肌肉骨骼疼痛：2004-2008 年瑞典初级保健医生开具的 NSAID 和弱阿片类药物处方 - 回顾性患者病历审查。
Musculoskeletal pain: prescription of NSAID and weak opioid by primary health care physicians in Sweden 2004-2008 - a retrospective patient record review.
机构信息
Department of Anaesthesia, Institute for Clinical Sciences at Sahlgrenska Academy, Mölndal Hospital, Gothenburg, Sweden;
出版信息
J Pain Res. 2010 Aug 4;3:131-5. doi: 10.2147/jpr.s12052.
PURPOSE
To study the prescription of oral analgesics for musculoskeletal pain by primary care physicians over a 5-year period in Sweden.
DESIGN
A retrospective automatic database review of patient records at four primary health care centers. All prescriptions of NSAIDs, weak opioids, and coprescriptions of gastroprotecting medications to patients with musculoskeletal were retrieved for the period January 1, 2004 to November 11, 2008.
RESULTS
A total of 27,067 prescriptions prescribed to 23,457 patients with musculoskeletal pain were analyzed. Of all prescriptions, NSAIDs were the most commonly prescribed analgesic comprising 79%, tramadol was the second most commonly prescribed analgesic comprising 9%, codeine the third most (7%), and dextropropoxyphene the fourth (5%). The proportion of NSAIDs and weak opioids and the proportion of the different weak opioids prescribed showed no change over time. The proportion of nonselective and selective NSAIDs prescribed changed; Coxib prescriptions decreased from 9% to 4% of all analgesics prescribed in 2004-2007 with no change in 2008.
CONCLUSION
NSAIDs were found to be the dominant class of analgesic prescribed by primary care physicians to patients diagnosed as musculoskeletal pain. No change was observed in the proportion of NSAID and weak opioid prescription over the period studied. Prescription of selective Coxibs decreased and was less than 4% in 2008. The impact on gastrointestinal and cardiovascular adverse effects associated with the extensive prescription of NSAIDS for musculoskeletal pain warrants further analysis.
目的
研究瑞典基层医疗保健医生在 5 年内对肌肉骨骼疼痛开具口服止痛药的处方情况。
设计
对四家初级保健中心的患者记录进行回顾性自动数据库审查。检索了 2004 年 1 月 1 日至 2008 年 11 月 11 日期间所有开具给肌肉骨骼疼痛患者的非甾体抗炎药、弱阿片类药物和胃保护药物的处方。
结果
共分析了 23457 名肌肉骨骼疼痛患者的 27067 份处方。在所有处方中，非甾体抗炎药是最常用的镇痛药，占 79%；曲马多是第二常用的镇痛药，占 9%；可待因是第三常用的镇痛药，占 7%；右旋丙氧芬是第四常用的镇痛药，占 5%。非甾体抗炎药和弱阿片类药物的比例以及所开弱阿片类药物的比例在不同时间没有变化。所开非选择性和选择性非甾体抗炎药的比例发生了变化；2004-2007 年，环氧化酶-2 抑制剂（Coxib）处方从所有镇痛药处方的 9%降至 4%，2008 年无变化。
结论
非甾体抗炎药被发现是基层医疗保健医生为诊断为肌肉骨骼疼痛的患者开具的主要类别的镇痛药。在所研究的时间段内，非甾体抗炎药和弱阿片类药物的处方比例没有变化。选择性 Coxib 的处方减少，2008 年低于 4%。广泛开具非甾体抗炎药治疗肌肉骨骼疼痛与胃肠道和心血管不良事件相关，值得进一步分析。
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