Viatris Pharmaceuticals Japan Inc, Minato-ku, Tokyo, Japan
Viatris Pharmaceuticals Japan Inc, Minato-ku, Tokyo, Japan.
BMJ Open. 2022 Nov 10;12(11):e056846. doi: 10.1136/bmjopen-2021-056846.
To assess the potential benefit of a behavioural change programme in working individuals with chronic pain or headache, in the form of increased physician consultation.
Retrospective observational database study.
Members of employment-based healthcare insurance in Japan.
Individual-level data of working individuals aged <75 years from November 2019 through March 2020 were extracted from a database managed by MinaCare Co., Ltd. Included individuals had records of programme participation and chronic pain or headache (self-reported), and did not consult physicians for ≥3 months before programme participation.
Physician consultation rates after participating in the programme were examined from December 2019 through March 2020, separately for chronic pain and headache. Baseline characteristics included age, pain numeric rating scale (NRS) score (for chronic pain), suspected migraine (for headache), labour productivity including absenteeism and presenteeism, and 4-month indirect costs in Japanese yen (JPY).
The baseline mean age (±SD) of 506 individuals with chronic pain was 46.8±10.1 years; that of 352 individuals with headache was 43.6±9.9 years. Of those with chronic pain, 71.4% had an NRS score≥4, and 49.7% of those with headache had suspected migraine. Overall, 11.3% and 5.4% of those with chronic pain or headache consulted physicians, respectively. The mean baseline absenteeism and presenteeism were 1.5% and 19.1% in those with chronic pain, and 1.5% and 23.0% in those with headache. The baseline indirect costs were 586 941.6 JPY and 1 060 281.6 JPY among those with chronic pain or headache, respectively.
Given that the individuals did not regularly consult physicians before the programme despite reporting substantial symptoms, our results suggest the potential benefit of educational programmes encouraging physician consultation. Further studies are required to evaluate how to effectively implement such educational programmes via healthcare insurers to reduce the burden of pain symptoms and overall medical costs.
评估以增加医生就诊为形式的行为改变计划对慢性疼痛或头痛的在职个体的潜在益处。
回顾性观察性数据库研究。
从 MinaCare 有限公司管理的数据库中提取 2019 年 11 月至 2020 年 3 月期间年龄<75 岁的在职个体的个体水平数据。纳入的个体有计划参与和慢性疼痛或头痛（自我报告）的记录，并且在计划参与前 3 个月内没有向医生就诊。
分别对慢性疼痛和头痛，从 2019 年 12 月至 2020 年 3 月期间检查参与该计划后的医生就诊率。基线特征包括年龄、疼痛数字评分量表（NRS）评分（用于慢性疼痛）、疑似偏头痛（用于头痛）、包括旷工和出勤的劳动生产力，以及日元（JPY）的 4 个月间接成本。
506 名慢性疼痛患者的基线平均年龄（±标准差）为 46.8±10.1 岁；352 名头痛患者的平均年龄为 43.6±9.9 岁。在慢性疼痛患者中，71.4%的 NRS 评分≥4，49.7%的头痛患者疑似偏头痛。总体而言，慢性疼痛或头痛患者中有 11.3%和 5.4%分别就诊了医生。慢性疼痛患者的平均基线旷工率和出勤率分别为 1.5%和 19.1%，头痛患者分别为 1.5%和 23.0%。慢性疼痛或头痛患者的基线间接成本分别为 586941.6 日元和 1060281.6 日元。
鉴于这些个体在报告大量症状的情况下，在计划参与之前并未定期向医生就诊，我们的结果表明，鼓励医生就诊的教育计划可能具有潜在益处。需要进一步研究如何通过医疗保险公司有效实施此类教育计划，以减轻疼痛症状和总体医疗成本的负担。
