Section of Acute Pain Management and Palliative Medicine, Rigshospitalet, University of Southern Denmark, Copenhagen, Denmark.
Clin J Pain. 2010 Nov-Dec;26(9):763-9. doi: 10.1097/AJP.0b013e3181f15daf.
The aims of this study were 2-fold: (1) to investigate the consequences of opioid use in individuals with chronic pain in the Danish population, and (2) to investigate the development of and recovery from chronic pain from 2000 to 2005.
Data derived from the Danish Health Interview Survey in 2000, which were linked on the individual level with register-based follow-up data. The survey was based on a county-stratified random sample of 16,684 individuals, out of which 10,434 individuals (62.5%) completed a face-to-face interview and returned a self-administered questionnaire. In addition, a subsample of the sample in 2000 was reinvited to a follow-up survey in 2005. In total, 3649 individuals (61.7%) of this subsample completed the interview and returned the questionnaire at baseline in 2000. At follow-up, 2354 of these participants completed the interview and returned the self-administered questionnaire. Respondents with cancer diagnosis were excluded from all analyses. Respondents with chronic pain were identified as having chronic/long-lasting pain more than 6 months.
The annual incidence for the development of and the recovery from chronic pain was 2.7% and 9.4%, respectively. Increasing age up to 64 years, short education, poor self-rated health, high body mass index, and physical strain at work were predictors of chronic pain. The odds of recovery from chronic pain were almost 4 times higher among individuals not using opioids compared with individuals using opioids. In addition, use of strong opioids was associated with poor health-related quality of life. Furthermore, the results indicated that individuals with chronic pain using strong opioids pain had a higher risk of death than individuals without chronic pain (HR: 1.67; 95% CI: 1.03-2.70). However, this study cannot exclude disease severity as the primary cause of increased mortality.
本研究旨在从以下两个方面对丹麦人群慢性疼痛患者使用阿片类药物的后果进行探讨：（1）研究慢性疼痛患者使用阿片类药物的后果；（2）从 2000 年至 2005 年，调查慢性疼痛的发生和康复情况。
本研究的数据来源于丹麦健康访谈调查（2000 年），该调查基于县分层随机样本，共抽取了 16684 名个体，其中 10434 人（62.5%）完成了面对面访谈，并提交了自我管理问卷。此外，该样本的子样本还邀请参加了 2005 年的随访调查。该子样本共有 3649 人（61.7%）完成了 2000 年的访谈和问卷调查。在随访中，其中 2354 人完成了访谈和问卷调查。所有分析均排除了癌症诊断患者。慢性疼痛患者被定义为患有持续/长期疼痛超过 6 个月的患者。
慢性疼痛的发生和康复的年发生率分别为 2.7%和 9.4%。年龄在 64 岁以下、受教育程度低、自我健康评价差、体重指数高、工作中身体劳损是慢性疼痛的预测因素。与使用阿片类药物的患者相比，不使用阿片类药物的患者从慢性疼痛中康复的几率几乎高出 4 倍。此外，使用强阿片类药物与较差的健康相关生活质量相关。此外，结果表明，使用强阿片类药物治疗慢性疼痛的患者比没有慢性疼痛的患者死亡风险更高（HR：1.67；95%CI：1.03-2.70）。然而，本研究不能排除疾病严重程度是导致死亡率增加的主要原因。
