Jobski Kathrin, Luque Ramos Andres, Albrecht Katinka, Hoffmann Falk
Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.
Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany.
Pharmacoepidemiol Drug Saf. 2017 Jul;26(7):766-774. doi: 10.1002/pds.4202. Epub 2017 Mar 26.
Pain and depressive symptoms are common in patients with rheumatoid arthritis (RA). Information on the prevalence and treatment of both conditions in German RA patients is scarce.
Using data from a nationwide statutory health insurance fund (BARMER GEK), 6193 RA patients aged 18 to 79 years were provided with a questionnaire covering a variety of items such as demographics, medical condition and quality of life in 2015. Pain caused by the joint disorder (11-point scale) was classified as none existent/mild, moderate or severe. Depressive symptoms were determined using the World Health Organization's five-item Well-being Index and categorized as none existent, mild or moderate/severe. Another item covered additional use of over-the-counter drugs. Data were linked to dispensation records.
A total of 3140 RA patients were included. Median age was 66 years (79% female). About 70% of patients were classified as having moderate or severe pain. Depressive symptoms were found in 52% and were far more common among patients with higher pain levels. Analgesic treatment ranged from 45% to 76% (non-opioid analgesics) and from 6% to 33% (opioids) in patients with no/mild pain and those reporting severe pain, respectively. In patients reporting moderate or severe pain, substantially higher prevalences of opioid use were observed among those with depressive symptoms. Depending on depressive symptoms, antidepressant use ranged from 7% to 37%. Overall, over-the-counter drug use varied between 30% and 59%.
Pain and depressive symptoms are highly prevalent in German RA patients, often present together and influence each other's treatment. Copyright © 2017 John Wiley & Sons, Ltd.
疼痛和抑郁症状在类风湿关节炎（RA）患者中很常见。关于德国RA患者中这两种情况的患病率和治疗的信息很少。
利用全国性法定健康保险基金（BARMER GEK）的数据，在2015年为6193名年龄在18至79岁的RA患者提供了一份问卷，涵盖各种项目，如人口统计学、医疗状况和生活质量。关节疾病引起的疼痛（11分制）分为无/轻度、中度或重度。使用世界卫生组织的五项幸福指数确定抑郁症状，并分为无、轻度或中度/重度。另一个项目涵盖非处方药的额外使用情况。数据与配药记录相关联。
共纳入3140名RA患者。中位年龄为66岁（79%为女性）。约70%的患者被分类为有中度或重度疼痛。52%的患者有抑郁症状，且在疼痛程度较高的患者中更为常见。在无/轻度疼痛和报告有重度疼痛的患者中，镇痛治疗的比例分别为45%至76%（非阿片类镇痛药）和6%至33%（阿片类镇痛药）。在报告有中度或重度疼痛的患者中，有抑郁症状的患者使用阿片类药物的比例明显更高。根据抑郁症状，抗抑郁药的使用比例在7%至37%之间。总体而言，非处方药的使用比例在30%至59%之间。
疼痛和抑郁症状在德国RA患者中非常普遍，常常同时出现并相互影响治疗。版权所有© 2017约翰·威利父子有限公司。
