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美国下背痛治疗方法的描述与比较

A Description and Comparison of Treatments for Low Back Pain in the United States.

作者信息

Salt Elizabeth, Gokun Yevgeniya, Rankin Kerr Anna, Talbert Jeffery

机构信息

Elizabeth Salt, PhD, APRN, College of Nursing, University of Kentucky, Lexington. Yevgeniya Gokun, MS, College of Nursing, University of Kentucky, Lexington. Anna Rankin Kerr, PhD, Department of Communication, University of Kentucky, Lexington. Jeffery Talbert, PhD, College of Pharmacy, University of Kentucky, Lexington.

出版信息

Orthop Nurs. 2016 Jul-Aug;35(4):214-21. doi: 10.1097/NOR.0000000000000258.

Abstract

BACKGROUND/OBJECTIVES: Low back pain (LBP), a prevalent costly condition, has evidence-based pharmacological and nonpharmacological treatments. Because the prevalence of LBP and the use of opioids differ between the U.S. Census Regions, we compared the treatments used for LBP and their related costs between regions.

METHODS

Deidentified patient health claims data from persons with LBP along with treatments received were extracted from a large commercially insured data set (2007-2009; N = 1,630,438). Descriptive statistics and analyses of variance were used during data analysis.

RESULTS

An opioid was used by 49.8% (n = 812,479) of this sample, whereas nonpharmacological therapies were used less frequently (8%, psychological therapies; 19%, exercise therapies; 12%, physical therapy). The median costs for pharmacological and nonpharmacological treatments are variable. We found significant differences in the medications and therapies used in the U.S. Census Regions (p < .0001).

CONCLUSION

Overuse of pharmacological treatment and underuse of nonpharmacological treatment are common among persons with LBP. Differences exist in the receipt of various LBP treatments geographically.

摘要

背景/目的:腰痛(LBP)是一种普遍且成本高昂的病症,有循证药理学和非药理学治疗方法。由于美国人口普查区域之间LBP的患病率和阿片类药物的使用情况有所不同,我们比较了各区域用于治疗LBP的方法及其相关费用。

方法

从一个大型商业保险数据集(2007 - 2009年;N = 1,630,438)中提取了LBP患者的匿名化患者健康索赔数据以及所接受的治疗方法。数据分析过程中使用了描述性统计和方差分析。

结果

该样本中有49.8%(n = 812,479)的人使用了阿片类药物,而非药理学疗法的使用频率较低(心理疗法8%;运动疗法19%;物理疗法12%)。药理学和非药理学治疗的中位数费用各不相同。我们发现美国人口普查区域在用药和治疗方法上存在显著差异(p < .0001)。

结论

LBP患者中普遍存在过度使用药理学治疗和不足使用非药理学治疗的情况。不同地区在接受各种LBP治疗方面存在差异。

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