Arthritis Clinic and Research Center, Peking University People's Hospital, Beijing, China.
Arthritis Institute, Peking University, Beijing, China.
Orthop Surg. 2022 Oct;14(10):2470-2479. doi: 10.1111/os.13446. Epub 2022 Aug 26.
Musculoskeletal pain is having growing impacts worldwide with clinical challenge in pain management. The purpose of the present study is to investigate the preferences of orthopedic surgeons of China for using medicine in musculoskeletal pain.
A questionnaire was developed, including the following domains, personal information, medication preference for pain treatment, and perceptions of topical medicine. Ten participants were selected to confirm the consistency of questionnaire. A cross-sectional survey was conducted in orthopedic physicians with different specialties in different regions of China via the online survey platform. The participants' survey results were analyzed one-way and multi-way using chi-square test and logistic regression.
The pre-survey analysis results of 10 randomly selected investigators were a mean weighted kappa coefficient of 0.76 (range 0.61-0.89), which indicated the substantial consistency of the present questionnaire. A total of 1099 orthopedic surgeons (mean age, 41.67 ± 8.31 years) responded to our survey, most of whom were male (90.72%), and most of whom worked in level III hospitals (63.24%) and trained in modern medicine (71.43%). Most surgeons who participated in the survey had used topical analgesics in their clinical work (95.81%), and most preferred to use topical analgesics (39.50%) or a combination of oral analgesics (28.87%). Primary reasons for preferring topical analgesics were as follows: less adverse reactions (68.01%); ease of use (60.90%); and not interfering with other oral medications (49.60%). The preference for prescribing topical analgesics increased with the education level of the respondent, where statistically significant differences were seen (P < 0.05). In addition, the level of the respondent's hospital, type of hospital, the respondent's profession, and their participation in surgical work influenced their preferences for topical analgesics (P < 0.05).
Orthopedic surgeons across China have different medication preferences in the treatment of musculoskeletal pain. The educational background of the physician largely influences the preference when selecting medications. To better improve the treatment of musculoskeletal pain, there is a need to improve the overall medical education of practitioners and to disseminate clinical practice guidelines.
肌肉骨骼疼痛在全球范围内的影响日益增大,临床疼痛管理面临挑战。本研究的目的是调查中国骨科医生对肌肉骨骼疼痛药物治疗的偏好。
设计问卷,包括个人信息、疼痛治疗药物偏好和局部用药物认知。选择 10 名参与者对问卷进行一致性确认。通过在线调查平台,对来自不同地区、不同专业的骨科医生进行横断面调查。采用卡方检验和 logistic 回归对参与者的调查结果进行单向和多向分析。
10 名随机选择的调查员的预调查分析结果的平均加权 Kappa 系数为 0.76(范围为 0.61-0.89),表明本问卷具有实质性一致性。共 1099 名骨科医生(平均年龄 41.67±8.31 岁)对我们的调查做出了回应,其中大多数为男性(90.72%),大多数在三级医院(63.24%)工作,接受的是现代医学培训(71.43%)。大多数参与调查的医生在临床工作中使用过局部镇痛药(95.81%),大多数人更喜欢使用局部镇痛药(39.50%)或口服镇痛药联合治疗(28.87%)。偏好局部镇痛药的主要原因如下:不良反应较少(68.01%);使用方便(60.90%);不干扰其他口服药物(49.60%)。随着受访者教育水平的提高,处方局部镇痛药的偏好程度也随之增加,且差异有统计学意义(P<0.05)。此外,受访者所在医院的级别、医院类型、受访者的职业以及他们是否参与手术工作也会影响他们对局部镇痛药的偏好(P<0.05)。
中国骨科医生在治疗肌肉骨骼疼痛方面的药物偏好存在差异。医生的教育背景在很大程度上影响了药物选择的偏好。为了更好地改善肌肉骨骼疼痛的治疗效果,有必要提高从业者的整体医学教育水平,并推广临床实践指南。