頭頸部がんにおける既にある精神疾患の危険因子と長期にわたるオピオイド使用
Nosayaba Osazuwa-Peters1,2,3,4,5, May Z Gao6, Russel R Kahmke1,3
1Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina.
JAMA otolaryngology-- head & neck surgery
|September 4, 2025
まとめ
うつ病やニコチン依存症のような 既にある精神疾患は 頭頸部がん患者のオピオイド処方のリスクを増大させます 早期スクリーニングは より安全なオピオイド処方法を指し示します
科学分野:
- 腫瘍学
- 精神科
- 薬理学について
背景:
- 頭頸部がん (HNC) は重大な精神的苦痛と関連しています.
- オピオイドの使用は癌の治療において一般的ですが,HNCにおける精神的要因との関連はよく理解されていません.
研究 の 目的:
- HNC患者における既存の精神疾患の危険因子とオピオイドの処方薬の使用との関連を調査する.
- これらの要因がオピオイド処方や長期オピオイド治療 (LTOT) を予測するかどうかを判断する.
主な方法:
- 電子医療記録を用いた遡及的なコホート研究 (2010年−2018年)
- オピオイドの使用前の成人HNC患者を含む,2年後のデータ分析.
- 精神的要因 (うつ病,ニコチン依存症など) の関連性を評価した多変量ロジスティック回帰 オピオイドの使用 (HNCの診断から12ヶ月以内に処方された薬またはLTOT)
主要な成果:
- 対象となったHNC患者11,335人のうち,23. 4%がオピオイドの処方箋を受け,4. 9%が12ヶ月以内にLTOTを受けた.
- うつ病 (aOR,1. 21),ニコチン依存 (aOR,1. 56),ベンゾジアゼピン使用 (aOR,1. 44) は,オピオイドの処方率が高いと関連していました.
- ニコチン依存症 (aOR,1. 77) は,LTOTの確率増加と関連した唯一の精神病因子でした.
結論:
- 既にある精神疾患,特にうつ病とニコチン依存症は,HNC患者におけるオピオイド処方とLTOTの増加と関連しています.
- これらの状態のスクリーニングは,HNCの管理において,情報に基づいた臨床意思決定とより安全なオピオイド処方のために不可欠です.
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