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全科医疗中疼痛的患病率。

Prevalence of pain in general practice.

作者信息

Hasselström Jan, Liu-Palmgren Jenny, Rasjö-Wrååk Görel

机构信息

Department of Clinical Sciences, Family Medicine Stockholm, Karolinska Institutet, Stockholm, Sweden.

出版信息

Eur J Pain. 2002;6(5):375-85. doi: 10.1016/s1090-3801(02)00025-3.

Abstract

OBJECTIVE

The aim of this study is to estimate the prevalence and diagnostic pattern of pain at the primary care level during one year in a group practice. This practice serves the patients of a geographically defined area with approximately 14,000 inhabitants.

DESIGN

Retrospective analysis of all computerised records of a GP group practice during one year, using a combined computerised search technique and manual check-up.

SETTING

Tumba Primary Care District, Stockholm County, Sweden.

SUBJECTS

All records of patients who visited Tumba primary care practice during one year.

MAIN OUTCOME MEASURES

Pain diagnoses, pain duration, analgesic use, pain category, and referrals.

RESULTS

Little less than 30% of the patients, who were treated at a primary care practice, had some kind of medically defined pain problem, requiring the attention of a GP. A little less than half of these patients received a prescription for analgesic drugs. The pain diagnoses at a primary care level showed a predominance of musculoskeletal pain. The patients with pain were much older than population and total practice patients. Among the patients, 37% were in a state of acute pain, 37% suffered from chronic pain, 13% had an intermediate pain duration of 1-3 months, and 11% had a chronic intermittent pain condition (predominantly migraine).

CONCLUSIONS

Painful states of the musculoskeletal system constitute more than 2/3 of painful states in primary care. Viewed from a primary care perspective, pain has a great impact on GPs' day-to-day activities and on health economy in general.

摘要

目的

本研究旨在评估在一年时间里,一个联合诊所初级保健层面疼痛的患病率及诊断模式。该诊所为一个地理区域内约14000名居民的患者提供服务。

设计

采用计算机搜索技术与人工检查相结合的方法,对一家全科医生联合诊所在一年中的所有计算机记录进行回顾性分析。

地点

瑞典斯德哥尔摩郡通巴初级保健区。

研究对象

在一年中前往通巴初级保健诊所就诊的所有患者记录。

主要观察指标

疼痛诊断、疼痛持续时间、镇痛药使用情况、疼痛类别及转诊情况。

结果

在初级保健诊所接受治疗的患者中,略少于30%存在某种医学定义的疼痛问题,需要全科医生关注。其中略少于一半的患者接受了镇痛药处方。初级保健层面的疼痛诊断显示肌肉骨骼疼痛占主导。疼痛患者比总体人群和诊所所有患者的年龄都大得多。患者中,37%处于急性疼痛状态,37%患有慢性疼痛,13%的疼痛持续时间为1至3个月,属于中期疼痛,11%患有慢性间歇性疼痛(主要是偏头痛)。

结论

肌肉骨骼系统的疼痛状态在初级保健中占疼痛状态的2/3以上。从初级保健角度来看,疼痛对全科医生的日常活动以及总体卫生经济都有很大影响。

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