Luo Xuemei, Pietrobon Ricardo, Curtis Lesley H, Hey Lloyd A
Center for Clinical Effectiveness, Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27710, USA.
Spine (Phila Pa 1976). 2004 Dec 1;29(23):E531-7. doi: 10.1097/01.brs.0000146453.76528.7c.
Secondary analysis of the 2000 Medical Expenditure Panel Survey (MEPS). OBJECTIVE.: To examine national prescription patterns of nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants among individuals with back pain in the United States.
There is a lack of information on national prescription patterns of NSAIDs and muscle relaxants among individuals with back pain in the United States.
Traditional NSAIDs, cyclooxygenase-2-specific (COX-2) inhibitors, and muscle relaxants were investigated. Individuals with back pain were stratified by socio-demographic characteristics and geographic regions. For each medication category, overall prescribing frequency was compared across different strata and individual drug prescription was analyzed.
Traditional NSAIDs, COX-2 inhibitors, and muscle relaxants, respectively, accounted for 16.3%, 10%, and 18.5% of total prescriptions for back pain in 2000. Among individual drugs, ibuprofen and naproxen accounted for most of the prescriptions for traditional NSAIDs (60%), whereas two thirds of the prescriptions for muscle relaxants were attributable to cyclobenzaprine, carisoprodol, and methocarbamol. Prescription of COX-2 inhibitors or muscle relaxants demonstrated wide variations across different regions. Several individual characteristics including age, race, and educational level were associated with the prescription of some of the medications.
Neither traditional NSAIDs, nor COX-2 inhibitors, nor muscle relaxants dominated prescriptions for back pain. However, a small number of individual drugs were attributable to most of the prescriptions for traditional NSAIDs or muscle relaxants. The prescription of some of the medications demonstrated wide variations across different regions or different racial and educational groups. More studies are needed to understand the source of the variations and what constitutes optimal prescribing.
对2000年医疗支出小组调查（MEPS）进行二次分析。
研究美国背痛患者使用非甾体抗炎药（NSAIDs）和肌肉松弛剂的全国处方模式。
美国缺乏关于背痛患者使用NSAIDs和肌肉松弛剂的全国处方模式的信息。
对传统NSAIDs、环氧化酶-2特异性（COX-2）抑制剂和肌肉松弛剂进行调查。背痛患者按社会人口统计学特征和地理区域分层。对于每种药物类别，比较不同分层的总体处方频率并分析个体药物处方情况。
2000年，传统NSAIDs、COX-2抑制剂和肌肉松弛剂分别占背痛总处方的16.3%、10%和18.5%。在个体药物中，布洛芬和萘普生占传统NSAIDs处方的大部分（60%），而肌肉松弛剂处方的三分之二归因于环苯扎林、卡立普多和美索巴莫。COX-2抑制剂或肌肉松弛剂的处方在不同地区差异很大。包括年龄、种族和教育水平在内的几个个体特征与某些药物的处方有关。
无论是传统NSAIDs、COX-2抑制剂还是肌肉松弛剂，都没有在背痛处方中占主导地位。然而，少数个体药物占传统NSAIDs或肌肉松弛剂处方的大部分。某些药物的处方在不同地区或不同种族和教育群体之间差异很大。需要更多研究来了解这些差异的来源以及什么构成最佳处方。
