成人急诊出院时处方阿片类药物的趋势:美国，2006-2017。

Q2 Medicine

National health statistics reports Pub Date : 2020-01-01

Pinyao Rui, Loredana Santo, Jill J Ashman

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引用次数: 0

摘要

目的:本报告描述了2006-2007年至2016-2017年期间成人急诊科(ED)出院时阿片类药物处方的趋势，包括选定的患者和医院特征以及阿片类药物的处方类型。方法:数据来自2006-2017年全国医院门诊医疗调查。研究人群包括所有18岁及以上的急诊科患者。研究的主要结果是急诊科出院时处方的阿片类药物，使用Cerner Multum的麻醉性镇痛药(代码60)和麻醉性镇痛药组合(代码191)的三级治疗类别代码进行定义。结果:出院时使用阿片类药物的成人急诊科就诊比例从2006-2007年(19.0%)到2010-2011年(21.5%)上升，然后从2010-2011年到2016-2017年(14.6%)下降。下降率最高的是18-44岁的年轻人(从2010-2011年的25.5%下降到2016-2017年的15.3%)和居住在中小都市县的人(从2010-2011年的24.3%下降到2016-2017年的14.5%)。从2006-2007年(11.3%)到2010-2011年(12.4%)，服用吗啡等效阿片类药物的就诊比例有所增加，从2010-2011年到2016-2017年(6.7%)有所下降。从2006-2007年(3.8%)到2010-2011年(5.5%)，服用强于吗啡的阿片类药物的就诊比例同样有所增加，2016-2017年降至3.0%。相比之下，使用弱于吗啡的阿片类药物就诊的比例从2006-2007年的4.0%下降到2010-2011年的3.6%，并在2016-2017年上升到5.0%。出院时处方的阿片类药物中，对乙酰氨基酚-氢可酮的比例从2012-2013年的53.1%下降到2016-2017年的41.5%，曲马多和对乙酰氨基酚-可待因的比例相应上升。出院时处方阿片类药物相关的主要诊断包括牙痛、尿石症(肾结石、膀胱结石或尿路结石)、骨折损伤、背痛和四肢疼痛。对于所有排名靠前的诊断，从2010-2011年到2016-2017年，阿片类药物的就诊比例有所下降，尽管尿石症的下降没有统计学意义。

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Trends in Opioids Prescribed at Discharge From Emergency Departments Among Adults: United States, 2006-2017.

Objective-This report describes trends in opioid prescribing at emergency department (ED) discharge among adults from 2006-2007 through 2016-2017, by selected patient and hospital characteristics and the type of opioids prescribed. Methods-Data are from the 2006-2017 National Hospital Ambulatory Medical Care Survey. The study population included all ED visits by patients aged 18 and over. The main outcome studied was opioids prescribed at ED discharge, defined using Cerner Multum's third-level therapeutic category codes for narcotic analgesics (Code 60) and narcotic-analgesic combinations (Code 191). Results-The percentage of ED visits by adults with opioids prescribed at discharge increased from 2006-2007 (19.0%) through 2010-2011 (21.5%) and then decreased from 2010-2011 through 2016-2017 (14.6%). The rate of decrease was highest among visits by younger adults aged 18-44 (from 25.5% in 2010-2011 to 15.3% in 2016-2017) and those living in medium or small metropolitan counties (24.3% in 2010-2011 to 14.5% in 2016-2017). The percentage of visits with morphine-equivalent opioids prescribed increased from 2006-2007 (11.3%) through 2010-2011 (12.4%) and decreased from 2010-2011 through 2016-2017 (6.7%). The percentage of visits with stronger than morphine opioids prescribed similarly increased from 2006-2007 (3.8%) through 2010-2011 (5.5%) and decreased to 3.0% in 2016-2017. In contrast, the percentage of visits with weaker than morphine opioids prescribed decreased from 4.0% in 2006-2007 through 3.6% in 2010-2011 and increased to 5.0% in 2016-2017. Among all opioids prescribed at discharge, the percentage with acetaminophen-hydrocodone prescribed decreased from 53.1% in 2012-2013 to 41.5% in 2016-2017, with a corresponding increase for both tramadol and acetaminophen-codeine. Top diagnoses associated with an opioid prescribed at discharge included dental pain, urolithiasis (stones in the kidney, bladder, or urinary tract), fracture injuries, back pain, and extremity pain. For all top diagnoses, the percentage of visits with an opioid prescribed decreased from 2010-2011 through 2016-2017, though the decrease was not statistically significant for urolithiasis.

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来源期刊

National health statistics reports Medicine-Public Health, Environmental and Occupational Health

CiteScore

6.50

自引率

0.00%

发文量

期刊介绍： Notice: Effective January 2008 the title, National Health Statistics Reports (NHSR), replaces Advance Data from Vital and Health Statistics (AD). NHSRs will be numbered sequentially beginning with 1. The last AD report number is 395. These reports provide annual data summaries, present analyses of health topics, or present new information on methods or measurement issues.