Centre d'Evaluation et Traitement de la Douleur, INSERM U987, Hôpital Cochin, Université de Paris, Paris, France.
Kantar, Horsham, Pennsylvania, USA.
Pain Pract. 2022 Mar;22(3):359-371. doi: 10.1111/papr.13093. Epub 2021 Nov 26.
This study assessed associations between severity of, and prescription medication use for, chronic low back pain (CLBP) and health-related quality of life, health status, work productivity, and healthcare resource utilization.
This cross-sectional study utilized SF-12, EQ-5D-5L, and work productivity and activity impairment (WPAI) questionnaires, and visits to healthcare providers among adults with self-reported CLBP participating in the National Health and Wellness Survey in Germany, France, UK, Italy, and Spain. Respondents were stratified into four groups according to pain severity (mild or moderate/severe) and prescription medication use (Rx-treated or Rx-untreated). Differences between groups were estimated using generalized linear models controlling for sociodemographics and health characteristics.
Of 2086 respondents with CLBP, 683 had mild pain (276 Rx-untreated, 407 Rx-treated) and 1403 had moderate/severe pain (781 Rx-untreated, 622 Rx-treated). Respondents with moderate/severe pain had significantly worse health-related quality of life (SF-12v2 physical component summary), health status (EQ-5D-5L), and both absenteeism and presenteeism compared with those with mild pain, including Rx-untreated (moderate/severe pain Rx-untreated vs. mild pain Rx-untreated, p ≤ 0.05) and Rx-treated (moderate/severe pain Rx-treated vs. mild pain Rx-treated, p ≤ 0.05) groups. Significantly more visits to healthcare providers in the last 6 months were reported for moderate/severe pain compared with mild pain for Rx-treated (least squares mean 13.01 vs. 10.93, p = 0.012) but not Rx-untreated (8.72 vs. 7.61, p = 0.072) groups. Health-related quality of life (SF-12v2 physical component summary) and health status (EQ-5D-5L), as well as absenteeism and presenteeism, were significantly worse, and healthcare utilization was significantly higher, in the moderate/severe pain Rx-treated group compared with all other groups (all p ≤ 0.05).
Greater severity of CLBP was associated with worse health-related quality of life, health status, and absenteeism and presenteeism, irrespective of prescription medication use. Greater severity of CLBP was associated with increased healthcare utilization in prescription medication users.
本研究评估了慢性下背痛（CLBP）严重程度和处方药物使用与健康相关生活质量、健康状况、工作生产力以及医疗资源利用之间的关联。
本横断面研究利用 SF-12、EQ-5D-5L 和工作生产力和活动障碍（WPAI）问卷，以及德国、法国、英国、意大利和西班牙参加国家健康和健康调查的报告有 CLBP 的成年人对医疗保健提供者的就诊情况。根据疼痛严重程度（轻度或中度/重度）和处方药物使用（Rx 治疗或 Rx 未治疗），将受访者分为四组。使用控制社会人口统计学和健康特征的广义线性模型估计组间差异。
在 2086 名有 CLBP 的受访者中，683 人有轻度疼痛（276 人 Rx 未治疗，407 人 Rx 治疗），1403 人有中度/重度疼痛（781 人 Rx 未治疗，622 人 Rx 治疗）。与轻度疼痛相比，中重度疼痛患者的健康相关生活质量（SF-12v2 生理成分综合评分）、健康状况（EQ-5D-5L）以及旷工和在职病假均显著更差，包括 Rx 未治疗（中重度疼痛 Rx 未治疗与轻度疼痛 Rx 未治疗相比，p≤0.05）和 Rx 治疗（中重度疼痛 Rx 治疗与轻度疼痛 Rx 治疗相比，p≤0.05）组。与轻度疼痛相比，过去 6 个月内报告接受医疗保健提供者就诊的中度/重度疼痛患者Rx 治疗组明显更多（最小平方均值 13.01 与 10.93，p=0.012），而 Rx 未治疗组则不然（8.72 与 7.61，p=0.072）。健康相关生活质量（SF-12v2 生理成分综合评分）和健康状况（EQ-5D-5L）以及旷工和在职病假在中重度疼痛 Rx 治疗组明显更差，医疗保健利用率明显更高，与所有其他组相比（均 p≤0.05）。
CLBP 严重程度的增加与健康相关生活质量、健康状况和旷工和在职病假的恶化有关，无论是否使用处方药物。CLBP 严重程度的增加与处方药物使用者的医疗保健利用率增加有关。
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