在接受长期阿片类药物治疗的患者中,阿片类药物剂量减少率与过量服用之间的关联
Jason M Glanz1,2, Stanley Xu3, Komal J Narwaney1
1Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA.
Substance abuse
|September 13, 2023
概括
快速降低阿片类药物剂量 (>每月30%以上) 在长期接受阿片类药物治疗的患者中显著增加过量剂量风险. 建议慢慢减小剂量,以尽量减少在停用阿片类药物治疗期间过量服用的风险.
科学领域:
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
- 临床医学 临床医学
背景情况:
- 缩短长期阿片类药物治疗是常见的.
- 快速降低剂量可能会增加过量服用的风险.
研究的目的:
- 对比不同阿片类药物剂量减少率 (≤10%,11-20%,21-30%,每月>30%) 与稳定剂量的过量风险.
- 评估阿片类药物逐渐减少后过量服用的风险.
主要方法:
- 对17540名长期接受阿片类药物治疗的患者进行了回顾性队列研究 (2006-2019).
- 确定了阿片类药物剂量模式和致命/非致命的过量剂量.
- 使用了Cox比例危险回归与倾向性得分权重.
主要成果:
- 42.7%的患者经历了剂量减少.
- 每月减少剂量率>30%与过量服用风险增加有关 (aHR为1个月5.33,随着时间的推移而下降).
- 较慢的逐渐减少率没有显示过量服用风险增加.
结论:
- 每月超过30%的阿片类药物剂量减少率增加了过量服用的风险.
- 建议缓慢降低剂量,以减轻阿片类药物逐渐减少的患者过量服用的风险.
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