| アブストラクト | OBJECTIVE: Up to one in five patients with axial spondyloarthritis (AxSpA) or psoriatic arthritis (PsA) newly initiated on opioids transition to long-term use within the first year. This study aimed to investigate individual factors associated with long-term opioid use among opioid new users with AxSpA/PsA. METHODS: Adult patients with AxSpA/PsA and without prior cancer who initiated opioids between 2006 and 2021 were included from Clinical Practice Research Datalink Gold, a national UK primary care database. Long-term opioid use was defined as having >/=3 opioid prescriptions issued within 90 days, or >/=90 days of opioid supply, in the first year of follow-up. Individual factors assessed included sociodemographic, lifestyle factors, medication use and comorbidities. A mixed-effects logistic regression model with patient-level random intercept was used to examine the association of individual characteristics with the odds of long-term opioid use. RESULTS: In total, 10 300 opioid initiations were identified from 8212 patients (3037 AxSpA; 5175 PsA). The following factors were associated with long-term opioid use: being a current smoker (OR: 1.62; 95%CI: 1.38,1.90), substance use disorder (OR: 2.34, 95%CI: 1.05,5.21), history of suicide/self-harm (OR: 1.84; 95%CI: 1.13,2.99), co-existing fibromyalgia (OR: 1.62; 95%CI: 1.11,2.37), higher Charlson Comorbidity Index (OR: 3.61; 95%CI: 1.69,7.71 for high scores), high MME/day at initiation (OR: 1.03; 95%CI: 1.02,1.03) and gabapentinoid (OR: 2.35; 95%CI: 1.75,3.16) and antidepressant use (OR: 1.69; 95%CI: 1.45,1.98). CONCLUSIONS: In AxSpA/PsA patients requiring pain relief, awareness of lifestyle, sociodemographic and prescribing characteristics associated with higher risk of long-term opioid use can prompt timely interventions such as structured medication reviews and smoking cessation to promote safer prescribing and better patient outcomes. |
|---|
| ジャーナル名 | Rheumatology (Oxford, England) |
|---|
| Pubmed追加日 | 2024/8/16 |
|---|
| 投稿者 | Huang, Yun-Ting; Jenkins, David A; Yimer, Belay Birlie; Jani, Meghna |
|---|
| 組織名 | Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research,;The University of Manchester, Manchester, UK.;Centre for Health Informatics, Division of Informatics, Imaging and Data Science,;NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation;Trust, Manchester Academic Health Science Centre, Manchester, UK.;Department of Rheumatology, Salford Royal Hospital, Northern Care Alliance,;Salford, UK. |
|---|
| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/39150473/ |
|---|
