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在MS中慢性处方阿片类药物的使用:与不良结果和急性医疗服务利用的关联
Aaron P Turner1,2,3,4, Carol Malte1, Anne Arewasikporn5
1VA Puget Sound Health Care System, Seattle, Washington, USA.
medRxiv : the preprint server for health sciences
|November 24, 2025
概括
多发性硬化症 (MS) 患者的慢性阿片类药物使用与跌倒增加和更高的医疗保健使用有关,包括住院和急诊. 定期进行风险评估对于管理这些不良结果至关重要.
科学领域:
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 多发性硬化症 (MS) 是一种慢性神经系统疾病.
- 慢性阿片类药物治疗有时用于MS患者的疼痛管理.
- 慢性阿片类药物使用与MS的不良结果之间的关联尚未完全理解.
研究的目的:
- 调查慢性处方阿片类药物使用与不良医疗结果之间的联系.
- 检查与MS患者急性医疗服务利用的关联.
主要方法:
- 使用国家VA行政数据进行回顾性队列研究.
- 倾向性得分匹配分析比较了1908名MS老兵在慢性阿片类药物治疗中与未接受治疗的人.
- 评估的结果包括跌倒,骨折,伤口,死亡率和阿片类药物处方后一年的医疗保健利用率.
主要成果:
- 慢性阿片类药物使用与更高的跌倒可能性相关 (ORadj=1.77,p=0.038).
- 在阿片类药物组中观察到住院病人的增加 (ORadj=1.21,p=0.028) 和急诊室的访问 (ORadj=1.25,p=0.001).
- 在骨折,伤口或全因死亡率方面没有发现显著差异,尽管在阿片类药物组中这些差异更高.
结论:
- 患有多发性硬化症的退伍军人慢性阿片类药物使用与跌倒的增加和医疗保健利用率的增加有关.
- 建议定期重新评估风险与益处,并向患者提供MS特定的阿片类药物风险的教育.
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