Truven Health Analytics, Bethesda, MD.
Pain Med. 2014 Apr;15(4):562-76. doi: 10.1111/pme.12328. Epub 2014 Jan 16.
To describe the characteristics, treatment, and health care expenditures of Medicare Supplemental-insured patients with painful diabetic peripheral neuropathy (pDPN), post-herpetic neuralgia (PHN), or fibromyalgia.
Retrospective cohort study.
United States clinical practice, as reflected within a database comprising administrative claims from 2.3 million older adults participating in Medicare supplemental insurance programs.
Selected patients were aged ≥65 years, continuously enrolled in medical and prescription benefits throughout years 2008 and 2009, and had ≥1 medical claim with an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code for DPN, PHN, or fibromyalgia, followed within 60 days by a medication or pain intervention procedure used in treating pDPN, PHN, or fibromyalgia during 2008-2009.
Utilization of, and expenditures on, pain-related and all-cause pharmacotherapy and medical interventions in 2009.
The study included 25,716 patients with pDPN (mean age 75.2 years, 51.2% female), 4,712 patients with PHN (mean age 77.7 years, 63.9% female), and 25,246 patients with fibromyalgia (mean age 74.4 years, 73.0% female). Patients typically had numerous comorbidities, and many were treated with polypharmacy. Mean annual expenditures on total pain-related health care and total all-cause health care, respectively, (in 2010 USD) were: $1,632, $24,740 for pDPN; $1,403, $16,579 for PHN; and $1,635, $18,320 for fibromyalgia. In age-stratified analyses, pain-related health care expenditures decreased as age increased.
The numerous comorbidities, polypharmacy, and magnitude of expenditures in this sample of Medicare supplemental-insured patients with pDPN, PHN, or fibromyalgia underscore the complexity and importance of appropriate management of these chronic pain patients.
描述患有痛性糖尿病周围神经病变（pDPN）、带状疱疹后神经痛（PHN）或纤维肌痛的医疗保险补充保险患者的特征、治疗方法和医疗保健支出。
回顾性队列研究。
美国临床实践，反映在一个数据库中，该数据库包含来自 230 万参加医疗保险补充保险计划的老年人的行政索赔。
入选患者年龄≥65 岁，在 2008 年和 2009 年连续参加医疗和处方福利，并且在 2008 年至 2009 年期间有≥1 次与 DPN、PHN 或纤维肌痛相关的国际疾病分类，第九版，临床修正诊断代码的医疗索赔，随后在 60 天内，根据治疗 pDPN、PHN 或纤维肌痛的药物或疼痛干预程序，在 2009 年使用药物或疼痛干预程序。
2009 年疼痛相关和全因药物治疗和医疗干预的使用情况和支出情况。
该研究纳入了 25716 例 pDPN 患者（平均年龄 75.2 岁，51.2%为女性）、4712 例 PHN 患者（平均年龄 77.7 岁，63.9%为女性）和 25246 例纤维肌痛患者（平均年龄 74.4 岁，73.0%为女性）。患者通常有多种合并症，许多人接受了多种药物治疗。2010 年美元）的疼痛相关医疗保健总支出和全因医疗保健总支出的平均值分别为：pDPN 为 1632 美元，24740 美元；PHN 为 1403 美元，16579 美元；纤维肌痛为 1635 美元，18320 美元。在年龄分层分析中，随着年龄的增长，疼痛相关的医疗保健支出减少。
患有 pDPN、PHN 或纤维肌痛的医疗保险补充保险患者样本中存在大量合并症、多种药物治疗和支出，这突显了对这些慢性疼痛患者进行适当管理的复杂性和重要性。
