在阿尔伯塔省的情节性偏头痛,慢性偏头痛和药物过度使用头痛的负担
Suzanne McMullen1, Erin Graves1, Paul Ekwaru1
1Medlior Health Outcomes Research Ltd., Calgary, AB, Canada.
概括
慢性偏头痛和药物过度使用的头痛患者面临的医疗费用和资源使用比偶发性偏头痛患者更高. 过度使用阿片类药物和不充分使用预防性治疗表明在偏头痛管理方面存在重大未满足的需求.
科学领域:
- 神经学 神经学
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
背景情况:
- 偏头痛是一种使人衰弱的神经疾病,具有重大公共卫生和经济影响.
- 了解不同类型偏头痛的疾病负担和治疗模式对于有效管理至关重要.
- 插曲性偏头痛 (EM),慢性偏头痛 (CM) 和药物过度使用头痛 (MOH) 代表了具有潜在不同的医疗需求的不同患者群体.
研究的目的:
- 描述EM,CM和MOH患者的人口和临床概况.
- 在这三个偏头痛队伍中比较医疗保健资源利用率和相关成本.
- 分析每个队伍当前的治疗模式,包括急性和预防性药物使用.
主要方法:
- 使用加拿大阿尔伯塔省 (2012-2018) 的行政医疗保健数据进行的回顾性观察研究.
- 根据诊断代码或三药处方识别偏头痛患者.
- 使用逻辑回归参数和基于急性药物供应数据 (≥15天/月) 的MOH定义的CM;EM定义为没有CM或MOH.
主要成果:
- 确定了大型队列:EM (n=144,574),CM (n=27,283) 和MOH (n=11,485). 这些是最常见的.
- 与EM (4,251美元) 相比,CM (12,693美元) 和MOH (16,611.5美元) 的年平均医疗保健成本显著更高.
- 在所有队列中,阿片类药物是分发最多的急性药物 (31.7%-89.8%);预防性药物使用率低,除了MOH患者的抗药 (50%的分发).
结论:
- CM和MOH的疾病负担比EM大得多,医疗保健利用率和成本的增加证明了这一点.
- 广泛的急性药物,特别是阿片类药物的过度处方,以及基于证据的预防疗法的不足利用是普遍存在的.
- 这些发现强调了改善偏头痛管理策略的关键未满足需求,重点是适当的急性和预防性治疗.
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