PREVALENCE AND PATTERNS OF OPIOID USE IN CHRONIC PANCREATITIS.

IF 3 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinical and Translational Gastroenterology Pub Date : 2025-02-05 DOI:10.14309/ctg.0000000000000807

Anna Evans Phillips, Darwin L Conwell, Shuang Li, Jami L Saloman, Phil A Hart, Evan L Fogel, Santhi Swaroop Vege, Dana K Andersen, William E Fisher, Christopher E Forsmark, Stephen Pandol, Walter G Park, Mark D Topazian, Stephen K Van Den Eeden, Jose Serrano, Liang Li, Dhiraj Yadav

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引用次数: 0

Abstract

Background: Opioids are used to treat pain in chronic pancreatitis (CP), but little is known about current use patterns. The aims of this study were to characterize the utilization of opioids, and associations with clinical characteristics in adult patients with CP.

Methods: This cross-sectional analysis utilized baseline data from participants with definite CP enrolled in a cohort study in the US (PROCEED). Data on demographics, pain medication use, health care utilization, disability, and pain patterns were systematically collected in case report forms while quality of life (QOL) was assessed with patient-reported outcome instruments. Opioid use was classified according to strength (weak or strong) and frequency (scheduled or as-needed).

Results: A total of 681 participants (n=364, 53% male) were included: 299 (44%) were current opioid users (22% only weak opioids and 22% at least one strong opioid). Increasing frequency and severity of pain was associated with increase of weak, strong, as-needed, or scheduled opioids. Neuromodulators were used by ∼40% of participants; increasing use was associated with increasing frequency and severity of pain. On multivariate analysis, independent predictors associated with strength and frequency of current opioid use were pain patterns (ORs 1.84-8.32 and ORs 1.92-8.52, respectively, p<0.001) and prior celiac plexus block (OR 3.54, 95% CI 1.82-6.87) and (OR 3.42, 95% CI 1.76-6.64), respectively. Participants using opioids had higher prevalence of disability, healthcare utilization and poorer QOL.

Conclusions: Opioid use in CP is common and associated with increased pain severity and constancy. These data provide foundational estimates for future trials that can elucidate the complex interactions between patient factors, pain, and interventions.

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背景：阿片类药物可用于治疗慢性胰腺炎（CP）患者的疼痛，但人们对目前的使用模式知之甚少。本研究旨在了解阿片类药物的使用情况，以及与慢性胰腺炎成年患者临床特征的关系：这项横断面分析利用了美国一项队列研究（PROCEED）中明确患有 CP 的参与者的基线数据。通过病例报告表系统收集了有关人口统计学、止痛药物使用、医疗保健使用、残疾和疼痛模式的数据，并通过患者报告结果工具评估了生活质量（QOL）。阿片类药物的使用根据强度（弱或强）和频率（按计划或按需要）进行分类：共纳入 681 名参与者（364 人，53% 为男性）：299人（44%）目前使用阿片类药物（22%仅使用弱阿片类药物，22%至少使用一种强阿片类药物）。疼痛频率和严重程度的增加与弱阿片、强阿片、按需阿片或计划阿片的增加有关。40%的参与者使用神经调节剂；使用量的增加与疼痛频率和严重程度的增加有关。在多变量分析中，与当前阿片类药物使用强度和频率相关的独立预测因素是疼痛模式（ORs 1.84-8.32 和 ORs 1.92-8.52，pConclusions）：在 CP 中使用阿片类药物很常见，并且与疼痛严重程度和持续性增加有关。这些数据为未来的试验提供了基础性的估计，可以阐明患者因素、疼痛和干预措施之间复杂的相互作用。

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

Clinical and Translational Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.00

自引率

0.00%

发文量

114

审稿时长

16 weeks

期刊介绍： Clinical and Translational Gastroenterology (CTG), published on behalf of the American College of Gastroenterology (ACG), is a peer-reviewed open access online journal dedicated to innovative clinical work in the field of gastroenterology and hepatology. CTG hopes to fulfill an unmet need for clinicians and scientists by welcoming novel cohort studies, early-phase clinical trials, qualitative and quantitative epidemiologic research, hypothesis-generating research, studies of novel mechanisms and methodologies including public health interventions, and integration of approaches across organs and disciplines. CTG also welcomes hypothesis-generating small studies, methods papers, and translational research with clear applications to human physiology or disease. Colon and small bowel Endoscopy and novel diagnostics Esophagus Functional GI disorders Immunology of the GI tract Microbiology of the GI tract Inflammatory bowel disease Pancreas and biliary tract Liver Pathology Pediatrics Preventative medicine Nutrition/obesity Stomach.