在俄勒冈州实施医疗补助背痛政策后,慢性阿片类药物使用
Daniel M Hartung1, Sanae El Ibrahimi2, Catherine J Livingston3
1College of Pharmacy, Oregon State University, Portland, Oregon.
American journal of preventive medicine
|October 18, 2024
概括
俄勒冈州2016年背痛政策导致大多数医疗补助患者的阿片类药物剂量减少. 那些患有精神健康或物质使用障碍的人更有可能停止服用,这表明过量风险较高的患者的策略.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
- 疼痛管理 疼痛管理
背景情况:
- 俄勒冈州在2016年实施了一项政策,以加强对背部疼痛的医疗补助患者的护理.
- 该政策旨在解决在该人口中管理慢性阿片类药物治疗的挑战.
研究的目的:
- 确定与慢性阿片类药物治疗的医疗补助患者中阿片类药物剂量减少和停药相关的因素.
- 评估俄勒冈州2016年背痛政策对阿片类药物治疗管理的影响.
主要方法:
- 使用医疗补助行政索赔数据进行回顾性队列研究.
- 从2016年7月至12月期间,对长期稳定阿片类药物治疗的患者进行分析.
- 后勤回归模型评估了临床/人口因素与阿片类药物剂量减少或停药之间的关联 (2017年1月至12月).
主要成果:
- 83%的患者经历了阿片类药物剂量减少;14%停止治疗.
- 背部疼痛患者更有可能减少剂量 (AOR=1.19).
- 与心理健康诊断,物质使用障碍,阿片类药物使用障碍和布普伦诺芬接收相关的停药. 在黑人患者,老年人以及基线阿片类药物剂量较高的人群中不太可能发生.
结论:
- 大多数医疗补助受益者在俄勒冈州的背痛政策下经历了阿片类药物剂量减少.
- 停用阿片类药物似乎是针对有较高过量风险概况的患者.
- 研究结果表明,修改慢性疼痛阿片类药物处方实践的政策有效性.
更多相关视频
12:20Use of the Operant Orofacial Pain Assessment Device OPAD to Measure Changes in Nociceptive Behavior
Published on: June 10, 2013
21.1K
06:28Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
Published on: December 13, 2024
434
相关概念视频
01:25Analgesia and Pain Management
534
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...
534
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
234
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...
234
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
187
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...
187