{"title":"炎症性肠病患者疼痛和镇静药物的使用:一项基于全国人群的队列研究","authors":"Samantha Baillie,Sonia Saxena,Nishani Jayasooriya,Alex Bottle,Irene Petersen,Jonathan Blackwell,Richard Pollok","doi":"10.1111/apt.70247","DOIUrl":null,"url":null,"abstract":"BACKGROUND\r\nIndividuals with inflammatory bowel disease (IBD) often experience pain, mood disturbances, and sleep disruption, which may lead to greater use of pain-relieving and sedative medications compared with the general population. These are associated with increased mortality, paradoxical worsening of pain, and inappropriate IBD treatment discontinuation. Chronic prescribing and co-prescribing increase the risk of respiratory depression, dependence, and overdose.\r\n\r\nMETHODS\r\nUsing Clinical Practice Research Datalink, a large nationally representative dataset, we examined the annual prevalence of total, chronic (> 90 days opioids; > 28 days sedatives), and co-prescribed opioids, gabapentinoids and sedatives in adults with incident IBD from January 2010 to December 2019. Multivariable regression identified predictors of chronic or co-prescribing.\r\n\r\nRESULTS\r\nAmong 17,388 individuals, over 20% were prescribed a pain or sedative medication each year. Annual prevalence for opioids and gabapentinoids increased (13.6%-14% and 2.5%-5.6%, respectively) while sedative prevalence remained stable (8.4%). Chronic prescribing increased for strong opioids (3.6%-4.6%), weak opioids (3.6%-3.7%) and sedatives (4.2%-4.4%). Between 4.2% and 6.9% of individuals per year were co-prescribed opioids, gabapentinoids, and/or sedatives. Female sex, smoking, older age at diagnosis, Crohn's disease, and a diagnosis of inflammatory arthropathy, irritable bowel syndrome, fibromyalgia, or anxiety/depression were significantly associated with chronic and/or co-prescriptions of opioids or sedatives.\r\n\r\nCONCLUSION\r\nA substantial proportion of individuals with IBD are prescribed pain and sedative medications, including long-term and co-prescriptions. Identifying high-risk patients is essential to ensure they are prioritised for limited resources, such as psychological therapies, as alternatives to harmful prescriptions.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"86 1","pages":""},"PeriodicalIF":6.7000,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pain and Sedative Medication Use Among Individuals With Inflammatory Bowel Disease: A Nationwide Population-Based Cohort Study.\",\"authors\":\"Samantha Baillie,Sonia Saxena,Nishani Jayasooriya,Alex Bottle,Irene Petersen,Jonathan Blackwell,Richard Pollok\",\"doi\":\"10.1111/apt.70247\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"BACKGROUND\\r\\nIndividuals with inflammatory bowel disease (IBD) often experience pain, mood disturbances, and sleep disruption, which may lead to greater use of pain-relieving and sedative medications compared with the general population. These are associated with increased mortality, paradoxical worsening of pain, and inappropriate IBD treatment discontinuation. Chronic prescribing and co-prescribing increase the risk of respiratory depression, dependence, and overdose.\\r\\n\\r\\nMETHODS\\r\\nUsing Clinical Practice Research Datalink, a large nationally representative dataset, we examined the annual prevalence of total, chronic (> 90 days opioids; > 28 days sedatives), and co-prescribed opioids, gabapentinoids and sedatives in adults with incident IBD from January 2010 to December 2019. Multivariable regression identified predictors of chronic or co-prescribing.\\r\\n\\r\\nRESULTS\\r\\nAmong 17,388 individuals, over 20% were prescribed a pain or sedative medication each year. Annual prevalence for opioids and gabapentinoids increased (13.6%-14% and 2.5%-5.6%, respectively) while sedative prevalence remained stable (8.4%). Chronic prescribing increased for strong opioids (3.6%-4.6%), weak opioids (3.6%-3.7%) and sedatives (4.2%-4.4%). Between 4.2% and 6.9% of individuals per year were co-prescribed opioids, gabapentinoids, and/or sedatives. Female sex, smoking, older age at diagnosis, Crohn's disease, and a diagnosis of inflammatory arthropathy, irritable bowel syndrome, fibromyalgia, or anxiety/depression were significantly associated with chronic and/or co-prescriptions of opioids or sedatives.\\r\\n\\r\\nCONCLUSION\\r\\nA substantial proportion of individuals with IBD are prescribed pain and sedative medications, including long-term and co-prescriptions. Identifying high-risk patients is essential to ensure they are prioritised for limited resources, such as psychological therapies, as alternatives to harmful prescriptions.\",\"PeriodicalId\":121,\"journal\":{\"name\":\"Alimentary Pharmacology & Therapeutics\",\"volume\":\"86 1\",\"pages\":\"\"},\"PeriodicalIF\":6.7000,\"publicationDate\":\"2025-07-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Alimentary Pharmacology & Therapeutics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/apt.70247\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Alimentary Pharmacology & Therapeutics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/apt.70247","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Pain and Sedative Medication Use Among Individuals With Inflammatory Bowel Disease: A Nationwide Population-Based Cohort Study.
BACKGROUND
Individuals with inflammatory bowel disease (IBD) often experience pain, mood disturbances, and sleep disruption, which may lead to greater use of pain-relieving and sedative medications compared with the general population. These are associated with increased mortality, paradoxical worsening of pain, and inappropriate IBD treatment discontinuation. Chronic prescribing and co-prescribing increase the risk of respiratory depression, dependence, and overdose.
METHODS
Using Clinical Practice Research Datalink, a large nationally representative dataset, we examined the annual prevalence of total, chronic (> 90 days opioids; > 28 days sedatives), and co-prescribed opioids, gabapentinoids and sedatives in adults with incident IBD from January 2010 to December 2019. Multivariable regression identified predictors of chronic or co-prescribing.
RESULTS
Among 17,388 individuals, over 20% were prescribed a pain or sedative medication each year. Annual prevalence for opioids and gabapentinoids increased (13.6%-14% and 2.5%-5.6%, respectively) while sedative prevalence remained stable (8.4%). Chronic prescribing increased for strong opioids (3.6%-4.6%), weak opioids (3.6%-3.7%) and sedatives (4.2%-4.4%). Between 4.2% and 6.9% of individuals per year were co-prescribed opioids, gabapentinoids, and/or sedatives. Female sex, smoking, older age at diagnosis, Crohn's disease, and a diagnosis of inflammatory arthropathy, irritable bowel syndrome, fibromyalgia, or anxiety/depression were significantly associated with chronic and/or co-prescriptions of opioids or sedatives.
CONCLUSION
A substantial proportion of individuals with IBD are prescribed pain and sedative medications, including long-term and co-prescriptions. Identifying high-risk patients is essential to ensure they are prioritised for limited resources, such as psychological therapies, as alternatives to harmful prescriptions.
期刊介绍:
Alimentary Pharmacology & Therapeutics is a global pharmacology journal focused on the impact of drugs on the human gastrointestinal and hepato-biliary systems. It covers a diverse range of topics, often with immediate clinical relevance to its readership.