School of Social Sciences, Education and Social Work, Queen's University of Belfast, Belfast, UK.
Salford Royal NHS Foundation Trust, Salford, UK.
Dev Med Child Neurol. 2021 Sep;63(9):1085-1092. doi: 10.1111/dmcn.14854. Epub 2021 Mar 31.
To explore data linkage and pain medication as a proxy for pain, to assess differences in pain medication between the cerebral palsy (CP) and the general populations, and to identify factors associated with pain medication in CP.
This cross-sectional study linked the Northern Ireland CP Register and two administrative health care databases for people resident in Northern Ireland born between 1981 and 2008. Pain medication as a proxy was validated by replicating analyses from the Study of Participation of Children with Cerebral Palsy Living in Europe (SPARCLE) studies. Logistic regression compared pain medication in the CP and general populations. Multi-level regression models assessed factors associated with pain medication in the CP cohort.
The sample size was 701 075, of whom 1430 (0.2%) were people with CP. There were 358 969 males and 340 677 females in the general population, and 810 males and 620 females in the CP population, with an age range of 4 to 31 years in both groups. The validation exercise produced results similar to the SPARCLE studies. More people with CP received pain medication (61% vs 50.9%) and had twice the odds of being prescribed opioid analgesics (odds ratio [OR]=2.81, 95% confidence interval [CI] 2.32-3.40). Among those with CP, the odds of being prescribed pain medication were higher for: females (OR=1.34, 95% CI 1.06-1.70), younger age (OR=1.60, 95% CI 1.02-2.51), Gross Motor Function Classification System level V (OR=2.60, 95% CI 1.52-4.47), seizures (OR=2.55, 95% CI 1.68-3.87), and higher deprivation score (OR=2.06, 95% CI 1.41-3.24).
Pain medication is an effective proxy for pain. More people with CP were prescribed pain medication than the general population. Pain medication for people with CP is not only dependent on physiological and clinical characteristics, but also environmental factors. What this paper adds Data linkage using pain medication as a proxy for experiencing pain is a valid method. People with cerebral palsy (CP) are more likely to experience pain than the general population. People with CP have over twice the odds of receiving opioids compared to the general population. The odds of being prescribed pain medication were higher for females with CP. Prescription of pain medication among those with CP is not only dependent on clinical characteristics, but also environmental factors.
探索数据链接和疼痛药物作为疼痛的替代指标，评估脑瘫（CP）和普通人群之间疼痛药物使用的差异，并确定 CP 中与疼痛药物使用相关的因素。
本横断面研究将北爱尔兰 CP 登记处和北爱尔兰居民的两个行政医疗保健数据库进行了链接，这些居民出生于 1981 年至 2008 年之间。通过复制欧洲脑瘫儿童参与研究（SPARCLE）研究中的分析，验证了疼痛药物作为替代指标的有效性。逻辑回归比较了 CP 和普通人群中疼痛药物的使用情况。多水平回归模型评估了 CP 队列中与疼痛药物使用相关的因素。
样本量为 701075 人，其中 1430 人（0.2%）患有 CP。普通人群中男性 358969 人，女性 340677 人，CP 人群中男性 810 人，女性 620 人，年龄范围均为 4 至 31 岁。验证性研究的结果与 SPARCLE 研究相似。更多的 CP 患者接受了疼痛药物治疗（61%对 50.9%），并且使用阿片类镇痛药的可能性是普通人群的两倍（比值比[OR]=2.81，95%置信区间[CI]2.32-3.40）。在 CP 患者中，以下因素与使用疼痛药物的可能性更高相关：女性（OR=1.34，95%CI 1.06-1.70）、年龄较小（OR=1.60，95%CI 1.02-2.51）、运动功能分级系统（Gross Motor Function Classification System）水平 V（OR=2.60，95%CI 1.52-4.47）、癫痫发作（OR=2.55，95%CI 1.68-3.87）和较高的剥夺评分（OR=2.06，95%CI 1.41-3.24）。
疼痛药物是一种有效的疼痛替代指标。接受疼痛药物治疗的 CP 患者比普通人群更多。CP 患者的疼痛药物治疗不仅取决于生理和临床特征，还取决于环境因素。本文的新增内容使用疼痛药物作为经历疼痛的替代指标进行数据链接是一种有效的方法。CP 患者比普通人群更有可能经历疼痛。与普通人群相比，CP 患者接受阿片类药物的可能性要高出两倍。CP 女性患者接受疼痛药物治疗的可能性更高。CP 患者处方疼痛药物不仅取决于临床特征，还取决于环境因素。
