J Urol. 2018 Jul;200(1):136-140. doi: 10.1016/j.juro.2017.12.055. Epub 2018 Jan 4.
We examined health care seeking activities during a 12-month period in a cohort of men and women with urological chronic pelvic pain syndromes.
A total of 191 men and 233 women with urological chronic pelvic pain syndrome were followed with biweekly, Internet based questionnaires about symptoms and health care seeking activities, including 1) health care provider contacts, 2) office visits, 3) emergency room/urgent care visits, 4) medication changes and 5) medical procedures. Multivariable modeling was used to determine the association of demographic and clinical variables with health care seeking. Super users were defined as individuals who reported health care seeking activity at least 11 times during the 23 biweekly assessments.
Health care seeking activities included a mean of 2.4 office contacts, 2.5 office visits, 1.9 medication changes, 0.9 medical procedures and 0.3 emergency room/urgent care visits. A total of 31 health care seeking super users accounted for 26% of health care seeking activities. Worse baseline pain severity and female gender were associated with a higher rate of all health care seeking activities except emergency room/urgent care visits. A nonurological chronic pain condition was associated with more provider contacts, office visits and medical procedures. Greater baseline depression symptoms were associated with more provider contacts, office visits and medication changes. Other examined variables, including patient age, symptom duration, catastrophizing, anxiety, urinary symptom severity and symptom variability, had a minimal association with health care seeking.
Health care seeking activities were strongly influenced by the severity of pain in patients with urological chronic pelvic pain syndromes but not by urinary symptom severity. Women and patients with nonurological overlapping pain conditions were more likely to be seen and treated for symptoms.
我们在患有下尿路慢性盆腔疼痛综合征的男性和女性队列中，研究了 12 个月期间的医疗保健寻求活动。
共对 191 名男性和 233 名女性患有下尿路慢性盆腔疼痛综合征进行了随访，每两周通过在线问卷评估症状和医疗保健寻求活动，包括 1）医疗保健提供者的接触，2）就诊次数，3）急诊/紧急护理就诊次数，4）药物变化和 5）医疗程序。多变量建模用于确定人口统计学和临床变量与医疗保健寻求之间的关联。超级用户被定义为在 23 次双周评估中至少报告 11 次医疗保健寻求活动的个体。
医疗保健寻求活动包括平均 2.4 次就诊次数、2.5 次就诊次数、1.9 次药物变化、0.9 次医疗程序和 0.3 次急诊/紧急护理就诊次数。共有 31 名医疗保健超级用户占医疗保健寻求活动的 26%。基线疼痛严重程度较差和女性性别与所有医疗保健寻求活动的发生率较高有关，除了急诊/紧急护理就诊次数外。非下尿路慢性疼痛状况与更多的提供者接触、就诊次数和医疗程序相关。基线时抑郁症状越严重，与更多的提供者接触、就诊次数和药物变化相关。其他检查变量，包括患者年龄、症状持续时间、灾难化、焦虑、尿症状严重程度和症状可变性，与医疗保健寻求的关系不大。
医疗保健寻求活动强烈受到患有下尿路慢性盆腔疼痛综合征患者疼痛严重程度的影响，但不受尿症状严重程度的影响。女性和患有非下尿路重叠疼痛状况的患者更有可能因症状而接受治疗。
