Rev. Soc. Esp. Dolor. 2021; 28(2): 82-91 / DOI: 10.20986/resed.2021.3845/2020
Valeria Villanueva, Juan Carlos Vélez, Ariel Castro
RESUMEN
Introducción: En algunos países el uso indebido de opioides está aumentando considerablemente, sin embargo en Chile no hay datos oficiales. El objetivo de este estudio fue identificar y describir a todos los pacientes en tratamiento por dolor crónico no oncológico (DCNO) con riesgo de uso indebido de opioides del Departamento de Rehabilitación del Hospital del Trabajador, Santiago de Chile, entre el 14 de agosto de 2018 y el 2 de febrero de 2020.
Material y métodos: Se realizó un estudio descriptivo transversal en 120 pacientes usuarios de opioides, con diagnóstico de DCNO. Se les aplicó una encuesta estructurada para caracterizarlos en base a datos demográficos, clínicos, uso indebido de opioides (COMM®) y calidad de vida relacionada con salud (SF 36 v.2).
Resultados: Se encontraron 35 pacientes (29,17 %) con riesgo de uso indebido de opioides. La mediana de edad fue de 50,7 años. El tiempo medio de consumo de opioides fue de 32,4 meses. El tramadol en asociación con paracetamol fue el opioide más utilizado. Se observó un mayor uso indebido, estadísticamente significativo, en los pacientes con diagnóstico de amputación (p = 0,026) y consumo de alcohol (p = 0,003). Además, el uso indebido se asoció de manera significativa con una menor puntuación en los dominios de rol físico (p = 0,0299), salud general (p = 0,0166), vitalidad (p = 0), salud mental (p = 0) y puntuación global de la escala SF 36 (p = 0,0003).
Conclusión: Nuestro estudio arrojó una prevalencia de un 29,1 % de riesgo de uso indebido de opioides, siendo esta similar a la encontrada en la literatura. Existe una relación entre uso indebido de opioides y consumo de alcohol, diagnóstico de amputación y una menor calidad de vida, lo que genera una mayor discapacidad en estos pacientes. Este es el primer informe en Chile al respecto.
ABSTRACT
Introduction: In some countries, the abuse of opioids is increasing considerably, however, in Chile there is no official data. The aim of this study was to identify and to describe all patients in treatment for chronic non-cancer pain (CNCP) at risk of opioid misuse within the Rehabilitation Department of Hospital del Trabajador, Santiago de Chile, from August 14, 2018 to February 02, 2020.
Material and methods: A descriptive cross-sectional study was carried out in 120 opioid users with a diagnosis of CNCP. A structured survey was applied to characterize them based on demographic, clinical data, opioid misuse (COMM®), and health-related quality of life (SF 36 v.2).
Results: We found 35 patients (29.17 %) with risk of opioid abuse. The median age was 50.7 years. The mean time of opioid consumption was 32.4 months. Tramadol in association with paracetamol was the most widely used opioid. Statistically significant increased misuse was observed in patients diagnosed with amputation (p-value = 0.026) and alcohol use (p-value = 0.003). Furthermore, misuse was significantly associated with a lower score in the domains of physical role (p-value = 0.0299), general health (p-value = 0.0166), vitality (p-value = 0), mental health (p-value = 0) and global score of the SF 36 scale (p-value = 0.0003).
Conclusion: Our study showed a 29,1 % prevalence of risk of opioid misuse, which is similar to that found in the literature. There is a relationship between opioid misuse and alcohol consumption, amputation diagnosis, and a lower quality of life, which generates greater disability in these patients. This is the first report in Chile.
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