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2011 年至 2015 年德国北部阿片类镇痛药危险处方的趋势。

Trends in risky prescriptions of opioid analgesics from 2011 to 2015 in Northern Germany.

机构信息

Centre for Interdisciplinary Addiction Research of Hamburg University (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

出版信息

J Psychopharmacol. 2020 Nov;34(11):1210-1217. doi: 10.1177/0269881120936544. Epub 2020 Jul 17.

Abstract

INTRODUCTION

Due to their euphoric and sedative effects, opioid analgesics have high potential for abuse and dependence. In the last decade in the USA and many Western European Countries the prescription rates of opioid analgesics have steadily increased.

OBJECTIVE

This study describes 5-year trends in the prescription of opioid analgesics and risk indicators such as duration, dose and 'doctor shopping' in Northern Germany.

METHODS

The annual rates of opioid analgesic prescriptions have been analysed for patients with statutory health insurance processed by the North German Pharmacy Data Center for the years 2011-2015. A distinction was made between non-cancer patients and cancer patients, and different groups according to prescription duration and dose level.

RESULTS

Between 2011 and 2015, the annual number of patients with opioid analgesic prescriptions increased from 500,000 to 550,000. About half of non-cancer-patients (85% of the total sample) and cancer patients received opioid analgesics for 90 days or less. The rates for long-term prescriptions (⩾9 months) ranged between 6-7% for non-cancer patients and 7-8% for cancer patients. Between 1.2-1.8% received opioid analgesics in doses of more than two defined daily doses. The majority of non-cancer patients with opioid analgesic prescriptions were female. The average age of non-cancer patients was 66 years. About 80% of non-cancer patients with first opioid analgesic prescription received World Health Organization step II medication.

CONCLUSION

For the first time, this study provides comprehensive patient-related analyses of opioid analgesic prescriptions in Germany over a 5-year period. Despite a slight increase in the overall number of opioid analgesic prescriptions, an epidemic spread of opioid analgesics cannot be observed.

摘要

简介

由于阿片类镇痛药具有欣快和镇静作用,因此具有很高的滥用和依赖潜力。在过去十年中,美国和许多西欧国家的阿片类镇痛药处方率稳步上升。

目的

本研究描述了德国北部阿片类镇痛药处方的 5 年趋势以及持续时间、剂量和“医生购物”等风险指标。

方法

对北德药房数据中心处理的 2011-2015 年有法定健康保险的患者的阿片类镇痛药处方的年率进行了分析。根据处方持续时间和剂量水平对非癌症患者和癌症患者进行了区分,并进行了不同组别的区分。

结果

2011 年至 2015 年间,接受阿片类镇痛药处方的患者人数从 50 万增加到 55 万。约一半的非癌症患者(总样本的 85%)和癌症患者接受阿片类镇痛药治疗的时间为 90 天或更短。长期处方(≥9 个月)的比例在非癌症患者中为 6-7%,在癌症患者中为 7-8%。1.2-1.8%的患者接受超过两种规定日剂量的阿片类镇痛药。接受阿片类镇痛药处方的大多数非癌症患者为女性。非癌症患者的平均年龄为 66 岁。约 80%首次接受阿片类镇痛药处方的非癌症患者接受了世界卫生组织二级药物。

结论

本研究首次提供了德国 5 年来阿片类镇痛药处方的全面患者相关分析。尽管阿片类镇痛药的总体处方数量略有增加,但并未观察到阿片类镇痛药的流行蔓延。

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