脊柱刺激后阿片类药物使用的长期减少:商业保险人口中的索赔分析
Robert Jason Yong1, Oth V Tran2, Alysha M McGovern2
1Pain Management Center, Brigham and Women's Hospital, Chestnut Hill, MA, USA.
Journal of pain research
|May 24, 2024
概括
脊髓刺激 (SCS) 疗法帮助大约四分之三的慢性疼痛患者减少或停止长期使用阿片类药物. 这种神经调节技术在减少对止痛药的依赖方面表现有前途.
科学领域:
- 神经学 神经学
- 疼痛医学 医学 疼痛医学
- 医疗器械 医疗器械
背景情况:
- 慢性非癌症性疼痛严重影响患者的生活质量.
- 神经调节,包括脊髓刺激 (SCS),是多模式疼痛管理的关键组成部分.
- 以前的研究表明,SCS可以减少短期的阿片类药物使用.
研究的目的:
- 评估脊髓刺激 (SCS) 对阿片类和非阿片类药物使用的长期影响.
- 评估SCS开始后三年或更长时间的慢性非癌症疼痛患者的药物使用模式.
主要方法:
- 对MerativeTM MarketScan®商业数据库的索赔分析,该数据库针对18岁以上开始SCS的患者.
- 纳入标准:≥1年基线数据和≥3年后续数据.
- 评估了阿片类药物停用,剂量降低,药物覆盖,联合药物 (二, gabapentinoids) 和多药.
主要成果:
- 在2669名SCS患者中,60%的人停止或减少了20%以上的阿片类药物每日剂量 (DD);另外15%的人减少了1-19%的DD.
- 较高的基线阿片类药物剂量与更少的中止 (OR 0.31) 相关,但更多的剂量减少 (OR 7.14).
- 覆盖日数中阿片类药物的平均比例 (PDC) 降低 (0.58至0.51,p<0.001);联合药物和多药物在SCS后显著减少.
结论:
- 在绝大多数慢性疼痛患者中,脊髓刺激疗法有助于长期减少或停止阿片类药物使用.
- 在慢性非癌症疼痛管理中,SCS提供了一种可行的策略,以减少对全身阿片类药物和其他止痛药的长期依赖.
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