Prescription time trends in patients with high-impact chronic pain: A National Patient Registry Study.

IF 3.5 2区 医学 Q1 ANESTHESIOLOGY European Journal of Pain Pub Date : 2024-10-28 DOI:10.1002/ejp.4746
Karin D Bruun, Caroline T Thorarinsson, Henrik B Vaegter, Floor D Zegers, Bente M Nørgård, Mette Wod
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Abstract

Background: High-impact chronic pain (HICP), defined as chronic pain with a significant impact on daily function, affects approximately 8% of the Western population. In Denmark, HICP still remains to be described at the population level. Some patients with HICP are referred to the Danish pain centres, where they are registered with a procedural code. We conducted a nationwide registry-based study of all Danish patients registered with a visit to a pain centre from January 2005 to March 2022, to explore time trends in the prescription of analgesics and sedatives in this HICP subpopulation. Furthermore, data on socioeconomics and hospital diagnoses are reported.

Methods: We used data from the Central Person Registry, the Danish National Patient Registry, the Danish National Prescription Registry, combined with data on socioeconomic information from Statistics Denmark. Data was collected on prescriptions 3 months before the first visit to a pain centre. Prescriptions were stratified into five calendar periods: before 2011, 2011-2013, 2014-2016, 2017-2019, and 2020-2022.

Results: We identified 66,577 patients referred to a pain centre. Over 15 years, prescriptions before referral declined for opioids (from 53.2% to 31.7%), NSAIDs (from 28.3% to 23.5%), antidepressants (from 20.5% to 16.8%), anxiolytics (from 12.3% to 3.2%), and sleep medication (from 15.8% to 7.6%). In contrast, prescriptions increased for paracetamol (from 31.1% to 48.9%) and gabapentinoids (from 19.2% to 27.7%).

Conclusions: In patients with HICP visiting Danish pain centres, prescriptions before referral decreased for opioids over 15 years, with a simultaneously increased prescription of gabapentinoids (gabapentin and pregabalin).

Significance statement: This nationwide study of 66,577 Danish patients with high-impact chronic pain reveals a significant decrease in filled opioid prescriptions over the past 15 years, with a simultaneous rise in gabapentinoid use before referral to pain centres. These findings suggest a shift in clinical practice towards alternative pain management strategies. The study underscores the need for continued research into the long-term effects of these changes and their impact on patient outcomes.

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影响较大的慢性疼痛患者的处方时间趋势:全国患者登记研究。
背景:高影响慢性疼痛(HICP)是指对日常功能有重大影响的慢性疼痛,约占西方人口的 8%。在丹麦,HICP 仍未在人口层面上得到描述。一些 HICP 患者会被转诊到丹麦疼痛中心,并在那里进行程序代码登记。我们对 2005 年 1 月至 2022 年 3 月期间在疼痛中心登记就诊的所有丹麦患者进行了一项全国范围的登记研究,以探讨 HICP 亚群中镇痛剂和镇静剂处方的时间趋势。此外,我们还报告了有关社会经济学和医院诊断的数据:我们使用了来自中央人员登记处、丹麦全国患者登记处和丹麦全国处方登记处的数据,以及丹麦统计局提供的社会经济信息数据。我们收集了首次到疼痛中心就诊前 3 个月的处方数据。处方被分为五个日历期:2011 年前、2011-2013 年、2014-2016 年、2017-2019 年和 2020-2022 年:结果:我们确定了 66577 名转诊至疼痛中心的患者。15年间,转诊前阿片类药物(从53.2%降至31.7%)、非甾体抗炎药(从28.3%降至23.5%)、抗抑郁药(从20.5%降至16.8%)、抗焦虑药(从12.3%降至3.2%)和睡眠药物(从15.8%降至7.6%)的处方量均有所下降。相比之下,扑热息痛(从31.1%增至48.9%)和加巴喷丁类药物(从19.2%增至27.7%)的处方量有所增加:结论:在丹麦疼痛中心就诊的 HICP 患者中,阿片类药物在转诊前的处方量在 15 年内有所减少,而加巴喷丁类药物(加巴喷丁和普瑞巴林)的处方量同时有所增加:这项针对 66577 名丹麦高影响慢性疼痛患者的全国性研究显示,在过去 15 年中,阿片类药物的处方大幅减少,与此同时,在转诊至疼痛中心之前使用加巴喷丁类药物的情况有所增加。这些发现表明,临床实践正在向替代性疼痛管理策略转变。该研究强调,有必要继续研究这些变化的长期效果及其对患者预后的影响。
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来源期刊
European Journal of Pain
European Journal of Pain 医学-临床神经学
CiteScore
7.50
自引率
5.60%
发文量
163
审稿时长
4-8 weeks
期刊介绍: European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.
期刊最新文献
Chronic pain among primary fentanyl users: The concept of self-medication. Plasma neurofilament light chain in fibromyalgia: A case control study exploring correlation with clinical and cognitive features. Pain-related impairment in daily activities after lung cancer surgery: A 1-year prospective cohort study. Neural correlates of pain acceptance and the role of the cerebellum: Comment. Prescription time trends in patients with high-impact chronic pain: A National Patient Registry Study.
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