Lappe Veronika, Grandt Daniel, Marschall Ursula, Petzke Frank, Häuser Winfried, Schubert Ingrid
PMV Forschungsgruppe an der Medizinischen Fakultät und Universitätsklinikum Köln, Universität zu Köln, Köln, Deutschland.
Klinikum Saarbrücken, Innere Medizin 1, Saarbrücken, Deutschland.
Schmerz. 2024 Dec 5. doi: 10.1007/s00482-024-00852-8.
The importance of opioids in the treatment of non-cancer pain is under debate. No current data are available from Germany on the prevalence of opioid treatment for non-cancer pain.
Data on the prevalence of short- and long-term opioid prescriptions for patients without cancer, prescribed agents, co-medication, specialty of prescribing physicians, demographic and clinical characteristics of patients.
Retrospective analysis of billing data of adult BARMER-insured persons without evidence of cancer (N = 6,771,075) in 2021 and for patients initiating opioid therapy in 2019 (n = 142,598).
In total, 5.7% of the insured persons without a cancer diagnosis received at least one prescription for an opioid in 2021, while 1.9% received long-term therapy. Tilidine and tramadol were the most frequently prescribed opioids in short- and long-term therapy. Women received opioids more frequently than men. The frequency of prescriptions significantly increased with age. In 2021, 22.5% of insured persons with long-term opioid therapy received a co-medication with pregabalin and/or gabapentin, 37.5% with an antidepressant and 58.1% with metamizole and/or NSAIDs. A total of 59.5% of first prescriptions were issued by general practitioners. In the first year of therapy, an average of 2.1 practices were involved in prescribing analgetics for people on long-term opioid therapy and 13 different chronic diseases were documented.
Opioid therapy for non-cancer-related pain is predominantly carried out by general practitioners in older and multi-morbid patients. The indication for or against opioid therapy requires shared decision-making with patients and, if necessary, their relatives, as well as a review of possible drug interactions.
阿片类药物在非癌性疼痛治疗中的重要性存在争议。德国目前尚无关于非癌性疼痛阿片类药物治疗患病率的可用数据。
获取无癌症患者短期和长期阿片类药物处方的患病率数据、处方药物、联合用药情况、开处方医生的专业、患者的人口统计学和临床特征。
对2021年无癌症证据的成年BARMER参保人员（N = 6,771,075）以及2019年开始阿片类药物治疗的患者（n = 142,598）的计费数据进行回顾性分析。
2021年，总计5.7%未被诊断出患有癌症的参保人员至少接受过一次阿片类药物处方，而1.9%接受长期治疗。替利定和曲马多是短期和长期治疗中最常开具的阿片类药物。女性比男性更频繁地接受阿片类药物治疗。处方频率随年龄显著增加。2021年，22.5%接受长期阿片类药物治疗的参保人员同时接受了加巴喷丁和/或普瑞巴林的联合用药，37.5%同时使用抗抑郁药，58.1%同时使用安乃近和/或非甾体抗炎药。总计59.5%的首次处方由全科医生开具。在治疗的第一年，平均有2.1家医疗机构参与为长期接受阿片类药物治疗的患者开具镇痛药，记录了13种不同的慢性病。
非癌性疼痛的阿片类药物治疗主要由全科医生对老年和多病患者进行。支持或反对阿片类药物治疗的指征需要与患者及其亲属（如有必要）共同决策，以及审查可能的药物相互作用。
