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首页> 外文期刊>Drugs and aging >What analgesics do older people use prior to initiating oxycodone for non-cancer pain? A retrospective database study
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What analgesics do older people use prior to initiating oxycodone for non-cancer pain? A retrospective database study

机译：老年人在开始使用羟考酮治疗非癌性疼痛之前会使用哪种镇痛药？回顾性数据库研究

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Background: Increased oxycodone use has been associated with adverse drug events, non-medical use and overdose deaths. Objectives: To explore patterns of non-opioid, weak opioid and strong opioid use prior to initiation of oxycodone for non-cancer pain in a predominantly older Australian population. Methods: A retrospective study was conducted using the Australian Government Department of Veterans' Affairs administrative claims database. Analgesic use 12 months prior to incident dispensing of oxycodone was determined for people in the community and in residential aged-care facilities (RACFs). Log-binomial regression was used to compute adjusted rate ratios (RRs) and 95 % confidence intervals (95 % CIs) for the use of other analgesics prior to initiating oxycodone. Results: Of 10,791 people who initiated oxycodone in 2010, 26 % in community settings and 13 % in RACFs were not dispensed other analgesics in the 12 months prior to initiating oxycodone. Thirty-four percent and 20 % of those in community settings and RACFs, respectively, were not dispensed other analgesics in the previous 4 months. Co-morbidity had little impact on prior analgesic use. Each additional co-morbid condition was associated with a 1.4 % increased likelihood (RR 1.014, 95 % CI 1.012-1.016; p < 0.0001) and a 1.2 % increased likelihood (RR 1.012, 95 % CI 1.009-1.015; p < 0.0001) of being dispensed another analgesic prior to initiating oxycodone in community and RACF settings, respectively. Conclusions: Oxycodone is frequently initiated for non-cancer pain without first trialing other analgesics. This highlights the need for prescribing practices to be reviewed in light of increasing concerns about adverse drugs events and death due to oxycodone, particularly in older people.
机译：背景：羟考酮的使用增加与药物不良反应，非医疗用途和过量死亡有关。目的：探讨在澳大利亚老年人群中，在开始使用羟考酮治疗非癌性疼痛之前，非阿片类药物，弱阿片类药物和强阿片类药物的使用方式。方法：使用澳大利亚政府退伍军人事务部行政索赔数据库进行回顾性研究。已确定在社区和住宅老年护理设施（RACF）中的患者在分配羟考酮事件前12个月使用止痛药。采用对数二项式回归来计算调整的比率（RRs）和95％的置信区间（95％CI），以便在开始羟考酮之前使用其他止痛药。结果：在2010年发起羟考酮的10,791人中，在发起羟考酮之前的12个月中，社区环境中的26％和RACF中的13％没有分配其他镇痛药。在过去的四个月中，分别没有使用其他镇痛剂的分别有34％和20％的社区环境和RACF。合并症对以前的止痛药使用影响很小。每种其他合并症都与可能性增加1.4％（RR 1.014，95％CI 1.012-1.016; p <0.0001）和1.2％可能性增加（RR 1.012，95％CI 1.009-1.015; p <0.0001）相关在社区和RACF环境中分别开始使用羟考酮之前，先分配另一种镇痛药。结论：羟考酮通常在未首先尝试其他镇痛药的情况下开始用于非癌性疼痛。这突出表明，鉴于对羟考酮引起的不良药物事件和死亡的关注日益增加，特别是在老年人中，有必要对处方做法进行审查。

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