Avalon Health Solutions, Inc., Philadelphia, PA 19102, USA.
Spinal Cord. 2013 Feb;51(2):126-33. doi: 10.1038/sc.2012.97. Epub 2012 Sep 4.
Retrospective database analysis.
To describe comorbidities, pain-related pharmacotherapy, healthcare resource use and costs among patients with spinal cord injury (SCI) newly prescribed pregabalin.
United Kingdom (UK).
Using The Health Improvement Network database, SCI patients newly prescribed (index event) pregabalin (N=72; average age 48 years; 53% female) were selected. Study measures were evaluated during both the 9-months pre-index and follow-up periods.
Prevalent comorbidities included musculoskeletal disorders (51.4%), digestive disorders (23.6%) and urogenital disorders (20.8%). Opioids were the most frequently prescribed medications (pre-index, 58.3%; follow-up, 61.1%, P=not significant (NS)) followed by nonsteroidal anti-inflammatory drugs (43.1 and 45.8%, P=NS). Use of anti-epileptics (other than pregabalin) recommended for SCI neuropathic pain decreased (25.0 vs 12.5%, P=0.0290), whereas sedative/hypnotic use (18.1 vs 26.4%, P=0.034) increased during follow-up. Over 50% of patients had visits to specialists, and at least 1 in every 10 had laboratory/radiology-related visits. There were numerical decreases in proportions of patients with emergency room visits (22.2 vs 13.9%, P=NS) and hospitalizations (16.7 vs 12.5%, P=NS) during follow-up. Medication costs were higher during follow-up (median, £ 561.4 vs £ 889.5, P<0.0001). Costs of outpatient visits were similar during both study periods (£ 1082.1 vs £ 1066.1) as were total medical costs (£ 1689.0 vs £ 2169.4) when costs of pregabalin prescriptions were excluded. Inclusion of pregabalin costs resulted in higher (P<0.0001) total medical costs during follow-up.
SCI patients had a high comorbidity, medication and healthcare resource use burden in clinical practice. Further research with larger sample sizes and more comprehensive data sources may serve to clarify study findings.
回顾性数据库分析。
描述新处方普瑞巴林的脊髓损伤（SCI）患者的合并症、与疼痛相关的药物治疗、医疗资源利用和成本。
英国（UK）。
使用健康改善网络数据库，选择新处方（索引事件）普瑞巴林（N=72；平均年龄 48 岁；53%为女性）的 SCI 患者。在索引前和随访期间评估研究措施。
常见合并症包括肌肉骨骼疾病（51.4%）、消化系统疾病（23.6%）和泌尿生殖系统疾病（20.8%）。阿片类药物是最常开的药物（索引前，58.3%；随访，61.1%，P=无显著差异（NS）），其次是非甾体抗炎药（43.1%和 45.8%，P=NS）。用于 SCI 神经性疼痛的抗癫痫药（除普瑞巴林外）的使用减少（25.0%比 12.5%，P=0.0290），而镇静/催眠药的使用增加（18.1%比 26.4%，P=0.034）。超过 50%的患者就诊于专科医生，每 10 名患者中至少有 1 名就诊于实验室/放射科。随访期间，急诊就诊和住院的患者比例呈数值下降（22.2%比 13.9%，P=无显著差异（NS））和（16.7%比 12.5%，P=无显著差异（NS））。随访期间药物治疗费用较高（中位数，£561.4 比 £889.5，P<0.0001）。在两个研究期间，门诊就诊费用相似（£1082.1 比 £1066.1），当不包括普瑞巴林处方费用时，总医疗费用相似（£1689.0 比 £2169.4）。纳入普瑞巴林费用后，随访期间的总医疗费用更高（P<0.0001）。
SCI 患者在临床实践中有很高的合并症、药物和医疗资源利用负担。进一步的研究需要更大的样本量和更全面的数据来源，以阐明研究结果。
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