研究動機:目前尚未有理論指出,baclofen的使用是否能減少因酒精導致之入院事件。因一般人無法識別baclofen的潛在影響,故本研究目標為分析Baclofen的使用時機與酒精導致之入院事件(一般住院及急診住院)相互關聯性。研究方法:本研究的方法控制,主要在探討baclofen使用時機所影響的入院發生率。Condition Poisson用於評估酒精依賴症、酒精濫用與因酒精誘發之精神疾病發病率,以及baclofen使用時機對於一般住院與急診住院之發生率。本研究模型根據年齡與精神藥物進行調整,子群分析則呈現出精神藥物暴露期間,資料來源使用台灣全民健康保險資料庫之2000年至2013年之病患。經資料篩選共有2904名的健康保險承保人,篩選條件為1.使用baclofen至少連續28天以上。2.於2000年至2013年有過因含酒精導致之一般住院或急診住院案例。3.於2000年至2013年間未因酒精相關而開立baclofen的處方籤。研究發現,僅有benzodiazepines, 抗精神病藥, psychostimulants, 與lithium,等精神病藥物,與baclofen結合時可減少IRR。結論:本研究發現baclofen可能能夠減少因酒精導致之一般住院及急診住院的發生率。
Objective: The effectiveness of baclofen in reducing alcohol-attributable admissions has thus far been inconclusive. The goal of this study is to analyze the relationship between baclofen use and the incidence of alcohol-attributable hospitalizations and emergency department (ED) admissions in a general population incognizant of potential effects of baclofen. Methods: The self-controlled case series method was used in this study to determine the incidence of admissions during baclofen use. Condition Poisson was used to estimate the incidence rate ratio (IRR) of alcohol dependence syndrome, alcohol abuse, and alcohol-induced mental disorders within hospitalizations and ED admissions during periods of baclofen use; models were adjusted for age and presence of psychotropic medications. Subgroup analysis was performed during psychotropic medication exposure. Taiwan’s National Health Insurance claims database was used to access the medical records of patients from 2000 to 2013. Results: A total of 2,904 beneficiaries were prescribed 28 or more days of baclofen, had at least case of alcohol-attributable hospitalizations or ED admissions, and were without prescription of baclofen related to alcohol. In the adjusted model baclofen was associated with a reduced incidence of alcohol-attributable hospitalization (IRR 0.64 95% CI 0.53-0.77) and ED admissions. (IRR 0.56 95% CI 0.49-0.65). Baclofen in combination with benzodiazepines, antipsychotics, psychostimulants, and lithium reduced IRR relative to only the respective psychotropic medication. Conclusion: These findings of this study indicate that baclofen may reduce the incidence of hospitalizations and emergency department admissions.
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