短期医疗保健资源利用与获得CDC告知的阿片类药物值在商业保险的新慢性阿片类药物使用者之间
Martin J Calabrese1, Fadia T Shaya2, Francis Palumbo2
1Department of Practice, Sciences, and Health Outcomes Research, University of Maryland Baltimore School of Pharmacy; Center for Medicare, Centers for Medicare & Medicaid Services, Baltimore, Maryland. ORCID: https://orcid.org/0000-0003-4304-396X.
Journal of opioid management
|March 27, 2024
概括
最近的疾病控制和预防中心 (CDC) 吗啡毫克相当量 (MME) /天门没有影响新慢性阿片类药物使用者的急性护理遭遇. 这些发现表明,MME/天减少政策可能不会减少这一群体的短期医疗保健使用率.
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
- 公共卫生政策 公共卫生政策
背景情况:
- 疾病控制和预防中心 (CDC) 更新了阿片类药物处方指南,引入了吗啡毫克相当量 (MME) /天的门.
- 评估这些门对医疗保健利用的影响对于为公共卫生政策提供信息至关重要.
研究的目的:
- 评估最近的CDC MME/day门建议与新慢性阿片类药物使用者 (NCOU) 中医疗保健使用之间的关联.
主要方法:
- 从2014年1月到2015年3月,对具有商业保险的NCOU进行了回顾性队列研究.
- 根据CDC的值,NCOU被分为低 (<50MME/天),中 (≥50至<90MME/天) 和高 (≥90MME/天) 风险组.
- 多变量后勤回归分析了急性护理遭遇 (ACE) 的调整几率,无论是全因还是与阿片类药物相关.
主要成果:
- 在低,中,高MME/day值组之间没有观察到所有原因ACE的统计学上显著差异.
- 与阿片类药物相关的ACE显示,与低组相比,中高MME/day组的ACE增加在统计学上是微不足道的.
- 所有原因ACE的调整后赔率比为1.01 (95% CI:0.94-1.28) 中等和1.01 (95% CI:0.84-1.22) 高门与低门.
- 与阿片类药物相关的ACE的调整后几率比为1.86 (95% CI:0.86-4.02) 对于中等和1.51 (95% CI:0.65-3.52) 对于高值与低值.
结论:
- 疾病预防控制中心的MME/day值与新慢性阿片类药物使用者中所有原因或阿片类药物相关的急性护理遭遇的短期变化无关.
- 目前专注于减少MME/day的早期干预策略可能不会立即减少NCOU的医疗保健利用率.
- 需要进一步的研究来调查这些值对该患者群体ACE的潜在长期影响.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
287
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...
287
Analgesia and Pain Management
614
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...
614
Opioid Analgesics: Morphine and Other Natural Cogeners
244
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...
244
Prescription, Nonprescription and Orphan Drugs
725
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...
725
Opioid Receptors: Overview
776
Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
776
Drug Classes and Categories
2.0K
Drugs can be classified according to their chemical composition or their intended therapeutic application. For instance, anti-infective agents that possess the ability to eliminate pathogens or suppress their growth and reproduction can be grouped based on the organisms they target or their chemical structure. Furthermore, drugs can be divided into prescription, nonprescription, or controlled substances. Prescription medications, such as antibiotics, require oversight from a licensed healthcare...
2.0K


