住院护理后的阿片类药物供应与炎症性肠病的不良结果有关
J Westley Heinle1, Sarah Kazzaz2, Eric W Schaefer3
1Division of Gastroenterology and Hepatology.
Journal of clinical gastroenterology
|November 4, 2025
概括
在医院出院后给炎症性肠病 (IBD) 患者开处方阿片类药物与更糟糕的临床结果有关,包括更多的急诊室访问和住院. 避免对IBD患者在出院后处方阿片类药物,以改善患者的护理.
科学领域:
- 胃肠病学 胃肠病学
- 临床药理学 临床药理学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 炎症性肠病 (IBD) 经常导致腹痛,往往导致阿片类药物处方.
- 有限的证据支持阿片类止痛药在IBD中的益处,同时存在严重的安全问题.
研究的目的:
- 为了研究炎症性肠病 (IBD) 的临床结果,患者在医院或急诊室 (ED) 退院后处方阿片类药物.
- 评估退院后阿片类药物使用与随后的医疗保健利用以及IBD患者的治疗升级之间的关联.
主要方法:
- 对于医院/ED访问的IBD患者的Merative MarketScan索赔数据库 (2017-2021) 的回顾性分析.
- 在出院后7天内接受阿片类药物治疗的IBD患者和没有接受阿片类药物治疗的IBD患者之间的临床结果的比较.
- 后勤回归分析,以评估释放后1,3,6个月的结果.
主要成果:
- 在35,890名IBD患者中,22.0%接受了出院后的阿片类药物处方.
- 阿片类药物使用者经历了明显更高的重复ED访问,住院和进一步的阿片类药物处方率.
- 服用阿片类药物的IBD患者更有可能接受皮质类固醇并需要药物升级;性结肠炎患者倾向于更多与IBD相关的手术.
结论:
- 处方阿片类药物的急性后护理与IBD患者的临床结果较差有关.
- 医生应谨慎行事,并在从ED或医院出院后,为IBD患者考虑替代阿片类药物.
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