阿片类药物治疗与反复的医疗保健访问,增加副作用和疼痛有关
Caroline E Freiermuth1,2, Jenny A Foster3, Pratik Manandhar4
1University of Cincinnati, Department of Emergency Medicine, Cincinnati, Ohio.
The western journal of emergency medicine
|December 3, 2024
概括
在急诊室 (ED) 中的阿片类药物疼痛治疗导致更多的非计划医疗保健访问,而不是鼻内NSAID. 这是由于疼痛增加和药物的副作用.
科学领域:
- 紧急医疗 紧急医疗
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
背景情况:
- 急性疼痛是急诊室 (ED) 访问的常见原因.
- 治疗决策涉及到平衡疗效,医疗利用和以患者为中心的结果,如副作用.
- 了解出院后的医疗保健利用对于有效的疼痛管理策略至关重要.
研究的目的:
- 调查急性疼痛治疗方案 (阿片类药物,鼻腔内无抗炎药物或两者) 与ED出院后非预定的医疗保健访问之间的关联.
- 为了确定疼痛严重程度和药物副作用是否调解了治疗和后续访问之间的关系.
主要方法:
- 对前性观察性AMPED队列研究的二次分析.
- 考克斯 (Cox) 对时间到第一次非预定的访问进行比例危险分析.
- 对于任何非计划的访问,重复测量后勤回归,包括对疼痛和副作用的调解分析.
主要成果:
- 在831名参与者中,有16.9%的参与者在ED释放后五天内进行了非预定的访问,大多数发生在访问后一天.
- 与阿片类药物单疗法相比,鼻内NSAID单疗法与较少的非预定访问有关 (AOR 0.63).
- 吸食阿片类药物与非计划性访问的更高概率有关,其介导因素是副作用 (AOR 2.24) 和更高的疼痛水平 (AOR 1.33).
结论:
- 与鼻内治疗相比,治疗急性疼痛的阿片类药物与非预定的医疗保健访问增加有关.
- 较高的持续疼痛水平和药物副作用的增加解释了医疗保健利用率的差异.
- 这些发现强调了在ED疼痛管理中考虑治疗相关因素的重要性,而不仅仅是立即缓解疼痛.
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