在患有慢性疼痛的患者中基于数据的阿片类药物风险审查:回顾性图表审查
Joshua Pogue1, Lily Lau1, Jeffrey Boyer1
1Southern Arizona VA Healthcare System, Tucson, Arizona, USA.
Journal of pain & palliative care pharmacotherapy
|November 29, 2023
概括
基于数据的阿片类药物风险审查可以减少严重不良事件 (SAE) 和过量服用. 然而,阿片类药物的逐渐减少和停药显著增加了与自杀有关的事件和SAE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:
- 与阿片类药物相关的严重不良事件 (SAE) 构成了重大的公共卫生挑战.
- 有效的风险减轻策略对于治疗阿片类药物治疗的慢性疼痛患者的管理至关重要.
研究的目的:
- 评估基于数据的阿片类药物风险评估对减少阿片类药物相关的SAE的影响.
- 为了比较SAE率6个月前和后实施风险审查过程.
主要方法:
- 在单个中心进行回顾性队列图表审查.
- 分析与阿片类药物相关的SAE,包括与自杀有关的事件和过量服用.
- 多变量逻辑回归和麦克纳马的测试用于统计比较.
主要成果:
- 与阿片类药物相关的SAE综合降低的主要结局不是统计学上显著的 (p=0.080).
- 阿片类药物缩与与自杀有关的事件 (6.64,p=0.05) 和SAE (10.43,p=0.02) 的显著更高的危险比率 (HR) 相关.
- 停用阿片类药物显示,自杀相关事件 (9.95,p=0.009) 和SAE (15.64,p=0.001) 的HR甚至更高.
结论:
- 基于数据的阿片类药物风险评估可能会降低慢性疼痛患者与阿片类药物相关的SAE的发生率.
- 阿片类药物的逐渐减少和停药被确定为与自杀有关的事件和SAE的重大风险因素.
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