Chronic Pain Treatment and Health Service Utilization of Veterans with Hepatitis C Virus Infection
Chronic Pain Treatment and Health Service Utilization of Veterans with Hepatitis C Virus Infection
复制标题
DOI：
10.1111/j.1526-4637.2012.01476.x
复制
发表时间：
2012-11-01
期刊：
影响因子：
3.1
通讯作者：
Morasco, Benjamin J.
中科院分区：
文献类型：
--
作者：
Lovejoy, Travis I.;Dobscha, Steven K.;Morasco, Benjamin J.
目标.据估计，丙型肝炎病毒（HCV）感染影响2%的美国普通人群，慢性疼痛是HCV感染者的常见并发症。本研究的主要目的是比较美国退伍军人的卫生服务利用率与丙型肝炎病毒的存在和不存在共病慢性疼痛。设计回顾性审查患者病历的横断面研究。患者通过美国退伍军人管理局医院招募的171名确诊为HCV的美国退伍军人。结果衡量标准。从参与者的电子病历中提取了过去5年的医疗服务利用数据。结果64%的HCV退伍军人（N = 110）患有慢性疼痛。患有HCV和慢性疼痛的退伍军人利用更多的卫生服务，包括住院总人数（比值比[OR] = 2.58 [1.46，4.56]）和住院接受精神科服务的天数（OR = 5.50 [3.37，8.99]），在对人口统计学、精神病学、物质使用、医学合并症进行统计学调整后，和残疾协变量。此外，患有HCV和慢性疼痛的患者接受初级保健提供者（OR = 1.73 [1.15，2.59]）、物理治疗师（OR = 9.57 [4.79，19.11]）和职业治疗师（OR = 2.72 [1.00，7.48]）的总门诊就诊次数更多。结论.患有HCV和慢性疼痛的患者比患有HCV但没有慢性疼痛的患者在更大程度上利用医疗服务。未来的研究，检查药物和非药物疼痛治疗的疗效与共病HCV和慢性疼痛的患者似乎是必要的。
Objectives. Hepatitis C virus (HCV) infection is estimated to affect 2% of the general U.S. population and chronic pain is a common comorbidity among persons with HCV. The primary purpose of this study was to compare health service utilization of U.S. military veterans with HCV with and without the presence of comorbid chronic pain. Design. Cross-sectional study with retrospective review of patient medical records. Patients. One hundred seventy-one U.S. military veterans with confirmed HCV, recruited through a single U.S. Veterans Administration hospital. Outcome Measures. Medical service utilization data from the past 5 years were extracted from participants' electronic medical records. Results. Sixty-four percent of veterans with HCV (N = 110) had chronic pain. Veterans with HCV and chronic pain utilized more health services including total inpatient stays (odds ratio [OR] = 2.58 [1.46, 4.56]) and days hospitalized for psychiatric services (OR = 5.50 [3.37, 8.99]), compared to participants with HCV and no chronic pain, after statistically adjusting for demographic, psychiatric, substance use, medical comorbidity, and disability covariates. In addition, those with HCV and chronic pain had more total outpatient visits with primary care providers (OR = 1.73 [1.15, 2.59]), physical therapists (OR = 9.57 [4.79, 19.11]), and occupational therapists (OR = 2.72 [1.00, 7.48]). Conclusions. Patients with HCV and chronic pain utilize medical services to a greater extent than patients with HCV but no chronic pain. Future studies that examine the efficacy of both pharmacological and nonpharmacological pain treatment for patients with comorbid HCV and chronic pain appear warranted.