METHODS: We analysed claim-level and service-level data from the Victorian workers\' compensation programme between 1 January 2010 and 31 December 2017 for workers with an accepted claim for a low back pain injury and who had programme-funded gabapentinoid dispensing. Secular trends were calculated as a proportion of gabapentinoid dispensings per year. Poisson, negative binomial and Cox hazards models were used to examine changes over time in incidence and time to first dispensing.
RESULTS: Of the 17 689 low back pain claimants, one in seven (14.7%) were dispensed at least one gabapentinoid during the first 2 years (n=2608). The proportion of workers who were dispensed a gabapentinoid significantly increased over time (7.9% in 2010 to 18.7% in 2017), despite a reduction in the number of claimants dispensed pain-related medicines. Gabapentinoid dispensing was significantly associated with an opioid analgesic or anti-depressant dispensing claim, but not claimant-level characteristics. The time to first gabapentinoid dispensing significantly decreased over time from 311.9 days (SD 200.7) in 2010 to 148.2 days (SD 183.1) in 2017.
CONCLUSIONS: The proportion of claimants dispensed a gabapentinoid more than doubled in the period 2010-2017; and the time to first dispensing halved during this period.
方法:我们分析了2010年1月1日至2017年12月31日维多利亚州工人补偿计划的索赔水平和服务水平数据,这些数据涉及接受了腰痛损伤索赔的工人,并接受了计划资助的加巴喷丁类药物配药。长期趋势计算为每年gabapentinoid分配量的比例。Poisson,我们使用负二项和Cox风险模型来检查发病率和首次分配时间随时间的变化.
结果:在17689名腰背痛索赔人中,在头2年中,七分之一(14.7%)分配了至少一种加巴喷丁(n=2608)。随着时间的推移,分配加巴喷丁的工人比例显着增加(2010年为7.9%,2017年为18.7%),尽管发放疼痛相关药物的索赔人数量有所减少。加巴喷丁类药物配药与阿片类镇痛药或抗抑郁药配药声称显着相关,但不是索赔人级别的特征。第一次gabapentinoid分配的时间随着时间的推移从2010年的311.9天(SD200.7)显着减少到2017年的148.2天(SD183.1)。
结论:在2010-2017年期间,索赔人分配加巴喷丁的比例增加了一倍以上;在此期间,首次分配的时间减少了一半。