Clinical characteristics and economic costs of patients with painful neuropathic disorders
Clinical characteristics and economic costs of patients with painful neuropathic disorders
复制标题
DOI：
10.1016/j.jpain.2003.12.004
复制
发表时间：
2004-04-01
期刊：
影响因子：
4
通讯作者：
Oster, G
中科院分区：
文献类型：
--
作者：
Berger, A;Dukes, EM;Oster, G
使用一个大型的美国健康保险索赔数据库，我们确定了所有的人年龄在18岁或以上的2个或更多的医疗遭遇在2000年的痛苦神经性疾病（PND）。我们还确定了一组年龄和性别匹配的无PND患者（匹配的对照组）。然后，我们比较了PND患者与匹配的对照组的临床特征和经济成本。研究数据库中共有55，686例PND患者。最常见的PND是背部和颈部疼痛伴神经病变（62.3%的PND患者）、头痛（12.1%）和糖尿病神经病变（10.8%）。与匹配的对照受试者相比，PND患者更可能患有其他疼痛相关疾病，包括纤维肌痛（对照受试者为6.0% vs 0.6%），骨关节炎（13.6% vs 3.6%）和其他慢性合并症，如冠心病（13.6% vs 6.5%）和抑郁症（6.4% vs 2.3%）。PND患者2000年的总医疗费用比对照组高3倍（分别为17，355美元和5，715美元）。我们的研究结果表明，PND患者的健康状况普遍较差，有较高的医疗保健费用比他们的同龄人没有这些conditions.Perspective：使用非甾体类抗炎药和阿片类药物是广泛的PND患者，而相对较少的抗癫痫药物和三环类抗抑郁药，这两种药物往往是更有效地对抗神经性疼痛。我们的研究提出了关于PND治疗在临床实践中的最佳性的问题。(C)2004年，美国疼痛协会。
Using a large US health insurance claims database, we identified all persons aged 18 years or older with 2 or more medical encounters in calendar year 2000 for painful neuropathic disorders (PNDs). We also identified an age- and gender-matched group of patients without PNDs (matched control subjects). We then compared the clinical characteristics and economic costs of PND patients with those of matched control subjects. There were a total of 55,686 patients with PNDs in the study database. The most frequently noted PNDs were back and neck pain with neuropathic involvement (62.3% of PND patients), causalgia (12.1%), and diabetic neuropathy (10.8%). In comparison with matched control subjects, PND patients were more likely to have other pain-related conditions, including fibromyalgia (6.0% vs 0.6% for control subjects), osteoarthritis (13.6% vs 3.6%), and other chronic comorbidities, such as coronary heart disease (13.6% vs 6.5%) and depression (6.4% vs 2.3%). Total calendar year 2000 health care charges were 3-fold higher for PND patients than matched control subjects ($17,355 vs $5,715, respectively). Our results suggest that patients with PNDs are generally in poorer health and have higher health care costs than their peers without these conditions.Perspective: Use of nonsteroidal anti-inflammatory agents and opioids was widespread in patients with PNDs, while relatively few received antiepileptic drugs and tricyclic antidepressants, both of which are often more effective against neuropathic pain. Our study raises questions about the optimality of PND treatment in clinical practice. (C) 2004 by the American Pain Society.