口服阿片类药物治疗癌性疼痛患者从医院到家庭过渡期间用药偏差的构建与验证

IF 3 3区 医学 Q1 ANESTHESIOLOGY
Pain Medicine Pub Date : 2025-09-01 DOI:10.1093/pm/pnaf119
Min Cao, Jialu Xu, Lan Zhu
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引用次数: 0

摘要

目的:从医院到家庭的过渡是药物错误的高风险时期,特别是在接受阿片类药物的患者中。我们构建并验证了癌症疼痛患者在医院到家庭过渡期间的用药偏差风险预测模型(MDRP)。方法:构建用药偏差评估表,判断MDRP建模组是否存在用药偏差。采用单因素分析和logistic回归分析影响因素。采用Hosmer-Lemeshow (H-L)曲线和受试者工作特征(ROC)曲线检验模型的预测效果优度。采用相同的方法进行外部验证,并制定了简单的风险评分量表。结果:造模组有用药偏差的占33.33%(51/153),无用药偏差的占66.67%(102/153)。BPI评分、合并症数量、是否有长期照顾者、药物依从性、是否存在焦虑/抑郁是MDRP构建的5个独立影响因素(P)结论:癌性疼痛患者的MDRP具有较高的敏感性和特异性。简易风险评分量表在临床实践中方便实用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Construction and validation of medication deviation in cancer pain patients with oral opioid formulations during hospital-to-home transition.

Objective: The transition from hospital to home is a high-risk period for medication errors, particularly in patients receiving opioids. We constructed and validated a Medication Deviation Risk Prediction Model (MDRP) in cancer pain patients during hospital-to-home transition.

Methods: The medication deviation assessment table was constructed to determine whether there was a medication deviation in the MDRP modeling group. Univariate analysis and logistic regression were used to analyze influencing factors. The model's goodness of predictive effect was tested using Hosmer-Lemeshow (H-L) and Receiver Operating Characteristic (ROC) curves. External validation was performed using the same methods, and developed a simple risk scoring scale.

Results: In the modelling group, 33.33% (51/153) had medication deviation, while 66.67% (102/153) had no medication deviation. BPI score, number of comorbidities, presence of long-term caregivers, medication adherence, and presence of anxiety/depression were the five independent influencing factors in the construction of MDRP (P < 0.05). The H-L test yielded p = 0.402, and the area under the ROC curves (AUC) was 0.875, with sensitivity at 0.765 and specificity at 0.882. The validation group results were consistent with the modeling group. a simple risk scoring scale was developed with a total score of 6, a cutoff value of 4, and an AUC of 0.886. The predictive accuracy of the scoring scale was 86.90%.

Conclusion: The MDRP of cancer pain patients had high sensitivity and specificity. The simple risk scoring scale was convenient and practical in clinical practice.

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来源期刊
Pain Medicine
Pain Medicine 医学-医学:内科
CiteScore
6.50
自引率
3.20%
发文量
187
审稿时长
3 months
期刊介绍: Pain Medicine is a multi-disciplinary journal dedicated to pain clinicians, educators and researchers with an interest in pain from various medical specialties such as pain medicine, anaesthesiology, family practice, internal medicine, neurology, neurological surgery, orthopaedic spine surgery, psychiatry, and rehabilitation medicine as well as related health disciplines such as psychology, neuroscience, nursing, nurse practitioner, physical therapy, and integrative health.
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