癌症诊断前后阿片类药物使用轨迹:基于人口的队列研究
Benjamin Daniels1, Tim Luckett2, Winston Liauw3
1Medicines Intelligence Research Program, School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.
Journal of pain and symptom management
|June 15, 2024
概括
在癌症诊断之前和之后的阿片类药物使用模式有显著差异. 诊断后的阿片类药物使用从诊断月份大幅增加,很少回到诊断前的水平,这表明非癌症因素会影响持续使用.
科学领域:
- 在瘤学瘤学.
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 在癌症前诊断时使用阿片类药物与癌症幸存者长期使用有关.
- 了解癌症诊断前后的阿片类药物使用模式至关重要,但尚未确立.
研究的目的:
- 研究癌症诊断前后阿片类药物开放轨迹的异质性.
- 在癌症幸存者和死者中识别阿片类药物使用的不同模式.
主要方法:
- 利用基于人口的分发数据与新南威尔士州的癌症和死亡通知相关.
- 在第一次癌症诊断之前的24个月内分析了阿片类药物启动 (2014-2016).
- 采用基于群体的轨迹建模来定义每月阿片类药物开放模式 (OMEmg) 诊断前后.
主要成果:
- 在21843名幸存者中确定了四种先诊断的阿片类药物开放轨迹:不经常,晚期增加,中度和持续.
- 观察到诊断月份左右的处方阿片类药物增加了83OMEmg,诊断后占主导地位的强度配方.
- 发现中度和持续的先诊断阿片类药物使用者在诊断后继续或增加使用率更高,很少有人停止治疗.
结论:
- 在癌症诊断之前和之后的阿片类药物使用模式中存在显著的异质性.
- 非癌症因素似乎推动了诊断后阿片类药物使用的很大一部分.
- 在癌症诊断时,阿片类药物的使用显著增加,并且没有恢复到诊断前的水平.
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