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纤维肌痛综合征:在门诊医疗保健中外用药物和非药物干预的流行情况。法定健康保险数据的分析。

Fibromyalgia syndrome: prevalence, pharmacological and non-pharmacological interventions in outpatient health care. An analysis of statutory health insurance data.

机构信息

Health Policy and Outcomes Research, Division Health Economics, Centre for Social Policy Research, University of Bremen, Außer der Schleifmühle 35-37, 28203 Bremen, Germany.

出版信息

Joint Bone Spine. 2011 Jan;78(1):80-4. doi: 10.1016/j.jbspin.2010.05.003. Epub 2010 Jul 31.

Abstract

OBJECTIVE

Fibromyalgia syndrome (FMS) is a chronic pain condition impacting on quality of life, causing physical and psychological impairment resulting in limited participation in professional and social life. The objective of this study was to assess the prevalence, recommended pharmacological and non-pharmacological interventions of FMS, patients' characteristics and to compare findings to current research.

METHODS

About 1.6 Mio patients of a German statutory health insurance company (GEK) in 2007 were analyzed for: (a) the prevalence of FMS (ICD-10: M79.7); (b) and comorbid depression (ICD-10: F32/33); (c) the recommended pharmacological and non-pharmacological intervention rates; (d) and characteristics of patients associated with being prescribed recommended interventions.

RESULTS

The (a) standardized prevalence of FMS in 2007 was 0.05% in men and 0.4% in women. (b) 51.9% of the patients with prevalent FMS had a comorbid depression in 2007 (88.2% female). (c) 66% of FMS patients received the recommended pharmacological treatment, 59% physical therapy, 6.1% cognitive-behavioural therapy and 3.4% a combination of these (multi-component therapy, MCT). (d) One year increase in age was associated with a 3% decrease in the predicted odds of receiving MCT (95%, CI 0.95-0.99).

CONCLUSION

The current data indicate an FMS-prevalence that differs from epidemiological surveys and screenings, probably due to methodological differences. Especially females with comorbid depression are affected. The likelihood of receiving MCT is not associated with gender, but with younger age. Yet, the findings seem to indicate insufficient and inadequate treatment, but FMS warrants more research.

摘要

目的

纤维肌痛综合征(FMS)是一种影响生活质量的慢性疼痛疾病,导致身体和心理功能障碍,从而限制了患者参与专业和社会生活的能力。本研究的目的是评估 FMS 的患病率、推荐的药物和非药物干预措施、患者特征,并将研究结果与当前研究进行比较。

方法

对 2007 年德国法定健康保险公司(GEK)的约 160 万名患者进行了以下分析:(a)FMS 的患病率(ICD-10:M79.7);(b)共患抑郁症(ICD-10:F32/33);(c)推荐的药物和非药物干预措施的使用率;(d)与接受推荐干预措施相关的患者特征。

结果

(a)2007 年 FMS 的标准化患病率为男性 0.05%,女性 0.4%。(b)2007 年,患有 FMS 的患者中 51.9%患有共患抑郁症(88.2%为女性)。(c)66%的 FMS 患者接受了推荐的药物治疗,59%接受了物理治疗,6.1%接受了认知行为治疗,3.4%接受了这些治疗的组合(多组分治疗,MCT)。(d)年龄增加 1 年,接受 MCT 的预测几率降低 3%(95%置信区间 0.95-0.99)。

结论

目前的数据表明,FMS 的患病率与流行病学调查和筛查结果不同,这可能是由于方法学上的差异。特别是患有共患抑郁症的女性受到影响。接受 MCT 的可能性与性别无关,而与年龄有关。然而,这些发现似乎表明治疗不足且不充分,但 FMS 需要更多的研究。

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