住院阿片类药物处方模式及其对再住院的影响:一个嵌套的病例控制研究,使用来自瑞士公立急性医院的数据
Aleksandra Stanisic1, Dominik Stämpfli1,2, Angela E Schulthess Lisibach3
1Institute of Pharmaceutical Sciences, ETH Zurich, Zurich, Switzerland.
Swiss medical weekly
|August 18, 2024
概括
使用阿片类药物出院的患者增加了他们在30天内重新入院的风险. 这项研究强调了阿片类药物管理和医院出院前逐渐减少处方的重要性,以改善患者的治疗结果.
科学领域:
- 临床医学 临床医学
- 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:
- 尽管已知的风险,但瑞士的阿片类药物处方正在增加.
- 如果未能在出院前逐渐减少术后阿片类药物,可能会导致不良事件.
- 出院后使用阿片类药物是重新入院的潜在风险因素.
研究的目的:
- 调查医院出院阿片类药物处方和随后的再住院之间的关联.
- 量化与出院时处方的阿片类药物相关的再住院风险.
主要方法:
- 用瑞士医院的电子健康记录进行了嵌套病例控制研究.
- 包括65岁或以上的患者,他们接受了阿片类药物并在18或30天内重新入院.
- 将病例与对照进行匹配,并使用条件逻辑回归来计算调整的赔率比率.
主要成果:
- 出院时服用阿片类药物与30天再入院的几率增加了48% (aOR 1.48;95% CI 1.25-1.75).
- 对于18天的再住院治疗,没有发现有意义的关联.
- 同时处方与二类药物/加巴类药物和较高的阿片类药物剂量是罕见的.
结论:
- 使用阿片类药物的患者的出院显著增加了30天再入院的可能性.
- 临床医生应优先考虑在患者出院前停止住院阿片类药物治疗.
- 实施阿片类药物管理计划,包括患者教育和监测至关重要.
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