Longitudinal Analysis of Opioid Analgesic Dose and Diabetes Quality of Care Measures
作者： Santosh Gautam , Luisa Franzini , Osama I. Mikhail , Wenyaw Chan , Barbara J. Turner
DOI: 10.1111/PME.12835
关键词: Emergency department 、 Morphine 、 Equivalent dose 、 Cohort 、 Anesthesia 、 Diabetes mellitus 、 Medical prescription 、 Opioid 、 Medicine 、 Chronic pain
摘要: Objective To examine associations of opioid analgesic dose with quality care for diabetes mellitus. Design Longitudinal statewide cohort. Subjects Subjects filled one or more prescriptions Schedule II/III opioids noncancer pain in Blue Cross Shield Texas from 2008 through 2012. Methods Opioid and outcomes were assessed 6-month intervals after first prescription. Two morphine equivalent measures daily quartiles total all prescriptions. In fixed effects models adjusted clinical treatment variables, examined five outcomes: hemoglobin A1c (HbA1c) test, low density lipoprotein cholesterol (LDL) any hospitalization, diabetes-related preventable emergency department (ED) visit. Results All doses associated ( P 900 mg), respectively, vs no but >900 mg had the lowest AOR LDL testing (0.74 [CI 0.68, 0.80]). The AORs hospitalization were, 8.19 (CI 7.21, 9.30) 2.76 2.19, 3.48) only 6.22 4.94, 7.83) 2.16 1.34, >100 dose. Both nonmonotonic ED use. Conclusions Daily especially was strongly poorer a cohort.
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