Пациенты с ревматическими заболеваниями и опиоидной зависимостью чаще обращаются в скорую помощь и реже получают базовую терапию

HealthDay News — Patients with rheumatic conditions and opioid use disorder (OUD) have distinct demographic and clinical characteristics, including lower use of disease-modifying antirheumatic drugs (DMARDs) and higher acute care use, according to a study published online July 13 in Arthritis Care & Research. Jacob S. Riegler, M.D., from the Cambridge Health Alliance in Massachusetts, and colleagues identified individuals with at least two billing codes for systemic lupus erythematosus, rheumatoid arthritis, spondyloarthritis, or osteoarthritis using the national All of Us Research Program. Demographics, psychiatric disorders, prescription medications (opioids, glucocorticoids, and DMARDs), comorbidities, and acute care use were compared for patients with and without OUD. The researchers found that 1,502 of the 37,282 (4 percent) patients with rheumatic conditions had OUD. Patients with OUD were younger than those without OUD, and they were more likely to have Medicaid insurance, psychiatric and medical comorbidities, and higher acute care use. In addition, they were more likely to have received prior prescription opioids (75.7 versus 45.8 percent) and glucocorticoids; they had a lower likelihood of having used biologic, targeted synthetic, or conventional DMARDs. Overall, 14.5 percent of patients with rheumatic diseases and OUD had received medications for OUDs (MOUDs). “Our descriptive analysis is unable to establish underlying drivers for these findings, and future research should identify risk factors for developing OUD (i.e., high-risk prescribing patterns, illicit opioid use ), identify potential drivers for differences in glucocorticoid and DMARD prescriptions (e.g., care access, prescribing patterns, disease activity), and evaluate MOUD initiation and treatment retention,” the authors write. Abstract/Full Text (subscription or payment may be required)