在日本使用基于医院的行政索赔数据库对美沙转换状态的调查
Shungo Imai1, Natsumi Aoki1, Keisuke Ikegami1
1Division of Drug Informatics, Keio University Faculty of Pharmacy, Minato-ku, Tokyo, Japan.
Journal of clinical pharmacology
|September 22, 2023
概括
在日本,为治疗癌症疼痛而转用美沙往往需要比预期更高的剂量,导致治疗持续时间延长. 这凸显了日本患者口服甲转化和管理方面的挑战.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 疼痛管理 疼痛管理
背景情况:
- 在其他强烈阿片类药物不足的情况下,甲对治疗癌症疼痛至关重要.
- 不一致的阿片类药物转换比率对美沙构成临床挑战.
- 在日本,非口服甲配方的有限供应可能会加剧这些问题.
研究的目的:
- 调查日本的甲转换的流行率和特征.
- 分析在甲开始期间的剂量要求和治疗持续时间.
- 确定影响高剂量甲转换的因素.
主要方法:
- 一个日本医院的行政索赔数据库 (2008年4月 - 2021年1月) 的回顾性分析.
- 包括转向甲治疗癌症疼痛的患者.
- 使用多变量逻辑回归评估"高剂量甲切换" (超过包装插件比例) 和切换的持续时间.
主要成果:
- 在370名注册患者中,有130人 (35.1%) 经历过高剂量甲转换.
- 与标准转换相比,高剂量甲转换完成的中位数持续时间更长 (12天).
- 年龄较小和门诊状态增加了高剂量切换的风险;同时使用NSAID和芬太尼降低了这种风险.
结论:
- 超过三分之一的日本癌症患者需要转换高剂量甲,这表明存在重大挑战.
- 延长治疗持续时间与高剂量甲切换有关.
- 由于这些观察到的困难,日本的甲转化和管理需要仔细考虑.
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