患有和未患有系统性自身免疫/炎症性风湿病的成年人使用阿片类药物的情况:2006-2019年美国全国数据分析》。

IF 3.7 2区 医学 Q1 RHEUMATOLOGY Arthritis Care & Research Pub Date : 2024-05-20 DOI:10.1002/acr.25378
Yinan Huang, Sebastian Bruera, Sandeep Krishna Agarwal, Maria E. Suarez-Almazor, Shadi Bazzazzadehgan, Sujith Ramachandran, Kaustuv Bhattacharya, John P. Bentley, Yi Yang
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引用次数: 0

摘要

研究目的本研究比较了患有或不患有系统性自身免疫/炎症性风湿病(SARDs)的门诊患者的阿片类药物处方情况,并评估了与SARDs阿片类药物处方相关的因素:这项横断面研究使用了 2006 年至 2019 年间的全国流动医疗护理调查。研究纳入了主要诊断为 SARDs(包括类风湿性关节炎、强直性脊柱炎、银屑病关节炎或系统性红斑狼疮)的成人(≥18 岁)就诊者。使用多变量逻辑回归(MLR)对患有与未患有 SARD 的阿片类药物处方情况进行了比较,其中考虑到了复杂的调查设计,并根据 Andersen 的医疗服务使用行为模型对诱发因素、促成因素和需求因素进行了调整。另一项多重回归研究了与 SARDs 中阿片类药物处方相关的预测因素:每年,SARDs 患者平均就诊 520 万人次(95% CI 358-682 万人次),而非 SARDs 患者平均就诊 7.8014 亿人次(95% CI 7.4756-8.1272 亿人次)。与非 SARDs 组(9.83%)相比,SARDs 组更有可能获得阿片类药物处方(22.53%)(aOR 2.65 [95% CI 1.68-4.18])。在 SARDs 就诊者中,50-64 岁的成年人(相对于 18-49 岁,aOR 为 1.95 [95% CI 为 1.05-3.65])和使用糖皮质激素(aOR 为 1.75 [95% CI 为 1.20-2.54])与阿片类药物处方几率增加有关,而相对于医疗保险(aOR 为 0.50 [95% CI 为 0.31-0.82])的私人保险与阿片类药物处方几率降低有关:结论:与非 SARDs 相比,SARDs 的阿片类药物处方量更高。结论:与非 SARDs 相比,SARDs 中阿片类药物的处方量较高,需要共同努力确定 SARDs 中阿片类药物处方的适当性。
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Opioid Treatment for Adults With and Without Systemic Autoimmune/Inflammatory Rheumatic Diseases: Analysis of 2006–2019 United States National Data

Objectives

This study compared opioid prescribing among ambulatory visits with systemic autoimmune/inflammatory rheumatic diseases (SARDs) or without and assessed factors associated with opioid prescribing in SARDs.

Methods

This cross-sectional study used the National Ambulatory Medical Care Survey between 2006 and 2019. Adult (≥18 years) visits with a primary diagnosis of SARDs, including rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, or systemic lupus erythematosus were included in the study. Opioid prescribing was compared between those with vs without SARDs using multivariable logistic regression accounting for the complex survey design and adjusting for predisposing, enabling, and need factors within Andersen's Behavioral Model of Health Services Use. Another multivariable logistic regression examined the predictors associated with opioid prescribing in SARDs.

Results

Annually, an average of 5.20 million (95% confidence interval [CI] 3.58–6.82) visits were made for SARDs, whereas 780.14 million (95% CI 747.56–812.72) visits were made for non-SARDs. The SARDs group was more likely to be prescribed opioids (22.53%) than the non-SARDs group (9.83%) (adjusted odds ratio [aOR] 2.65; 95% CI 1.68–4.18). Among the SARDs visits, patient age from 50 to 64 (aOR 1.95; 95% CI 1.05–3.65 relative to ages 18–49) and prescribing of glucocorticoids (aOR 1.75; 95% CI 1.20–2.54) were associated with an increased odd of opioid prescribing, whereas private insurance relative to Medicare (aOR 0.50; 95% CI 0.31–0.82) was associated with a decreased odds of opioid prescribing.

Conclusion

Opioid prescribing in SARDs was higher compared to non-SARDs. Concerted efforts are needed to determine the appropriateness of opioid prescribing in SARDs.

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来源期刊
CiteScore
9.40
自引率
6.40%
发文量
368
审稿时长
3-6 weeks
期刊介绍: Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.
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