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1997年至2018年魁北克非特异性下背痛药物索赔趋势

Trends in Drug Claims for Non-Specific Low Back Pain in Québec, 1997 to 2018.

作者信息

Ly Antarou, Sirois Caroline, Dionne Clermont E

机构信息

Department of Social and Preventive Medicine, Université Laval, Québec City, Canada.

Centre de Recherche du CHU de Québec-Université Laval, Québec City, Canada.

出版信息

Musculoskeletal Care. 2025 Jun;23(2):e70084. doi: 10.1002/msc.70084.

Abstract

OBJECTIVE

The aim of this study was to describe temporal trend of drugs claims after an episode of non-specific low back pain in Québec between 1997 and 2018, by pharmacological class.

METHODS

Data came from the PROspective Québec study on work and health (PROQ), the Régie de l'assurance maladie du Québec (RAMQ) and Québec hospital services (Med-Echo). RAMQ common denomination codes were used to identify the types of medication claimed for an episode of non-specific low back pain. Multivariate log-binomial regression models were used to evaluate temporal trends in claims for the main pharmacological classes, taking into account dependence between multiple episodes.

RESULTS

A total of 5214 episodes of non-specific low back pain were identified in 1658 people between 1997 and 2018. The mean age at the first medical service for low back pain was 64.1 years (standard deviation: 8.3 years). Results show a significant increase in opioid claims between 1997 and 1998 (4.1%) and 2009-2010 (12.7%) (p for trend = 0.0008), anticonvulsants between 1997 and 1998 (0.0%) and 2011-2012 (10.5%) (p for trend = 0.0002), and myorelaxants between 1997 and 1998 (2.0%) and 2009-2010 (8.8%) (p for trend < 0.0001), but no significant change in claims for antidepressants between 1997 and 1998 (0.5%) and 2016-2017 (2.6%) (p for trend = 0.5508).

CONCLUSION

Claims for opioids, anticonvulsants and myorelaxants for non-specific low back pain showed significant upward changes between 1997 and 2018 in Québec, in contrast to antidepressants. These temporal variations in claims were different for each group of drugs, with a greater variation for anticonvulsants.

摘要

目的

本研究旨在按药理学类别描述1997年至2018年魁北克省非特异性腰痛发作后药物索赔的时间趋势。

方法

数据来自魁北克工作与健康前瞻性研究(PROQ)、魁北克医疗保险局(RAMQ)和魁北克医院服务机构(Med-Echo)。使用RAMQ通用命名代码来识别非特异性腰痛发作所索赔的药物类型。采用多变量对数二项回归模型,在考虑多次发作之间的相关性的情况下,评估主要药理学类别的索赔时间趋势。

结果

1997年至2018年期间,在1658人中共识别出5214次非特异性腰痛发作。首次因腰痛接受医疗服务的平均年龄为64.1岁(标准差:8.3岁)。结果显示,1997年至1998年(4.1%)以及2009 - 2010年(12.7%)期间阿片类药物索赔显著增加(趋势p值 = 0.0008);1997年至1998年(0.0%)以及2011 - 2012年(10.5%)期间抗惊厥药索赔显著增加(趋势p值 = 0.0002);1997年至1998年(2.0%)以及2009 - 2010年(8.8%)期间肌松药索赔显著增加(趋势p值 < 0.0001);而1997年至1998年(0.5%)以及2016 - 2017年(2.6%)期间抗抑郁药索赔无显著变化(趋势p值 = 0.5508)。

结论

与抗抑郁药不同,1997年至2018年期间魁北克省非特异性腰痛的阿片类药物、抗惊厥药和肌松药索赔呈显著上升趋势。每组药物的索赔时间变化各不相同,抗惊厥药的变化更大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b63/11949773/36494caab71f/MSC-23-e70084-g003.jpg

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