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多模式疼痛管理对腰椎神经根病患者社会经济因素和医疗保健利用的中期积极影响:一项前瞻性研究。

Positive medium-term influence of multimodal pain management on socioeconomic factors and health care utilization in patients with lumbar radiculopathy: a prospective study.

作者信息

Benditz Achim, Loher Martin, Boluki Daniel, Grifka Joachim, Völlner Florian, Renkawitz Tobias, Maderbacher Günther, Götz Jürgen

机构信息

Department of Orthopedics, University Medical Center Regensburg, Asklepios Klinikum Bad Abbach, Bad Abbach, Germany.

出版信息

J Pain Res. 2017 Feb 14;10:389-395. doi: 10.2147/JPR.S128090. eCollection 2017.

Abstract

BACKGROUND

Multimodal pain management (MPM) represents a central approach to avoiding surgery in patients with lumbar radiculopathy. Independent of the type of health system, cost effectiveness and socioeconomic factors are becoming increasingly important. This study investigated the medium-term influence of conservative MPM on health care utilization and socioeconomic factors.

METHODS

This study compared subjective, objective, and socioeconomic factors of 60 patients after inpatient MPM because of lumbar radiculopathy, before and 1 year ± 2 weeks after treatment.

RESULTS

Over the course of the 1-year follow-up, one-third of the patients had not required any conservative treatment in comparison to 100% of patients before MPM therapy. The number of patients requiring analgesics could be significantly reduced from 26 to 12, and the number of patients who did not require any analgesics had increased from 14 to 32. After 1 year, the number of patients who had to regularly contact a physician because of low back pain (once per month for 6 months) had been reduced from 58 to 27.

CONCLUSION

MPM is an effective approach to treating lumbar radiculopathy and reducing its negative influence on socioeconomic factors. Therapeutic benefits also include a decrease in health care utilization. Therefore, health care providers should place the mid-term success for patients and socioeconomic factors before the short-term costs of therapy.

摘要

背景

多模式疼痛管理(MPM)是避免腰椎神经根病患者进行手术的核心方法。无论卫生系统类型如何,成本效益和社会经济因素都变得越来越重要。本研究调查了保守性MPM对医疗保健利用和社会经济因素的中期影响。

方法

本研究比较了60例因腰椎神经根病接受住院MPM治疗的患者在治疗前以及治疗后1年±2周的主观、客观和社会经济因素。

结果

在1年的随访过程中,三分之一的患者无需任何保守治疗,而在MPM治疗前所有患者都需要治疗。需要镇痛药的患者数量可从26例显著减少至12例,无需任何镇痛药的患者数量从14例增加至32例。1年后,因腰痛(连续6个月每月一次)而必须定期联系医生的患者数量从58例减少至27例。

结论

MPM是治疗腰椎神经根病并减少其对社会经济因素负面影响的有效方法。治疗益处还包括医疗保健利用率的降低。因此,医疗保健提供者应将患者的中期成功和社会经济因素置于治疗的短期成本之上。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c60b/5319423/861db323da76/jpr-10-389Fig1.jpg

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