Pain Medication Use & Risk Factors for Opioid Dependence

止痛药的使用

• 批准号: 6763992
• 负责人: Daniel Hal Solomon
• 金额: $ 21.63万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-01 至 2005-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6763992
• 关键词: analgesics; antiarthritic agent; arthritis therapy; chemical information system; chronic pain; clinical research; data collection methodology /evaluation; disease /disorder proneness /risk; drug addiction; drug administration rate /duration; endogenous opioid; human data; human old age (65+); iatrogenic disease; medical complication; osteoarthritis; rheumatoid arthritis; sensory depression; statistics /biometry; therapy adverse effect

DESCRIPTION (provided by applicant): Prescription opioid use is reported by approximately 5% of adults over 65. While much of this use follows standard prescribing guidelines, an unknown proportion leads to addiction and opioid abuse. The concerns recently raised in the media regarding Oxycontin and its frequent prescription for painful syndromes highlights the need for a careful evaluation of the rates and patterns of chronic opioid use and what proportion of that use is possibly problematic. Currently, little is known about the frequency of acute chronic opioid use in patients with chronic pain, and virtually nothing is known about or the patient and/or physician characteristics associated with chronic, potentially problematic, prescription opioid use. We propose to examine these issues in patients with arthritis. We will first determine the nature and frequency of chronic opioid use in two selected groups of patients with arthritis -- osteoarthritis and rheumatoid arthritis. Prescription opioid use will be examined in a community-based cohort of over 250,000 Medicare patients who receive prescription drug benefits through the State of Pennsylvania's Pharmaceutical Assistance Contract for the Elderly program. This cohort is typical in their demography and health care utilization, and represents an ideal group to study the patterns of chronic oploid use. Second, we will examine the rates and factors associated with potentially problematic chronic opioid use. Finally, we will determine the rates of opioid associated complications in this population. This research will be conducted in conjunction with the program Director of PACE, Thomas Snedden. He will actively participate in the research and will assure that our findings are integrated into opioid prescribing policy. Our goal is to use the results of the proposed research to inform a future intervention to improve opioid prescribing within this large pharmacy benefits program.

描述（申请人提供）：大约65岁以上的成年人报告了处方阿片类药物的使用。尽管大部分使用遵循标准处方指南，但不明的比例导致成瘾和阿片类药物滥用。最近在媒体上引起了人们对奥昔康及其频繁的疼痛综合症处方的关注，这突显了需要仔细评估慢性阿片类药物使用率和模式的需求，以及这种使用的比例可能是有问题的。当前，对于慢性疼痛患者中急性慢性阿片类药物使用的频率知之甚少，几乎对患者和/或医师的特征几乎不知情，与慢性，可能有问题的处方阿片类药物使用相关。我们建议在关节炎患者中检查这些问题。 我们将首先确定两组选定的关节炎患者 - 骨关节炎和类风湿关节炎的慢性阿片类药物使用的性质和频率。处方阿片类药物的使用将在一个社区的队列中进行检查，由25万名Medicare患者组成，他们通过宾夕法尼亚州的老年人计划获得处方药福利。该队列在他们的人口统计学和医疗保健利用中是典型的，并且代表了研究慢性类植物使用模式的理想群体。其次，我们将研究与潜在有问题的慢性阿片类药物使用相关的速率和因素。最后，我们将确定该人群中阿片类药物相关并发症的速率。 这项研究将与PACE计划主管Thomas Snedden一起进行。他将积极参与研究，并确保我们的发现纳入阿片类药物处方政策。我们的目标是利用拟议研究的结果来告知将来的干预措施，以改善该大型药房福利计划中的阿片类药物处方。

项目成果

Selective cyclooxygenase 2 inhibitors and cardiovascular events.

• DOI: 10.1002/art.21132
• 发表时间: 2005-07
• 期刊: Arthritis and rheumatism
• 作者: D. Solomon

Prescription opioid use among older adults with arthritis or low back pain.

患有关节炎或腰痛的老年人使用处方阿片类药物。

• DOI: 10.1002/art.21697
• 发表时间: 2006
• 期刊: Arthritis and rheumatism.
• 作者: Solomon,DanielH;Avorn,Jerry;Wang,PhilipS;Vaillant,George;Cabral,Danielle;Mogun,Helen;Sturmer,Til
• 通讯作者: Sturmer,Til