| Autor: |
Gabrielle Campbell, Firouzeh Noghrehchi, Suzanne Nielsen, Phillip Clare, Raimondo Bruno, Nicholas Lintzeris, Milton Cohen, Fiona Blyth, Wayne Hall, Briony Larance, Phillip Hungerford, Timothy Dobbins, Michael Farrell, Louisa Degenhardt |
| Jazyk: |
angličtina |
| Rok vydání: |
2020 |
| Předmět: |
|
| Zdroj: |
EClinicalMedicine, Vol 28, Iss , Pp 100592- (2020) |
| Druh dokumentu: |
article |
| ISSN: |
2589-5370 |
| DOI: |
10.1016/j.eclinm.2020.100592 |
| Popis: |
Background: The literature suggests patient characteristics and higher opioid doses and long-term duration are associated with problematic opioid behaviours but no one study has examined the role of all these factors simultaneously in a long-term prospective cohort study. Methods: Five-year, community-based, prospective cohort of people prescribed opioids for chronic non-cancer pain (CNCP). Logistic mixed effect models with multiple imputation were used to address missing data. Oral morphine equivalent (OME) mg per day was categorised as: 0 mg OME/day, 1–49 mg OME/day (reference), 50–89 mg OME/day, 90–199 mg OME/day and 200mg+ OME/day. Patient risk factors included: age, gender, substance use, mental health history and pain-related factors. Main outcomes included: Prescribed Opioids Difficulties Scale (PODS), Opioid-Related Behaviours In Treatment (ORBIT) scale, and ICD-10 opioid dependence. Multiple confounders for problematic opioid behaviours were assessed. Findings: Of 1,514 participants 44.4% were male (95%CI 41.9–46.9) and their mean age was 58 years (IQR 48–67). Participants had a mean duration of pain of 10 years (IQR 4.5–20.0) and had been taking strong opioids for a median of four years (IQR 1.0–10.0). At baseline, median OME/day was 73 (IQR 35–148). At 5-years, 85% were still taking strong opioids. PODS moderate-high scores reduced from 59.9% (95%CI 58.8–61.0) at baseline to 51.5% (95%CI 50.0–53.0) at 5-years. Around 9% met criteria for ICD-10 opioid dependence at each wave. In adjusted mixed effect models, the risk factors most consistently associated with problematic opioid use were: younger age, substance dependence, mental health histories and higher opioid doses. Interpretation: Both patient risk factors and opioid dose are associated with problematic opioid use behaviours. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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