在州医疗补助计划的入学者中,手术处方阿片类药物的发展轨迹
Jenna L McCauley1, Ralph C Ward2, David J Taber3
1Addiction Science Division, Department of Psychiatry, The Medical University of South Carolina, Charleston, South Carolina. ORCID: https://orcid.org/0000-0001-8406-2329.
超过三分之一的医疗补助患者在手术后成为慢性阿片类药物使用者. 手术前阿片类药物使用和并发症是长期阿片类药物依赖的关键风险因素.
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
- 公共卫生 公共卫生
背景情况:
- 手术后阿片类药物的使用日益令人担忧.
- 了解患者的发展轨迹对于干预至关重要.
研究的目的:
- 为了评估医疗补助患者在六次常见指数手术后的阿片类药物使用模式.
- 为了确定与慢性术后阿片类药物使用相关的因素.
主要方法:
- 对10,138名医疗补助病人的回顾性队列研究.
- 对2014-2017年行政索赔数据的分析.
- 基于小组的轨迹建模以确定15个月的阿片类药物使用模式.
主要成果:
- 37.7%的患者是慢性阿片类药物使用者 (手术后≥90天).
- 手术前使用阿片类药物,手术后30天使用和并发症是显著的预测因素.
- 确定了六种不同的阿片类药物使用轨迹.
结论:
- 在手术前对患者对现实的阿片类药物预期的教育至关重要.
- 对于那些在1-3个月内没有逐渐减少阿片类药物的患者来说,协调的术后护理至关重要.
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