AIM:长期服用阿片类药物的患者可同时接受纳洛酮处方

2016-06-28 fsy 译 MedSci原创

非故意过量涉及阿片类镇痛药是美国相关死亡的主要原因。该研究的目的是评估实施纳洛酮处方对于阿片类药物治疗慢性疼痛患者的可行性和效果。来自美国的研究人员进行了一项两年的非随机干预研究,该研究在美国加州旧金山的6个安全初级保健门诊进行。研究纳入了1985名接受长期阿片类药物治疗疼痛的成人。研究人员对提供者和诊所的工作人员进行了纳洛酮处方的培训和支持。研究结果是接受纳洛酮处方的患者比例,阿片类药物相关的急

非故意过量涉及阿片类镇痛药是美国相关死亡的主要原因。

该研究的目的是评估实施纳洛酮处方对于阿片类药物治疗慢性疼痛患者的可行性和效果。

来自美国的研究人员进行了一项两年的非随机干预研究,该研究在美国加州旧金山的6个安全初级保健门诊进行。研究纳入了1985名接受长期阿片类药物治疗疼痛的成人。研究人员对提供者和诊所的工作人员进行了纳洛酮处方的培训和支持。

研究结果是接受纳洛酮处方的患者比例,阿片类药物相关的急诊科(ED)访问情况,以及根据图表审查的阿片类药物剂量。

在1985例接受长期阿片类药物的患者中,38.2%的患者接受纳洛酮处方。在过去12个月中,接受更高剂量处方阿片类药物和阿片类药物相关ED就诊的患者更容易接受纳洛酮处方。与没有接受纳洛酮的患者相比,在接受处方的前6个月中,每个月会减少47%阿片类药物相关ED就诊(发生率比[IRR],0.53[95%CI,0.34〜0.83]; P=0.005),1年后减少63%(IRR,0.37[CI,0.22〜0.64];P<0.001)。在那些接受纳洛酮和没有接受纳洛酮的患者中,在一段时间内阿片类药物剂量并没有变化(IRR,1.03[CI,0.91〜1.27; P=0.61)。

接受阿片类止痛药处方的初级保健患者可以同时接受纳洛酮处方。当建议所有接受阿片类药物的患者接受纳洛酮时,提供者可能会优先考虑那些既定的危险因素。在初级保健的设置中提供纳洛酮可能有辅助的好处,如减少阿片类药物相关的不良事件。

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    2016-09-15 1e10c84am36(暂无匿称)

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    2016-09-14 1e10c84am36(暂无匿称)

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    2016-06-30 lhlxtx

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针对阿片类药物滥用率和过量服用率的上升,美国各州制定了法律以限制管制药品的处方及配药。但是目前这些法律对阿片类药物使用的影响尚未清楚。研究人员测试了处方阿片类药物收据和州制定的管制药品法律之间的关联。使用服务残疾受益人的医疗保险管理数据(这些参与者的年龄位于21-64岁,从2006到2012年,870万人年)和法律的原始数据集(如,处方药监控程序),研究人员研究了四个及以上阿片类药物处方受益者的年

JAMA Inter Med:阿片类药物对腰痛的影响研究

近期有研究表明,阿片类镇痛药为慢性腰痛患者提供了短期缓解,但是,指南建议的治疗剂量并没有给患者带来显著的临床受益。独立研究人员收集了20项安慰剂对照的随机临床试验数据,以评估阿片类镇痛药对腰背痛的疗效。使用VAS和数值评定量表测量研究的主要结局——疼痛。研究人员还用Oswestry功能障碍指数和罗兰莫里斯残疾问卷得分评估参与者残疾情况。并将疼痛和残疾转换为百分制量表,改善超过20分则视为临床显著有