Department of Physical and Rehabilitation, Turku University Hospital, FI-20521 Turku, Finland.
J Rehabil Med. 2014 Mar;46(3):283-6. doi: 10.2340/16501977-1262.
To investigate whether an interdisciplinary rehabilitation for chronic musculoskeletal disorders is associated with changes in the purchase of prescribed pain medication.
Prospective register-based study.
Employees in the public sector (n = 4,365) who participated in the rehabilitation programme between 1996 and 2009.
The changes in annual purchases of prescribed pain medication were measured for a 9-year exposure window, starting from 4 years before the start date of rehabilitation and ending 5 years after this date.
Purchases of prescribed pain medication increased throughout the follow-up in all medication groups. The steepest increase was observed for analgesics, antidepressants, and hypnotics and sedatives. The growth rate of annual purchase, however, slowed significantly following the year of the start of rehabilitation for analgesics (annual growth rate (rate ratio) before and after rehabilitation 1.27 and 1.04, respectively, difference in trend p < 0.001); antidepressants (rate ratio 1.17 and 1.09, p = 0.005); and muscle relaxants (rate ratio 1.31 and 1.01, p < 0.001). For anxiolytics, and hypnotics and sedatives, no differences were observed in the trends of annual purchase before and after rehabilitation.
Rehabilitation was associated with a slowing increase in purchases of prescribed pain medication amongst rehabilitants. This may be a reflection of the positive effect that rehabilitation has on the need for pain medication.
研究跨学科康复治疗慢性肌肉骨骼疾病是否与处方止痛药购买量的变化有关。
前瞻性基于登记的研究。
1996 年至 2009 年期间参加康复计划的公共部门员工（n=4365）。
在 9 年的暴露窗口内测量每年购买处方止痛药的变化，从康复开始日期前 4 年开始，到该日期后 5 年结束。
在所有药物组中，在整个随访期间，处方止痛药的购买量都在增加。镇痛药、抗抑郁药和催眠镇静剂的增幅最大。然而，在康复开始后的那一年，年购买量的增长率显著放缓，镇痛药的年增长率（康复前后的比率比）分别为 1.27 和 1.04，趋势差异 p<0.001；抗抑郁药（比率比 1.17 和 1.09，p=0.005）；和肌肉松弛剂（比率比 1.31 和 1.01，p<0.001）。对于抗焦虑药和催眠镇静剂，康复前后的年度购买趋势没有差异。
康复与康复者处方止痛药购买量的增长放缓有关。这可能反映了康复对止痛药需求的积极影响。
