在VA的长期阿片类药物治疗趋势:比慢性更间歇
Cynthia Kay1, Katherine Sherman2, Rodney Sparapani3
1Department of Medicine, Clement J. Zablocki VA Medical Center; Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin. ORCID: https://orcid.org/0000-0003-2649-6078.
Journal of opioid management
|May 6, 2025
概括
长期的阿片类药物治疗在退伍军人中很常见,但往往是间歇性的,而不是连续的. 这表明过去的研究可能高估了持续的长期阿片类药物使用.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 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:
- 阿片类药物治疗是慢性疼痛的常见治疗方法.
- 了解长期阿片类药物治疗 (LTOT) 模式对于患者护理和研究至关重要.
- 退伍军人代表了具有高慢性疼痛和阿片类药物使用率的重要人口.
研究的目的:
- 分析退伍军人中阿片类药物处方填充的模式.
- 专门研究长期阿片类药物治疗 (LTOT) 在这个人群中的特征.
- 要区分连续和间歇的LTOT.
主要方法:
- 使用退伍军人事务公司数据仓库数据 (2008-2018) 进行回顾性研究.
- 包括18岁以上的退伍军人,有门诊阿片类药物处方,但不包括癌症,息治疗或临终关怀.
- 根据补充间隔 (<7, <30, <90天) 定义的连续阿片类药物处方.
主要成果:
- 分析了746,658名患者和超过500万个连续阿片类药物处方.
- 16-35%的连续脚本持续至少90天; 1-8%持续2年.
- 很大一部分患者接受了长期的阿片类药物治疗,尽管经常间歇.
结论:
- 长期的间歇性阿片类药物治疗在退伍军人中很普遍.
- 连续,不间断的每月阿片类药物处方,典型的假定LTOT,是不常见的.
- 过去对LTOT的研究可能过于简化了模式,可能反映了周期性使用而不是连续使用.
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