腰痛患者使用抗抑郁药的模式：一项使用工人赔偿数据的回顾性研究。

IF 3.5 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2024-12-17 DOI:10.1002/ejp.4773

Giovanni E. Ferreira, Michael Di Donato, Christopher G. Maher, Christina Abdel Shaheed, Stephanie Mathieson, Alex Collie

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引用次数: 0

摘要

背景：抗抑郁药通常用于治疗腰痛（LBP），但对这一人群中抗抑郁药的使用模式知之甚少。本研究的目的是确定抗抑郁药的配药和转换模式，在澳大利亚工人接受工人赔偿索赔LBP，并调查配药和转换相关的因素。方法：本回顾性研究包括2010年至2018年接受的腰痛工人赔偿时间损失索赔的数据，并进行了2年的随访。我们描述了分配抗抑郁药的类型，分配指数抗抑郁药的时间，以及研究中的人是否切换到不同的抗抑郁药。逻辑回归模型调查了与第一次分配抗抑郁药和切换到不同的抗抑郁药相关的因素。结果：2476例LBP患者（14%）在中位（IQR） 28周（10.9-54.7）后至少服用一次抗抑郁药。阿米替林是在任何一个点上分配最多的抗抑郁药（47.8%），也是最常见的指数抗抑郁药（42.9%）。此外，32.7%的人至少换了一次不同的抗抑郁药。性别、年龄、在服用抗抑郁药之前服用过阿片类药物、加巴喷丁类药物或地西泮、接受过心理服务以及社会经济劣势与服用抗抑郁药有关。结论：七分之一的腰痛患者服用抗抑郁药，最常见的是阿米替林。抗抑郁药通常与阿片类药物、加巴喷丁类药物和地西泮等其他止痛药联合使用。意义：每七名腰痛患者中就有一人服用抗抑郁药，最常见的是阿米替林，其次是度洛西汀。抗抑郁药通常在6个月后配发，在配发阿片类药物、加巴喷丁类药物和地西泮等其他药物后配发。由于数据的管理性质，该研究无法推断抗抑郁药是否用于治疗疼痛或其他健康问题，如精神健康状况。

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Patterns of antidepressant use in people with low back pain: A retrospective study using workers' compensation data

Background

Antidepressants are commonly used to treat low back pain (LBP), but little is known about patterns of antidepressant use in this population. This study aimed to identify patterns of antidepressant dispensing and switching in Australian workers with an accepted workers' compensation claim for LBP, and to investigate factors associated with dispensing and switching.

Methods

This retrospective study included data from accepted workers' compensation time loss claims for LBP between 2010 and 2018 with a 2-year follow-up. We described the type of antidepressant dispensed, the time for the index antidepressant to be dispensed, and whether people in the study switched to a different antidepressant. Logistic regression models investigated factors associated with antidepressants being dispensed for the first time and for switching to a different antidepressant.

Results

Antidepressants were dispensed to 2476 people with LBP (14%) at least once after a median (IQR) of 28 (10.9–54.7) weeks. Amitriptyline was the most dispensed antidepressant at any one point (47.8%), and the most common index antidepressant (42.9%). Also, 32.7% of people switched to a different antidepressant at least once. Sex, age, having been dispensed opioids, gabapentinoids or diazepam prior to antidepressants being dispensed, having used psychological services, and socioeconomic disadvantage were associated with antidepressant dispensing.

Conclusion

One in seven people with LBP were dispensed an antidepressant, most commonly amitriptyline. Antidepressants were commonly used in combination with other pain medicines such as opioids, gabapentinoids and diazepam.

Significance

Antidepressants were dispensed to one in seven people with low back pain, most commonly amitriptyline followed by duloxetine. Antidepressants were typically dispensed after 6 months and after other medicines such as opioids, gabapentinoids and diazepam had been dispensed. Due to the administrative nature of the data, the study cannot infer whether antidepressants were dispensed to treat pain or other health problems, such as a mental health condition.

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.