同时使用阿片类药物和 gabapentin 对老年人跌倒风险的影响
Jacob T Painter1, Cheng Peng1, Mary Burlette2
1Division of Pharmaceutical Evaluation & Policy, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Journal of pain & palliative care pharmacotherapy
|June 10, 2024
概括
同时使用阿片类药物和 gabapentin 显著增加了老年人的跌倒风险. 与阿片类药物单一治疗相比,这种联合治疗增加了风险,突出显示了需要谨慎的处方做法.
科学领域:
- 老年医学 老年医学
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 跌倒对老年人来说是一个主要的健康问题,导致严重伤害和死亡.
- 同时使用阿片类药物和 gabapentin 在这种人群中用于疼痛管理是常见的.
- 这种组合可能会增加老年患者跌倒的风险.
研究的目的:
- 调查加巴丁与阿片类药物同时使用与老年人跌倒风险之间的关联.
- 为了比较组合治疗和阿片类药物单一治疗患者的跌倒风险.
主要方法:
- 追溯病例控制研究涉及1813名65-89岁的慢性阿片类药物治疗患者.
- 分析的重点在于2017-2020年间发生的首次跌倒,不包括以前有跌倒病史的患者.
- 使用后勤回归来评估同时使用药物和跌倒事件之间的关联.
主要成果:
- 同时使用 gabapentin 和阿片类药物与明显增加的跌倒风险有关 (调整后几率比率 = 1.73).
- 女性,81岁或以上,以及多种慢性疾病等因素也与较高的跌倒风险相关.
- 122名患者 (6.73%) 患有跌倒,其中232名 (12.80%) 患者同时使用 gabapentin 和阿片类药物.
结论:
- 与阿片类药物单独治疗相比,加巴丁和阿片类药物的联合治疗在老年人中增加了跌倒的风险.
- 临床实践应仔细考虑这种药物组合,并探索替代疼痛管理策略.
- 为了充分了解老年人群中加巴丁和阿片类药物联合使用的不良事件概况,需要进行进一步的研究.
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