在国家阿片类药物处方政策之后,长期阿片类药物患者的剂量变化
Sijia Qiu1,2, Yan Liu1, Doyinsola O Adetunji1
1Department of Health Behavior, Policy, and Administration Sciences, School of Public Health, University of Nevada, Reno, Reno, NV.
Medical care
|August 15, 2023
概括
在内华达州,内华达州.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 疼痛管理 疼痛管理
- 片政策 片政策
背景情况:
- 内华达州于2018年颁布了阿片类药物处方立法 (AB474),以与CDC的疼痛护理指南保持一致.
- 该研究重点关注长期阿片类药物患者,以评估法律对处方实践的影响.
研究的目的:
- 评估内华达州AB474立法与超过50毫克吗啡相当量 (MME) 的阿片类药物剂量之间的关联.
- 分析法律对长期阿片类药物使用者的阿片类药物剂量升级和降低时间的影响.
主要方法:
- 一个差异差异研究设计比较了内华达州和科罗拉多州使用医疗补助药房索赔的剂量变化.
- 使用后勤回归和生存分析 (间隔时间模型) 来评估MME值的变化和剂量调整的时间.
- 包括6个月内至少有120天供应的患者.
主要成果:
- 与科罗拉多州相比,内华达州的法律与超过50MME的阿片类药物处方减少了2.9%.
- 在内华达州,立法与剂量升级速度较慢 (aHR=0.75),但降级速度也较慢 (aHR=0.87).
- 在政策实施后,科罗拉多州的升级速度较慢 (aHR=1.04) 和降级速度较慢 (aHR=0.97).
结论:
- 超过50MME的阿片类药物剂量减少似乎主要是由剂量升级的速度较慢而不是更快的降级驱动的.
- 政策后的供应日数较长可能会导致观察到的剂量缓解速度较慢.
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