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关节炎疼痛管理:药物治疗和生活方式改变。

MANAGING ARTHRITIS PAIN: MEDICATIONS AND LIFESTYLE CHANGES.

机构信息

1Department of Allied Healthcare & Sciences, Vivekananda Global University, Jaipur, India.

2Department of Orthopaedics, Teerthanker Mahaveer University, Moradabad, Uttar Pradesh, India.

出版信息

Georgian Med News. 2023 Jun(339):117-122.

Abstract

This study aims to characterize and contrast the triennial rates at which doctors prescribe PT, determine patient, doctor, and practicing characteristics related to every therapy suggestion, and assess pain relievers, lifestyle counseling, and PT as effective treatments for knee osteoarthritis (OA). We analyzed the National Ambulatory Medical Care Survey. Nonsteroidal anti-inflammatory drugs (NSAID), narcotics prescriptions, physical therapy referrals, and primary care physician visits for knee OA have been determined and evaluated. The average yearly rate after three years of therapy was determined. Using multivariable logistic modeling with adjustments for complicated sample design, we analyzed the relationships among patient, physician, and practice characteristics and treatments. Over time the patients were prescribed physical therapy to improve their lifestyle whereas the percentage of patients who were prescribed NSAIDs or drugs. Physical therapy, lifestyle therapy, and drugs were prescribed at similar rates across time for basic care doctor visits. There was an association between nonclinical characteristics and treatment suggestions, such as provider type, practice setting, and geographic proximity. Physical therapy (PT) and lifestyle counseling (LC) seem underused in patients with knee OA, but prescriptions for pain medication rose over the studied period. The treatment decisions varied due to variables outside of medicine. Increased usage of physical therapy and lifestyle changes, as well as decreased treatment variance for knee OA, are important areas for further study.

摘要

本研究旨在描述并对比医生开具物理治疗(PT)处方的三年期速率,确定与每一次治疗建议相关的患者、医生和执业特征,并评估止痛药、生活方式咨询和 PT 对膝骨关节炎(OA)的治疗效果。我们分析了全国门诊医疗调查。确定并评估了 NSAID、麻醉性镇痛药处方、物理治疗转诊和膝 OA 初级保健医生就诊的情况。在经过三年治疗后,确定了平均年治疗率。使用多变量逻辑回归模型,并对复杂样本设计进行调整,分析了患者、医生和执业特征与治疗之间的关系。随着时间的推移,患者被开具物理治疗以改善生活方式,而开具 NSAIDs 或麻醉性镇痛药的比例则有所下降。对于基础保健医生就诊,物理治疗、生活方式治疗和药物治疗的开具率在整个研究期间基本保持一致。非临床特征与治疗建议之间存在关联,如提供者类型、执业环境和地理位置等。在膝 OA 患者中,物理治疗(PT)和生活方式咨询(LC)的使用率似乎较低,但在研究期间,止痛药的处方量有所增加。由于医学以外的因素,治疗决策存在差异。增加物理治疗的使用和生活方式的改变,以及减少膝 OA 的治疗变异性,是进一步研究的重要领域。

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