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Abstract：
OBJECTIVE: The objective of this study was to evaluate discrepancies in prescription trends for analgesic medications in complex regional pain syndrome (CRPS) patients based on recommendations in the literature.
METHODS: We conducted a retrospective case-control study.
METHODS: A total of 2510 CRPS patients and 2510 demographic-matched controls participated in this study.
METHODS: The SlicerDicer feature in Epic was used to find patients diagnosed with CRPS I or II between January 2010 and November 2022. An equal number of age-, gender-, and race-matched controls without a CRPS diagnosis were retracted from Epic. General and CRPS-associated prescription frequencies for the following classes were retrieved for both cases and controls: benzodiazepines, bisphosphonates, calcitonin, capsaicin, neuropathic pain medications, NSAIDs, opioids, and steroids.
RESULTS: A total of 740 (29%) CRPS patients and 425 (17%) controls were prescribed benzodiazepines (95% CI 0.1-0.15), 154 (6.1%) CRPS patients and 52 (2.1%) controls were prescribed capsaicin (95% CI 0.03-0.05), 1837 (73%) CRPS patients and 927 (37%) controls were prescribed neuropathic pain medications (95% CI 0.05-0.34), 1769 (70%) CRPS patients and 1217 (48%) controls were prescribed opioids (95% CI 0.19-0.25), 1095 (44%) CRPS patients and 1217 (48%) controls were prescribed steroids (95% CI 0.08-0.14), and 1638 (65%) CRPS patients and 1765 (70%) controls were prescribed NSAIDs (95% CI -0.08-0.02), p < 0.001 for all classes. With CRPS-associated prescriptions, (95% CI 0.05-0.16, p < 0.001) more CRPS patients were prescribed opioids (N = 398, 59%) than controls (N = 327, 49%).
CONCLUSIONS: CRPS is difficult to treat with significant variance in suggested treatment modalities. Based on the results of our study, there is a divergence between some published recommendations and actual practice.
METHODS: We conducted a retrospective case-control study.
METHODS: A total of 2510 CRPS patients and 2510 demographic-matched controls participated in this study.
METHODS: The SlicerDicer feature in Epic was used to find patients diagnosed with CRPS I or II between January 2010 and November 2022. An equal number of age-, gender-, and race-matched controls without a CRPS diagnosis were retracted from Epic. General and CRPS-associated prescription frequencies for the following classes were retrieved for both cases and controls: benzodiazepines, bisphosphonates, calcitonin, capsaicin, neuropathic pain medications, NSAIDs, opioids, and steroids.
RESULTS: A total of 740 (29%) CRPS patients and 425 (17%) controls were prescribed benzodiazepines (95% CI 0.1-0.15), 154 (6.1%) CRPS patients and 52 (2.1%) controls were prescribed capsaicin (95% CI 0.03-0.05), 1837 (73%) CRPS patients and 927 (37%) controls were prescribed neuropathic pain medications (95% CI 0.05-0.34), 1769 (70%) CRPS patients and 1217 (48%) controls were prescribed opioids (95% CI 0.19-0.25), 1095 (44%) CRPS patients and 1217 (48%) controls were prescribed steroids (95% CI 0.08-0.14), and 1638 (65%) CRPS patients and 1765 (70%) controls were prescribed NSAIDs (95% CI -0.08-0.02), p < 0.001 for all classes. With CRPS-associated prescriptions, (95% CI 0.05-0.16, p < 0.001) more CRPS patients were prescribed opioids (N = 398, 59%) than controls (N = 327, 49%).
CONCLUSIONS: CRPS is difficult to treat with significant variance in suggested treatment modalities. Based on the results of our study, there is a divergence between some published recommendations and actual practice.
摘要：
目的：本研究的目的是根据文献中的建议，评估复杂区域疼痛综合征（CRPS）患者的镇痛药物处方趋势的差异。
方法：我们进行了回顾性病例对照研究。
方法：共有2510名CRPS患者和2510名人口统计学匹配的对照者参与了这项研究。
方法：使用Epic中的SlicerDicer特征查找在2010年1月至2022年11月期间诊断为CRPSI或II的患者。同等数量的年龄-，性别-,没有CRPS诊断的种族匹配对照从Epic撤回。在病例和对照中检索了以下类别的一般和CRPS相关处方频率：苯二氮卓类药物，双膦酸盐，降钙素,辣椒素,神经性疼痛药物，NSAIDs,阿片类药物,和类固醇。
结果：总共740名（29％）CRPS患者和425名（17％）对照者服用了苯二氮卓类药物（95％CI0.1-0.15），154例（6.1%）CRPS患者和52例（2.1%）对照者服用辣椒素（95%CI0.03-0.05），1837例（73%）CRPS患者和927例（37%）对照者服用了神经性疼痛药物（95%CI0.05-0.34），1769名（70%）CRPS患者和1217名（48%）对照者服用阿片类药物（95%CI0.19-0.25），1095例（44%）CRPS患者和1217例（48%）对照者服用类固醇（95%CI0.08-0.14），1638例（65%）CRPS患者和1765例（70%）对照者服用NSAIDs（95%CI-0.08-0.02），所有类别的p<0.001。与CRPS相关的处方，（95％CI0.05-0.16，p<0.001）比对照组（N=327，49％）更多的CRPS患者服用阿片类药物（N=398，59％）。
结论：CRPS难以治疗，建议的治疗方式存在显著差异。根据我们的研究结果,一些公布的建议和实际做法之间存在分歧。
方法：我们进行了回顾性病例对照研究。
方法：共有2510名CRPS患者和2510名人口统计学匹配的对照者参与了这项研究。
方法：使用Epic中的SlicerDicer特征查找在2010年1月至2022年11月期间诊断为CRPSI或II的患者。同等数量的年龄-，性别-,没有CRPS诊断的种族匹配对照从Epic撤回。在病例和对照中检索了以下类别的一般和CRPS相关处方频率：苯二氮卓类药物，双膦酸盐，降钙素,辣椒素,神经性疼痛药物，NSAIDs,阿片类药物,和类固醇。
结果：总共740名（29％）CRPS患者和425名（17％）对照者服用了苯二氮卓类药物（95％CI0.1-0.15），154例（6.1%）CRPS患者和52例（2.1%）对照者服用辣椒素（95%CI0.03-0.05），1837例（73%）CRPS患者和927例（37%）对照者服用了神经性疼痛药物（95%CI0.05-0.34），1769名（70%）CRPS患者和1217名（48%）对照者服用阿片类药物（95%CI0.19-0.25），1095例（44%）CRPS患者和1217例（48%）对照者服用类固醇（95%CI0.08-0.14），1638例（65%）CRPS患者和1765例（70%）对照者服用NSAIDs（95%CI-0.08-0.02），所有类别的p<0.001。与CRPS相关的处方，（95％CI0.05-0.16，p<0.001）比对照组（N=327，49％）更多的CRPS患者服用阿片类药物（N=398，59％）。
结论：CRPS难以治疗，建议的治疗方式存在显著差异。根据我们的研究结果,一些公布的建议和实际做法之间存在分歧。
