退院后持续使用阿片类药物和阿片类药物管理:单一中心的回顾性队列研究
Sandra Hapca1, Louise Peet1, Christine Gibson1
1Department of Anaesthesia, NHS Grampian, Aberdeen, UK.
British journal of pain
|November 18, 2024
概括
退院后持续使用阿片类药物影响了近四分之一的患者,这些患者被处方为新的强阿片类药物. 女性性别,入院前的心理健康问题和先前的阿片类药物使用是关键的风险因素. 一个急性疼痛服务 (APS) 显示在减少这种持续的阿片类药物使用中起着保护作用.
科学领域:
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
- 药理学 药理学是指药理学的学科.
背景情况:
- 术后持续使用阿片类药物是一个重要的公共卫生问题,有助于发病率和死亡率.
- 阿片类药物管理旨在合理化处方和减轻有害的阿片类药物使用.
- 急性疼痛服务 (APS) 在管理阿片类药物处方和使用方面发挥着作用.
研究的目的:
- 确定新强阿片类药物释放的队列中的持续性阿片类药物使用率.
- 为了确定与持续的阿片类药物使用相关的风险因素.
- 评估APS随访对持续阿片类药物使用的影响.
主要方法:
- 对住院患者的回顾性四年队列研究,这些患者被转介到APS,并因使用新型强阿片类药物而出院.
- 调查出院后持续的阿片类药物使用率,风险因素和使用模式.
- 对APS社区后续行动的分析.
主要成果:
- 在接受新型强阿片类药物治疗后出院的患者中,有24%的患者持续使用阿片类药物.
- 风险因素包括女性性别 (OR: 1.89),入院前的精神健康史 (OR: 2.85),以及入院前的阿片类药物使用 (OR: 1.79).
- 与没有APS社区随访的患者相比,持久性阿片类药物使用率 (22%) 较低 (32%).
结论:
- 出院时的阿片类药物处方可以导致高达25%的患者持续使用阿片类药物.
- 在医院和出院后,APS在合理化阿片类药物使用方面表现出保护作用.
- 需要进一步制定阿片类药物管理政策,包括提高意识和术前风险评估.
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