在医疗保险受益者下肢截肢后的阿片类药物消费
Alexander N Khouri1, Nishant Ganesh Kumar1, Hsou-Mei Hu2
1Department of Surgery, Section of Plastic Surgery, University of Michigan, Ann Arbor, Michigan, USA.
概括
在下肢截肢后,长期使用阿片类药物很常见,风险因素包括年龄较小和同时服用 gabapentinoids 或镇静剂的处方. 高风险的处方做法在没有重大变化的情况下继续存在.
科学领域:
- 疼痛管理 疼痛管理
- 整形外科手术 整形外科手术
- 药理学 药理学是指药理学的学科.
背景情况:
- 下肢截肢后的阿片类药物处方和使用模式,尽管有国家质量改善倡议,但仍未得到充分研究.
- 了解这些模式对于优化患者护理和减轻长期阿片类药物使用相关风险至关重要.
研究的目的:
- 为了确定下肢截肢后扩大阿片类药物使用的风险因素.
- 评估这一患者群体中高风险阿片类药物处方的比例.
主要方法:
- 对2009-2018年医疗保险索赔数据进行了回顾性分析.
- 该研究包括5191名接受下肢截肢的患者,不包括那些在180天内出院或随后接受手术的患者.
- 长期使用阿片类药物,慢性使用阿片类药物和高风险处方被定义并使用多层混合效应逻辑回归来分析.
主要成果:
- 在非慢性阿片类药物使用者中,23.2%的人发展出新的持续性阿片类药物使用,与年龄<55岁相关, gabapentinoid填充和镇静剂/焦虑缓解剂填充.
- 91.2%的慢性阿片类药物使用者经历了手术后长期使用阿片类药物.
- 高风险处方率保持不变,82.3%的慢性阿片类药物使用者接触过这种做法.
结论:
- 长期使用阿片类药物是下肢截肢后经常出现的结果.
- 高风险的阿片类药物处方做法普遍存在,并且在研究期间没有得到改善,突出显示需要进行干预.
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