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[德国风湿性疾病患者的镇痛药处方:一项医保报销数据分析。德文版]

[Prescription of analgesics in patients with rheumatic diseases in Germany : A claims data analysis. German version].

作者信息

Albrecht K, Marschall U, Callhoff J

机构信息

Programmbereich Epidemiologie und Versorgungsforschung, Deutsches Rheuma-Forschungszentrum Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.

Abteilung Medizin und Versorgungsforschung, Barmer, Wuppertal, Deutschland.

出版信息

Z Rheumatol. 2021 Apr;80(3):243-250. doi: 10.1007/s00393-021-00962-z. Epub 2021 Feb 26.

Abstract

OBJECTIVE

To investigate the prescription frequency of analgesics in persons diagnosed with rheumatoid arthritis (RA), axial spondylarthritis (axSpA), psoriatic arthritis (PsA) and systemic lupus erythematosus (SLE) in 2019 using claims data.

METHODS

Persons ≥ 18 years insured in 2019 with a diagnosis of RA (M05, M06), axSpA (M45), PsA (M07.0-3) or SLE (M32.1,8,9) were included. Analgesics were identified by the anatomic therapeutic classification (ATC) system. Reported is the percentage of individuals with ≥ 1 analgesics prescription for the respective rheumatic diagnosis in 2019 and for opioids age-standardized in each of the years 2005-2019. In addition, the proportion of long-term opioid use (prescriptions in ≥ 3 consecutive quarter years) in 2006 and 2019 is compared.

RESULTS

Metamizole (29-33%) was the most commonly prescribed analgesic. Nonsteroidal anti-inflammatory drugs (NSAID)/coxibs were prescribed from 35% (SLE) to 50% (axSpA). Of the patients 11-13% were prescribed weak and 6-8% strong opioids. From 2005 to 2019, the proportion of persons with an opioid prescription remained stable, with similar or slightly decreasing proportions of weak opioids and more frequent prescriptions of strong opioids. The proportion of long-term opioid prescriptions increased from 2006 to 2019 from 8.9% to 11.0% (RA), from 6.9% to 9.1% (axSPA), from 7.8% to 9.5% (PsA), and from 7.5% to 8.8% (SLE), corresponding to a 17-24% increase.

CONCLUSION

The prescription of opioids for persons with inflammatory rheumatic diagnoses is not as high in Germany as in other countries; however, the proportion of long-term prescriptions has considerably increased. The frequent prescription of metamizole is conspicuous.

摘要

目的

利用索赔数据调查2019年诊断为类风湿性关节炎(RA)、中轴型脊柱关节炎(axSpA)、银屑病关节炎(PsA)和系统性红斑狼疮(SLE)的患者中镇痛药的处方频率。

方法

纳入2019年年龄≥18岁且诊断为RA(M05、M06)、axSpA(M45)、PsA(M07.0 - 3)或SLE(M32.1、8、9)的参保人员。通过解剖治疗学分类(ATC)系统识别镇痛药。报告的是2019年各风湿性诊断中有≥1次镇痛药处方的个体百分比,以及2005 - 2019年各年份按年龄标准化的阿片类药物处方情况。此外,比较了2006年和2019年长程使用阿片类药物(连续≥3个季度有处方)的比例。

结果

安乃近(29 - 33%)是最常开具处方的镇痛药。非甾体抗炎药(NSAID)/昔布类药物的处方比例从35%(SLE)到50%(axSpA)不等。11 - 13%的患者开具了弱阿片类药物,6 - 8%的患者开具了强阿片类药物。从2005年到2019年,开具阿片类药物处方的人群比例保持稳定,弱阿片类药物的比例相似或略有下降,强阿片类药物的处方更频繁。2006年至2019年,长程阿片类药物处方比例从8.9%增至11.0%(RA),从6.9%增至9.1%(axSPA),从7.8%增至9.5%(PsA),从7.5%增至8.8%(SLE),增幅为17 - 24%。

结论

在德国,炎性风湿性疾病患者的阿片类药物处方率不像其他国家那么高;然而,长程处方的比例大幅增加。安乃近的频繁处方引人注目。

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