在美国 (2017-2022) 手术后长期使用处方阿片类药物:基于人口的研究研究
Andrew J Schoenfeld1, Zara Cooper2, Amanda Banaag3
1Center for Surgery and Public Health, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Lancet regional health. Americas
|January 7, 2025
概括
打击阿片类药物危机的努力导致了手术后长期处方阿片类药物使用的显著减少. 这些发现表明,成功的干预措施可以减少手术后的阿片类药物依赖.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 疼痛管理 疼痛管理
背景情况:
- 全球努力打击阿片类药物危机已经持续了十年.
- 这些策略的有效性需要适当的测量,并且在不同的人群中可能有所不同.
- 基线风险因素可以影响干预措施对阿片类药物使用的影响.
研究的目的:
- 为了比较手术后长期处方阿片类药物使用的变化.
- 在美国国家队列中分析2017年至2022年的趋势.
- 评估干预措施对手术后阿片类药物使用的影响.
主要方法:
- 利用了TRICARE对接受14项代表性外科手术的个人索赔数据.
- 对比了2017-19年和2020-22年间手术后长期处方阿片类药物使用率.
- 使用修改后的Poisson回归分析,调整以考虑混因素和相互作用效应.
主要成果:
- 总共有410,326次手术事件被分析.
- 长期的手术后阿片类药物使用量从11% (2017 - 2019) 降至6% (2020 - 2022),风险比为0.51.
- 在所有美国人口普查部门,种族少数群体,较低社会经济群体和手术前阿片类药物使用者中观察到减少.
结论:
- 这项研究代表了手术后阿片类药物使用的大规模纵向评估.
- 与2017-19年相比,在2020-22年手术后观察到处方阿片类药物使用的临床相关减少.
- 这些发现可能反映了国家趋势,因为研究队列的代表性.
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