Analgesic methadone prescribing in community health centers among patients with chronic pain.

Q3 Medicine Journal of opioid management Pub Date : 2023-09-01 DOI:10.5055/jom.0811

Steffani R Bailey, Jean P O'Malley, Daniel M Hartung, Nathalie Huguet, Miguel Marino, John Muench

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Abstract

Objective: To examine analgesic methadone prescriptions among community health center (CHC) patients with chronic pain.

Design: Observational; two cross-sectional periods.

Setting: Oregon and California CHCs.

Patients: Chronic pain patients with ≥1 visit in 2012-2013 or 2017-2018 (N = 158,239).

Outcomes: Changes in adjusted relative rates (aRRs) of receiving no opioids, short-acting only, long-acting only other than methadone, and methadone; characteristics associated with ≥1 methadone prescription.

Results: Opioid prescribing declined over time, with the largest decrease in methadone (aRR = 0.19, 95 percent confidence interval: 0.14-0.27). Among patients receiving ≥1 long-acting opioid, variables associated with methadone prescribing included being aged <65 years, having nonprivate insurance, and an opioid use disorder (OUD) diagnosis. From 2012-2013 to 2017-2018, aRR increased among patients with OUD and decreased for those aged 18-30 (vs ≥65), uninsured and Medicaid-insured (vs private), and race/ethnicity other than non-Hispanic Black (vs non-Hispanic White).

Conclusions: Methadone prescribing decreased in CHCs but remained elevated for several high-risk demographic groups.

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社区卫生中心慢性疼痛患者镇痛药美沙酮处方。

目的:了解社区卫生中心(CHC)慢性疼痛患者镇痛药物美沙酮的使用情况。设计:观察;两个横截面时期。环境:俄勒冈州和加利福尼亚州的CHCs。患者:2012-2013年或2017-2018年就诊≥1次的慢性疼痛患者(N = 158,239)。结果:不接受阿片类药物、仅短效、仅美沙酮以外的长效和美沙酮的调整相对率(aRRs)的变化;与≥1次美沙酮处方相关的特征。结果:阿片类药物处方随着时间的推移而减少，其中美沙酮的减少幅度最大(aRR = 0.19, 95%可信区间:0.14-0.27)。在接受≥1种长效阿片类药物治疗的患者中，与美沙酮处方相关的变量包括年龄。结论:CHCs的美沙酮处方减少，但在一些高危人群中仍增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of opioid management Medicine-Anesthesiology and Pain Medicine

CiteScore

1.00

自引率

0.00%

发文量

期刊介绍： The Journal of Opioid Management deals with all aspects of opioids. From basic science, pre-clinical, clinical, abuse, compliance and addiction medicine, the journal provides and unbiased forum for researchers and clinicians to explore and manage the complexities of opioid prescription.