在COVID-19大流行期间阿片类药物服药的趋势:回顾性队列研究
Amir Marashi1, David Warren1, Gary Call2
1School of Computing, Macquarie University, Macquarie Park, Australia.
JMIR public health and surveillance
|September 1, 2023
概括
由于COVID-19大流行,阿片类药物使用障碍 (OUD) 患者的药物坚持率下降. 对阿片类药物使用障碍 (MOUD) 药物坚持度的下降可能会对治疗结果产生负面影响.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 由于破坏患者护理,COVID-19大流行给阿片类药物危机带来了风险.
- 药物坚持对于治疗阿片类药物使用障碍 (MOUD) 药物治疗的积极结果至关重要.
- 流行病相关的干扰可能会对MOUD的坚持产生负面影响.
研究的目的:
- 为了确定MOUD患者在COVID-19大流行期间是否经历了降低药物坚持.
- 调查大流行对MOUD坚持率的影响.
主要方法:
- 这是一项回顾性队列研究,利用来自美国6个州 (2018-2021) 的医疗补助申请数据.
- 2020年3月,在疫情爆发之前和之后的MOUD药物坚持情况进行了比较.
- 利用覆盖日数比例 (PDC) 来测量依从性,使用断点和β回归分析.
主要成果:
- 分析包括37,604名患者和79,991名PDC得分.
- 在COVID-19流行病和PDC得分之间发现了统计学上显著的负相关性 (系数-0.076,或0.925).
- 流行病开始后,MOUD的遵守率下降.
结论:
- COVID-19大流行与阿片类药物使用障碍患者的药物坚持程度下降有显著的关联.
- 这些发现凸显了大流行对MOUD治疗连续性的不利影响.
- 保持对MOUD的坚持对于管理阿片类药物危机至关重要,尤其是在公共卫生紧急情况下.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
333
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...
333
Opioid Analgesics: Morphine and Other Natural Cogeners
287
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...
287
Drug Therapy
68
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
68
Analgesia and Pain Management
654
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...
654
Prescription, Nonprescription and Orphan Drugs
764
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...
764
Drug Abuse and Addiction: Pharmacological Phenomena
508
Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not...
508


