Di Gangi Stefania, Pichierri Giuseppe, Zechmann Stefan, Rosemann Thomas, Plate Andreas
Institute of Primary Care, University and University Hospital Zurich, 8091 Zürich, Switzerland.
J Clin Med. 2021 Mar 26;10(7):1366. doi: 10.3390/jcm10071366.
Acute low back pain (LBP) is one of the most prevalent diseases worldwide. Since there is evidence of excessive prescriptions of analgesics, i.e., opioids, the aim of this study was to describe the use of pain medications in patients with LBP in the Swiss primary care setting. A retrospective, observational study was performed using medical prescriptions of 180 general practitioners (GP) during years 2009-2020. Patterns of pain medications (nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol, and opioids) as well as co-medications were analyzed in patients with a LBP diagnosis. Univariable and multivariable regression analyses assessed GP and patient characteristics associated with the prescription of pain medication. Patients included were 10,331 (mean age 51.7 years, 51.2% female); 6449 (62.4%) received at least one pain medication and of these 86% receive NSAIDs and 22% opioids. GP characteristics (i.e., self-employment status) and patient characteristics (male gender and number of consultations) were associated with significantly higher odds of receiving any pain medication in multivariable analysis. 3719 patients (36%) received co-medications. Proton-pump-inhibitors and muscle relaxants were the most commonly used co-medications. In conclusion, two-thirds of LBP patients were treated with pain medications. Prescribing patterns were conservative, with little use of strong opioids and co-medications.
急性腰痛是全球最常见的疾病之一。鉴于有证据表明存在镇痛药（即阿片类药物）的过度处方情况，本研究的目的是描述瑞士初级医疗环境中腰痛患者的止痛药物使用情况。我们利用2009年至2020年期间180名全科医生（GP）的医疗处方进行了一项回顾性观察研究。对诊断为腰痛的患者的止痛药物（非甾体抗炎药（NSAIDs）、对乙酰氨基酚和阿片类药物）以及联合用药模式进行了分析。单变量和多变量回归分析评估了与止痛药物处方相关的全科医生和患者特征。纳入的患者有10331名（平均年龄51.7岁，51.2%为女性）；6449名（62.4%）接受了至少一种止痛药物，其中86%接受了NSAIDs，22%接受了阿片类药物。在多变量分析中，全科医生特征（即自营职业状况）和患者特征（男性性别和就诊次数）与接受任何止痛药物的几率显著较高相关。3719名患者（36%）接受了联合用药。质子泵抑制剂和肌肉松弛剂是最常用的联合用药。总之，三分之二的腰痛患者接受了止痛药物治疗。处方模式较为保守，强效阿片类药物和联合用药的使用较少。
