関連しており, 理学療法や脊椎手術は苦悩とマイナスの関係を示した.
結論:
- CLBPに対するオピオイドの処方では大きな差異があり,より困難な状況や少数民族のアイデンティティを持つ患者に不釣り合いの影響を及ぼします.
- モルヒネ,ヒドロコドン,トラマドールの処方量は,特に黒人またはアフリカ系アメリカ人および非白人ヒスパニック系またはラテン系の人々の間で,困難に直面しているCLBP患者で増加しています.
- 原因関係を確立し,公正なCLBPケアのための標的の介入を伝えるために,さらなる研究が必要である.
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