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头痛管理中处方药使用的模式及预测因素:2000年医疗支出小组调查结果

Patterns and predictors of prescription medication use in the management of headache: findings from the 2000 Medical Expenditure Panel Survey.

作者信息

Devine Joshua W, Farley Joel F, Hadsall Ronald S

机构信息

Social and Administrative Graduate Program, College of Pharmacy, University of Minnesota, MN 55455, USA.

出版信息

Headache. 2005 Oct;45(9):1171-80. doi: 10.1111/j.1526-4610.2005.00240.x.

Abstract

OBJECTIVE

The primary objectives were to examine national trends of prescription medication use for headache and explore patterns of variation in the use of these medications across social and demographic levels.

BACKGROUND

Despite widespread use of prescription medication for management of headache, little is known about utilization patterns or patient characteristics associated with receiving this type of treatment.

METHODS

This study conducted a secondary analysis of data obtained during the 2000 Medical Expenditure Panel Survey, a representative survey of the U.S. noninstitutionalized population. Weighted descriptive statistics and logistic regression models were used to evaluate patterns and rates of overall prescription medication use in patients reporting headache as a household condition.

RESULTS

An estimated 9.7 million people 18 years or older reported suffering from headache in 2000. Of these, 46% reported using at least one medication for the treatment of headache. Migraine-specific abortive medication (ie, selective serotonin receptor agonists and ergotamine derivatives) was the most frequently reported medication class, used by 36% of participants. Opiate analgesics and butalbital-containing products also experienced extensive prescribing reported by 22% and 17% of survey respondents, respectively. After adjustment for covariates, wide variation in the use of prescription medication was observed across sociodemographic characteristics including age, ethnicity, and insurance status.

CONCLUSION

The observed variation in prescription medication use by drug class and sociodemographic characteristics suggests strategies are needed for improving current prescribing patterns in this patient population.

摘要

目的

主要目的是研究全国范围内用于治疗头痛的处方药使用趋势,并探讨这些药物在社会和人口层面的使用变化模式。

背景

尽管处方药广泛用于头痛治疗,但对于接受此类治疗的使用模式或患者特征知之甚少。

方法

本研究对2000年医疗支出小组调查期间获得的数据进行了二次分析,该调查是对美国非机构化人口的代表性调查。使用加权描述性统计和逻辑回归模型来评估报告头痛为家庭疾病的患者总体处方药使用模式和比率。

结果

估计2000年有970万18岁及以上的人报告患有头痛。其中,46%的人报告使用至少一种药物治疗头痛。偏头痛特异性终止药物(即选择性5-羟色胺受体激动剂和麦角胺衍生物)是最常报告的药物类别,36%的参与者使用。阿片类镇痛药和含布他比妥的产品也有大量处方,分别有22%和17%的调查受访者报告使用。在对协变量进行调整后,观察到在年龄、种族和保险状况等社会人口特征方面,处方药使用存在很大差异。

结论

观察到的按药物类别和社会人口特征划分的处方药使用差异表明,需要采取策略来改善该患者群体目前的处方模式。

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