在患有炎症性肠病的人群中使用疼痛和镇静药物:全国性基于人口的队列研究
Samantha Baillie1,2, Sonia Saxena2, Nishani Jayasooriya1,2
1Institute for Infection and Immunity, City St George's University of London, London, UK.
相当数量的炎症性肠病 (IBD) 患者接受疼痛和镇静剂处方,包括长期和联合使用. 识别有风险的个体对于替代治疗至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 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:
- 患有炎症性肠病 (IBD) 的人经常经历疼痛,情绪问题和睡眠障碍.
- 这可能导致疼痛缓解剂和镇静剂的使用增加,与死亡率和治疗不坚持等不良结果相关.
- 这些药物的慢性和联合处方增加了呼吸系统抑郁,依赖和过量服用的风险.
研究的目的:
- 调查成年人发生炎症性肠病 (IBD) 的阿片类药物, gabapentinoid 和镇静剂处方的流行情况.
- 从2010年到2019年分析这些药物的总,慢性和联合处方趋势.
- 确定与IBD患者慢性或联合处方这些药物的预测因子.
主要方法:
- 利用临床实践研究数据链接,这是一个大型,全国代表性的数据集.
- 检查了总的,慢性 (阿片类药物>90天;镇静剂>28天) 和同时处方的阿片类药物, gabapentinoids 和镇静剂在发生IBD的成年人中的年度患病率.
- 采用多变量回归来确定慢性或共同处方的预测因素.
主要成果:
- 在17388名IBD患者中,超过20%的人每年接受疼痛或镇静药物治疗.
- 阿片类药物和 gabapentinoid 的患病率增加,而镇静剂的患病率保持稳定.
- 长期处方的强阿片类药物和镇静剂增加了;每年4.2%-6.9%的人共同处方这些药物.
- 慢性/联合处方的预测因素包括女性性别,吸烟,老年,克罗恩氏病和焦虑/抑郁等并发症.
结论:
- 很大一部分IBD患者接受疼痛和镇静药物,包括长期和联合处方.
- 识别高风险患者对于优先考虑心理治疗等替代治疗方法至关重要.
- 这种方法旨在减轻与IBD管理中有害处方相关的风险.
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