본문 바로가기
KERD
논문KCI 등재

한 상급종합병원 내 Fentanyl Buccal Tablet의 의존 경향 파악 및 위험 요인 분석

Recent Statistics and Risk Factors of Fentanyl Buccal Tablet Related Opioid Dependence Tendency at a Tertiary Hospital in Korea

3

조회

0

다운로드

3

인용

0

참고문헌

키워드

초록

Background and Objective : Previous studies on the safety of fentanyl buccal tablets (FBT) have often dismissed patients with a high likelihood of drug abuse or who have been strongly controlled by dose or usage of FBT. For these reasons, we could not confirm the current state of dependence or addiction of opioid pain medication in patients suing FBT in an actual clinical setting. The purpose of this study was to analyze the FBT use status in a tertiary hospital in Korea and the risk factors related opioid dependence tendency and to contribute to the safe use of FBT. Methods : We retrospectively reviewed electronic medical records of cancer patients admitted to the wards that received FBT at a tertiary hospital in Korea From January to May 2018. The proportion of patients with dependence tendency due to FBT was investigated. Logistic regression analysis was performed to determine the risk factors. The significance level was p 0.05. Results : Of the total 275 patients, four had FBT dependence tendency, with a ratio of 1.45%. Additionally, smoking history (odds ratio=23.51, p=0.02) and one-day immediate opioid analgesic dose excluding FBT (odds ratio=1.15, p=0.01) were the risk factors for dependence tendency on opioid analgesic due to FBT. Conclusions : The proportion of patients with dependence tendency due to FBT in a tertiary hospital at Korea was 1.45%, which was higher than the general incidence of dependence or addiction of opioid analgesics used to mitigate cancer pain. Thus, patients taking this drug should be closely monitored for dependence and addiction. Additionally, medical staffs must be fully aware of patients’risk factors. Although this study has limitations as a retrospective study, it may be reliable data for the safe use of opioid analgesic by confirming the dependence tendency and risk factors of FBT in clinical practice.

Abstract

Background and Objective : Previous studies on the safety of fentanyl buccal tablets (FBT) have often dismissed patients with a high likelihood of drug abuse or who have been strongly controlled by dose or usage of FBT. For these reasons, we could not confirm the current state of dependence or addiction of opioid pain medication in patients suing FBT in an actual clinical setting. The purpose of this study was to analyze the FBT use status in a tertiary hospital in Korea and the risk factors related opioid dependence tendency and to contribute to the safe use of FBT. Methods : We retrospectively reviewed electronic medical records of cancer patients admitted to the wards that received FBT at a tertiary hospital in Korea From January to May 2018. The proportion of patients with dependence tendency due to FBT was investigated. Logistic regression analysis was performed to determine the risk factors. The significance level was p 0.05. Results : Of the total 275 patients, four had FBT dependence tendency, with a ratio of 1.45%. Additionally, smoking history (odds ratio=23.51, p=0.02) and one-day immediate opioid analgesic dose excluding FBT (odds ratio=1.15, p=0.01) were the risk factors for dependence tendency on opioid analgesic due to FBT. Conclusions : The proportion of patients with dependence tendency due to FBT in a tertiary hospital at Korea was 1.45%, which was higher than the general incidence of dependence or addiction of opioid analgesics used to mitigate cancer pain. Thus, patients taking this drug should be closely monitored for dependence and addiction. Additionally, medical staffs must be fully aware of patients’risk factors. Although this study has limitations as a retrospective study, it may be reliable data for the safe use of opioid analgesic by confirming the dependence tendency and risk factors of FBT in clinical practice.

참고문헌 (25)

  1. Lewis M.A.O., "Burket’s Oral Medicine. Diagnosis and Treatment", Journal of Orthodontics, 30(4), pp.346~ (2003)
  2. Neufeld NJ, "Cancer pain : a review of epidemiology, clinical quality and value impact", Future Oncol, 13(9), pp.833~841 (2017)
  3. Swarm R, "Adult cancer pain", J Natl Compr Canc Netw, 8(9), pp.1046~1086 (2010)
  4. Paice JA, "Management of Chronic Pain in Survivors of Adult Cancers : American Society of Clinical Oncology Clinical Practice Guideline", J Clin Oncol, 34(27), pp.3325~3345 (2016)
  5. Hagen NA, "A titration strategy is needed to manage breakthrough cancer pain effectively : observations from data pooled from three clinical trials", J Palliat Med, 10(1), pp.47~55 (2007)
  6. Schug SA, "Fentanyl Formulations in the Management of Pain : An Update", Drugs, 77(7), pp.747~763 (2017)
  7. Jandhyala R, "Efficacy of rapid-onset oral fentanyl formulations vs. oral morphine for cancer-related breakthrough pain: a meta-analysis of comparative trials", J Pain Symptom Manage, 46(4), pp.573~580 (2013)
  8. Ashburn MA, "The efficacy and safety of fentanyl buccal tablet compared with immediate-release oxycodone for the management of breakthrough pain in opioid-tolerant patients with chronic pain", Anesth Analg, 112(3), pp.693~702 (2011)
  9. "세계1위 복제약 업체 테바가 보여준 한국시장 침투전략" (2017)[URL]
  10. Ballantyne JC, "Opioid dependence and addiction during opioid treatment of chronic pain", Pain, 129(3), pp.235~255 (2007)
  11. Cicero TJ, "Relative preferences in the abuse of immediaterelease versus extended-release opioids in a sample of treatment-seeking opioid abusers", Pharmacoepidemiol Drug Saf, 26(1), pp.56~62 (2017)
  12. Iwanicki JL, "Abuse and Diversion of Immediate Release Opioid Analgesics as Compared to Extended Release Formulations in the United States", PLoS One, 11(12), pp.e0167499~ (2016)
  13. "Safety alert for fentanyl buccal tablets", J Pain Palliat Care Pharmacother, 22(1), pp.47~ (2008)
  14. Nalamachu SR, "Long-term dosing, safety, and tolerability of fentanyl buccal tablet in the management of noncancer-related breakthrough pain in opioid-tolerant patients", Curr Med Res Opin, 27(4), pp.751~760 (2011)
  15. Passik SD, "Aberrant drug-related behavior observed during a 12-week open-label extension period of a study involving patients taking chronic opioid therapy for persistent pain and fentanyl buccal tablet or traditional short-acting opioid for breakthrough pain", Pain Med, 15(8), pp.1365~1372 (2014)
  16. Castaneda AM, "Addressing Opioid-Related Chemical Coping in Long-Term Opioid Therapy for Chronic Noncancer Pain : A Multicenter, Observational, Cross-Sectional Study", J Clin Med, 7(10), pp.354~ (2018)
  17. Passik SD, "Pain and aberrant drug-related behaviors in medically ill patients with and without histories of substance abuse", Clin J Pain, 22(2), pp.173~181 (2006)
  18. Minozzi S, "Development of dependence following treatment with opioid analgesics for pain relief : a systematic review", Addiction, 108(4), pp.688~698 (2013)
  19. Chou R, "Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain", J Pain, 10(2), pp.113~130 (2009)
  20. Kaye AD, "Prescription Opioid Abuse in Chronic Pain:An Updated Review of Opioid Abuse Predictors and Strategies to Curb Opioid Abuse (Part 2)", Pain Physician, 20(2s), pp.S111~S133 (2017)
  21. Butler SF, "Validation of a screener and opioid assessment measure for patients with chronic pain", Pain, 112(1-2), pp.65~75 (2004)
  22. Webster LR, "Predicting aberrant behaviors in opioid-treated patients : preliminary validation of the Opioid Risk Tool", Pain Med, 6(6), pp.432~442 (2005)
  23. Passik SD, "Aberrant drug-related behavior observed during clinical studies involving patients taking chronic opioid therapy for persistent pain and fentanyl buccal tablet for breakthrough pain", J Pain Symptom Manage, 41(1), pp.116~125 (2011)
  24. Edlund MJ, "Risk factors for clinically recognized opioid abuse and dependence among veterans using opioids for chronic non-cancer pain", Pain, 129(3), pp.355~362 (2007)
  25. Basu D, "Use of Family CAGE-AID questionnaire to screen the family members for diagnosis of substance dependence", Indian J Med Res, 143(6), pp.722~730 (2016)

관련 논문AI추천

Initial titration with 200 μg fentanyl buccal tablets: a retrospective safety analysis in Korean cancer patientsDong-Hoe Koo, Ha-Na Cho, Mi-Young Kwon, Seung‑Sei Lee, Sukjoong Oh, Yun‑Gyoo Lee대한내과학회 · The Korean Journal of Internal Medicine2018 · 제33권 제3호A Prospective, Single-Cohort, Open, Multi-center, Observational Study of Sublingual Fentanyl for Breakthrough Cancer Pain: Effectiveness, Safety, and Tolerability in Korean Cancer Patients고수진, 김세형, 배상병, 배우균, 송은기, 신성훈, 안진석, 양예원, 오소연, 오호석, 이민영, 이평복, 조윤영, 최윤선대한암학회 · Cancer Research and Treatment2025 · 제57권 제4호Effect of Dose Escalation with Single Opioid, Fentanyl Matrix in Patients Not Controlling Cancer Pain: A Multicenter, Prospective, Observational Study in Korea고성애, 김미정, 남승현, 류헌모, 박승우, 이경희, 이규택대한암학회 · Cancer Research and Treatment2013 · 제45권 제4호Comparison of Fentanyl-Based Rapid Onset Opioids for the Relief of Breakthrough Cancer Pain: Drug Price Based on Effect Size김성출, 김은영, 박지나, 백진솔, 윤여진, 정하연, 홍정화한국임상약학회 · 한국임상약학회지2023 · 제33권 제1호마약류 진통제 안전관리 방안 마련을 위한 설문연구김정보, 박소영, 박송희, 손현아, 안숙희, 오상현, 은명온, 이수빈, 이영희, 이정화, 임양순, 정지은, 천승현, 최서용, 한혜원한국병원약사회 · 병원약사회지2023 · 제40권 제3호A Korean Nationwide Survey for Breakthrough Cancer Pain in an Inpatient Setting강석윤, 김도연, 김영성, 백선경, 심선진, 이준영대한암학회 · Cancer Research and Treatment2016 · 제48권 제2호

이 간행물의 다른 논문 (6건)