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纤维肌痛症中医疗服务的利用和药物消耗:克拉利特健康服务数据库的横断面分析。

Utilisation of healthcare services and drug consumption in fibromyalgia: A cross-sectional analysis of the Clalit Health Service database.

机构信息

Department of Medicine 'B', Sheba Medical Center, Tel-Hashomer, Israel.

Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.

出版信息

Int J Clin Pract. 2021 Nov;75(11):e14729. doi: 10.1111/ijcp.14729. Epub 2021 Aug 18.

Abstract

AIM

To investigate the health care utilisation and drug consumption of patients with fibromyalgia (FM).

MATERIALS AND METHODS

This is a cross-sectional study using the Clalit Health Care database. Clalit is the largest HMO in Israel, serving more than 4.4 million enrollees. We identified FM patients and age and sex-matched controls. Indicators of healthcare utilisation and drug consumption were extracted and analysed for both groups.

RESULTS

The study included 14 296 FM patients and 71 324 controls. The mean age was 56 years, with a women predominance of 92%. The mean number of visits across of all healthcare services (hospitalisations, emergency department visit, general practitioner clinic visits, rheumatology clinic visits, and pain clinic visits) and the mean difference (MD) were significantly higher for FM patients compared with controls (MD 0.66, P < .001; MD 0.23, P < .001; MD 7.49, P < .001; MD 0.31, P < .001; MD 0.13, P < .001), respectively. Drug use was significantly and consistently higher among FM patients compared with controls; NSAIDs (non-steroidal anti-inflammatory drugs) OR 2.56, P < .001; Opioids OR 4.23, P < .001; TCA (tricyclic antidepressants) OR 8.21, P < .001; Gabapentinoids OR 6.31, P < .001; SSRI (selective serotonin reuptake inhibitors) OR 2.07, P < .001; SNRI (serotonin-norepinephrine reuptake inhibitor) OR 7.43, P < .001.

CONCLUSION

Healthcare utilisation and drug use are substantially higher among patients with FM compared with controls.

摘要

目的

调查纤维肌痛(FM)患者的医疗保健利用和药物消费情况。

材料和方法

这是一项使用克里莱特医疗保健数据库的横断面研究。克里莱特是以色列最大的 HMO,为超过 440 万参保人提供服务。我们确定了 FM 患者和年龄及性别匹配的对照组。对两组患者的医疗保健利用和药物消费指标进行了提取和分析。

结果

该研究包括 14296 名 FM 患者和 71324 名对照组。平均年龄为 56 岁,女性占 92%。所有医疗服务(住院、急诊就诊、全科医生诊所就诊、风湿病诊所就诊和疼痛诊所就诊)的平均就诊次数以及平均值差异(MD)均显著高于对照组(MD0.66,P<0.001;MD0.23,P<0.001;MD7.49,P<0.001;MD0.31,P<0.001;MD0.13,P<0.001)。与对照组相比,FM 患者的药物使用率明显更高且更一致;非甾体抗炎药(NSAIDs)OR2.56,P<0.001;阿片类药物 OR4.23,P<0.001;三环抗抑郁药(TCA)OR8.21,P<0.001;加巴喷丁类药物 OR6.31,P<0.001;选择性 5-羟色胺再摄取抑制剂(SSRIs)OR2.07,P<0.001;选择性 5-羟色胺和去甲肾上腺素再摄取抑制剂(SNRI)OR7.43,P<0.001。

结论

与对照组相比,FM 患者的医疗保健利用和药物使用明显更高。

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