日本慢性疼痛的社会负担：一项网络调查。

The societal burden of chronic pain in Japan: an internet survey.

作者信息

Takura Tomoyuki, Ushida Takahiro, Kanchiku Tsukasa, Ebata Nozomi, Fujii Koichi, DiBonaventura Marco daCosta, Taguchi Toshihiko

机构信息

Department of Health Economics and Industrial Policy, Osaka University Graduate School of Medicine, Osaka, Japan.

出版信息

J Orthop Sci. 2015 Jul;20(4):750-60. doi: 10.1007/s00776-015-0730-8. Epub 2015 May 12.

DOI:10.1007/s00776-015-0730-8

PMID:25963609

Abstract

OBJECTIVES

Chronic pain affects between 10-20 % of the population of Japan and several specific types of chronic pain have been found to be associated with worse health outcomes. The aim of the current study was to investigate the economic burden of chronic pain as well as the health status among Japanese patients.

METHODS

Data from the Japan National Health and Wellness Survey (NHWS), a cross-sectional health survey of adults, were used (N = 30,000). Respondents with chronic pain (N = 785) were compared with respondents without chronic pain (N = 29,215) with respect to health status (using the SF-12v2), work productivity and activity impairment (WPAI questionnaire), and healthcare resource use using regression modeling, controlling for demographic and health history covariates. Indirect costs were calculated using wage rates and the human capital method.

RESULTS

Back pain (72.10 %) and shoulder pain/stiffness (54.90 %) were the most prevalent pain types. Adjusting for demographic and health history differences, respondents with chronic pain reported lower health status [mental component summary (MCS): 44.26 vs. 51.14; physical component summary (PCS): 44.23 vs. 47.48; both p < 0.05], greater absenteeism (4.74 vs. 2.74 %), presenteeism (30.19 vs. 15.19 %), overall work impairment (31.70 vs. 16.82 %), indirect costs (¥ 1488,385 vs. ¥ 804,634), activity impairment (33.45 vs. 17.25 %), physician visits (9.31 vs. 4.08), emergency room (ER) visits (0.19 vs. 0.08), and hospitalizations (0.71 vs. 0.34) (all p < 0.05). Nearly 60 % of respondents with chronic pain were untreated. The mean level of pain severity in the last week was 5.26 (using a 0-11 scale); being female, being elderly, having low income, and having multiple pain types were significantly associated with greater pain severity (all p < 0.05). Regular exercise was associated with lower pain severity (p < 0.05).

CONCLUSIONS

The results suggest that chronic pain has a significant association in an individual's health status, work productivity, daily activity impairment, healthcare resource use, and economic burden in Japan. Along with low treatment rates, a multidisciplinary approach may lead to an improved quality of life and reduce the economic burden among patients with chronic pain in Japan.

摘要

目的

慢性疼痛影响着10%-20%的日本人口，并且已发现几种特定类型的慢性疼痛与更差的健康结果相关。本研究的目的是调查日本患者中慢性疼痛的经济负担以及健康状况。

方法

使用来自日本国民健康与福祉调查（NHWS）的数据，这是一项针对成年人的横断面健康调查（N = 30,000）。将患有慢性疼痛的受访者（N = 785）与无慢性疼痛的受访者（N = 29,215）在健康状况（使用SF-12v2）、工作生产力和活动障碍（WPAI问卷）以及医疗资源使用方面进行比较，采用回归模型，并控制人口统计学和健康史协变量。间接成本使用工资率和人力资本法进行计算。

结果

背痛（72.10%）和肩痛/僵硬（54.90%）是最常见的疼痛类型。在调整人口统计学和健康史差异后，患有慢性疼痛的受访者报告的健康状况较差[心理成分总结（MCS）：44.26对51.14；身体成分总结（PCS）：44.23对47.48；两者p < 0.05]，旷工率更高（4.74%对2.74%），出勤主义（30.19%对15.19%），总体工作障碍（31.70%对16.82%），间接成本（1,488,385日元对804,634日元），活动障碍（33.45%对17.25%），看医生次数（9.31次对4.08次），急诊室就诊次数（0.19次对0.08次）以及住院次数（0.71次对0.34次）（所有p < 0.05）。近60%的慢性疼痛受访者未接受治疗。上周疼痛严重程度的平均水平为5.26（使用0-11量表）；女性、老年人、低收入以及多种疼痛类型与更高的疼痛严重程度显著相关（所有p < 0.05）。经常锻炼与较低的疼痛严重程度相关（p < 0.05）。