2001年至2019年按年龄和性别划分的阿片类药物处方国际趋势：一项基于18个国家和一个特别行政区人口数据库的观察性研究

IF 7.4 2区医学 Q1 CLINICAL NEUROLOGY

CNS drugs Pub Date : 2025-11-01 Epub Date: 2025-09-01 DOI:10.1007/s40263-025-01215-2

Adrienne Y L Chan, Shahram Bahmanyar, Kebede Beyene, Greta Bushnell, Bruce Carleton, Amy Hai Yan Chan, Sharon Cook, Stephen Crystal, Kari Furu, Svetla Gadzhanova, Patricia García Poza, Rosa Gini, Sabrina Giometto, Jeff Harrison, Ulrike Haug, Christine Hsu, Harpa Lind Hjördísar Jónsdóttir, Joe Kai, Øystein Karlstad, Ju Hwan Kim, Kiyoshi Kubota, Edward Chia-Cheng Lai, Hyesung Lee, Wallis C Y Lau, Kathy H Li, Ersilia Lucenteforte, Géric Maura, Anke Neumann, Virginia Pate, Anton Pottegård, Nadeem Qureshi, Lotte Rasmussen, Johan Reutfors, Elizabeth E Roughead, Leena Saastamoinen, Tsugumichi Sato, Oliver Scholle, C C M Schuiling-Veninga, Chin-Yao Shen, Ju-Young Shin, Til Stürmer, Katja Taxis, Marco Tuccori, Stephen Weng, Kirstie H T W Wong, Helga Zoega, Kenneth K C Man, Ian C K Wong

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引用次数: 0

摘要

目的：按性别和年龄划分阿片类镇痛药处方的跨国趋势和模式。设计、环境和参与者：我们使用来自18个国家和一个特别行政区的基于人口的数据库，研究了2001年至2019年使用通用方案开具的阿片类镇痛药处方。主要结局指标：我们按地理区域、性别和年龄测量阿片类药物处方，以95%置信区间（CI）估计每100人每年流行、事件和非事件阿片类药物处方，并使用随机效应模型对跨国和区域阿片类药物处方进行meta分析。时间趋势通过平均年绝对变化报告，使用线性混合模型估计。在多变量分析中，我们进一步探讨了性别和年龄对流行阿片类药物处方的影响。结果：超过2.48亿人被纳入。在纳入的国家/地区中，综合跨国阿片类药物处方患病率为9.0%。2015年阿片类药物处方患病率从日本的2.7%到冰岛的19.7%不等。阿片类药物处方患病率的年平均绝对变化范围从- 1.53% （95% CI - 2.06, - 1.00；美国医疗补助计划）到+ 1.24% （95% CI 1.02, 1.46；韩国）。合并跨国事件阿片类药物处方（4.9%;95% CI 4.1, 5.9）高于合并跨国非事件阿片类药物处方（3.7%;95% CI 2.9, 4.8）。女性和年龄越大，阿片类药物处方越高。本研究的主要局限性包括缺乏研究期间或数据源未涵盖的个体的数据，以及缺乏药物依从性和适应症的信息。结论：阿片类药物处方在地理区域之间仍然不平衡；然而，研究结果表明，不同国家/地区的趋势趋同。阿片类药物处方的性别和年龄差异被确定。

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International Trends in Opioid Prescribing by Age and Sex from 2001 to 2019: An Observational Study Using Population-Based Databases from 18 Countries and One Special Administrative Region.

Objective: To characterize multinational trends and patterns of opioid analgesic prescribing by sex and age.

Design, setting, and participants: We studied opioid analgesic prescribing from 2001 to 2019 with common protocol using population-based databases from eighteen countries and one special administrative region.

Main outcome measures: We measured opioid prescribing by geographical region, sex and age, estimating annual prevalent, incident, and nonincident opioid prescribing per 100 population with a 95% confidence interval (CI) and meta-analyzed the multinational and regional opioid prescribing with a random-effects model. Time trends were reported through average annual absolute changes, estimated using linear mixed models. We further explored the effect of sex and age on prevalent opioid prescribing in the multivariable analysis.

Results: Over 248 million individuals were included. Pooled multinational opioid prescribing prevalence was 9.0% amongst included countries/regions. Opioid prescribing prevalence in 2015 ranged from 2.7% in Japan to 19.7% in Iceland. Average annual absolute changes in opioid prescribing prevalence per year ranged from - 1.53% (95% CI - 2.06, - 1.00; United States Medicaid) to + 1.24% (95% CI 1.02, 1.46; South Korea). Pooled multinational incident opioid prescribing (4.9%; 95% CI 4.1, 5.9) was higher than pooled multinational nonincident opioid prescribing (3.7%; 95% CI 2.9, 4.8). The female sex and older age were associated with higher opioid prescribing. Main limitations of this study include the absence of data from study duration or individuals not covered by the data sources and the lack of information on medication adherence and indication.

Conclusions: Opioid prescribing remains unbalanced across geographical regions; however, results suggest a tendency to convergence across countries/regions. Differences in opioid prescribing by sex and age were identified.

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来源期刊

CNS drugs 医学-精神病学

CiteScore

12.00

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： CNS Drugs promotes rational pharmacotherapy within the disciplines of clinical psychiatry and neurology. The Journal includes: - Overviews of contentious or emerging issues. - Comprehensive narrative reviews that provide an authoritative source of information on pharmacological approaches to managing neurological and psychiatric illnesses. - Systematic reviews that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. - Adis Drug Reviews of the properties and place in therapy of both newer and established drugs in neurology and psychiatry. - Original research articles reporting the results of well-designed studies with a strong link to clinical practice, such as clinical pharmacodynamic and pharmacokinetic studies, clinical trials, meta-analyses, outcomes research, and pharmacoeconomic and pharmacoepidemiological studies. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in CNS Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.