脊柱相关诊断的患者的疼痛严重程度和阿片类药物使用
Chijioke M Okeke1,2, Javeria Khalid2, J Douglas Thornton1,2
1The Prescription Drug Misuse Education and Research (PREMIER) Center, College of Pharmacy, University of Houston, Houston, TX, United States.
Frontiers in pain research (Lausanne, Switzerland)
|January 28, 2026
概括
在脊柱相关诊断 (SRD) 中,高疼痛严重程度与阿片类药物使用增加有关. 这项研究强调了美国成年SRD患者的疼痛干扰和阿片类药物处方之间的关联.
科学领域:
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 临床指南主张在腰部疼痛中谨慎使用阿片类药物,并将其保留给严重的耐药病例.
- 在脊柱相关诊断 (SRD) 中,关于疼痛水平和阿片类药物利用的证据仍然有限.
- 了解疼痛严重程度与SRD中阿片类药物处方模式之间的关系对于基于证据的实践至关重要.
研究的目的:
- 研究自我报告的疼痛严重程度与美国成年人中被诊断患有SRD的阿片类药物使用之间的关联.
- 量化SRD患者全国样本中阿片类药物处方的流行率.
- 在SRD的背景下确定与阿片类药物使用相关的因素.
主要方法:
- 对2018-2021年医疗支出小组调查 (MEPS) 数据的回顾性横截面分析.
- 纳入标准:美国成年人 (≥18岁) 患有SRD诊断和疼痛处方.
- 通过退伍军人Rand-12项目 (疼痛干扰工作) 评估疼痛严重程度;从处方记录中确定阿片类药物的使用;用于分析的多变量逻辑回归.
主要成果:
- 美国大约有191万名SRD成年人每年接受止痛药,其中63.92%获得阿片类药物处方.
- 超过一半 (52.06%) 的SRD患者报告高疼痛干扰日常活动.
- 与低疼痛干扰相比,高疼痛干扰显著增加了阿片类药物使用的几率 (OR=2.92,95% CI:1.49-5.70).
结论:
- 在接受止痛药的SRD患者中,很大一部分人被处方阿片类药物,特别是那些经历了高水平疼痛干扰的人.
- 这些发现支持了临床建议,因为它们证明了在SRD中疼痛严重程度较高和阿片类药物使用增加之间存在联系.
- 需要进一步的研究,以全面了解阿片类药物使用模式,并优化脊柱相关诊断患者的疼痛管理策略.
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