Department of Health Services Research, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany.
Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Pharmacoepidemiol Drug Saf. 2024 Aug;33(8):e5865. doi: 10.1002/pds.5865.
Pain is a common symptom following proximal femoral fractures (PFF), however, information on its treatment in terms of agents and type of use (scheduled vs. pro re nata [PRN]) is scarce. The main objective of this study was to examine pain medication regimens according to pain intensity following PFF. Furthermore, we explored the utilization of medication plans.
The "ProFem"-study on healthcare provision, functional ability, and quality of life after PFF is a German population-based prospective cohort study based on statutory health insurance data and individually linked survey data from different time points including information on the currently used medication. This present analysis refers to the participants' baseline interviews (about 3 months following PFF) conducted from 2018 to 2019 in the participants' private surroundings.
The study population comprised 444 participants (mean age: 81.2 years, 71.0% female). Half of them reported high intensity pain, and the mean value for the EuroQol visual analogue scale was 50.8. Most commonly used analgesics were metamizole and tilidine/naloxone. Among participants with high intensity pain, 21.9% received only PRN pain medication and 17.2% no pain medication at all. Overall, 61.5% of participants presented any (printed) medication plan and only 25.2% a "federal standardized medication plan" (BMP).
As a substantial number of patients reports high intensity pain about 3 months following a PFF, the large proportion of those receiving no or only PRN pain medication raises questions regarding the appropriateness of the therapy. The overall low utilization of the BMP indicates potential for improvement.
疼痛是股骨近端骨折（PFF）后的常见症状，但关于其治疗药物及使用方式（计划性给药与按需给药[PRN]）的信息却很有限。本研究的主要目的是根据 PFF 后疼痛的严重程度来检查疼痛药物治疗方案。此外，我们还探讨了药物治疗方案的使用情况。
“ProFem”-研究是一项基于法定健康保险数据和不同时间点的个体链接调查数据的德国基于人群的前瞻性队列研究，包括目前使用药物的信息。本分析参考了 2018 年至 2019 年在参与者私人环境中进行的基线访谈（约在 PFF 后 3 个月），该访谈包含了参与者的基本信息。
研究人群包括 444 名参与者（平均年龄：81.2 岁，71.0%为女性）。其中一半报告疼痛强度高，EuroQol 视觉模拟量表的平均值为 50.8。最常使用的镇痛药是甲灭酸和替啶/纳洛酮。在疼痛强度高的参与者中，21.9%仅接受 PRN 疼痛药物治疗，17.2%根本未接受任何疼痛药物治疗。总体而言，61.5%的参与者出示了任何（印刷）药物治疗方案，只有 25.2%的参与者出示了“联邦标准化药物治疗方案”（BMP）。
由于相当数量的患者在 PFF 后约 3 个月报告疼痛强度高，接受无或仅 PRN 疼痛药物治疗的患者比例很大，这引发了对治疗方法是否恰当的质疑。BMP 的总体利用率低表明存在改进的空间。
