PDF(Pubmed)
Abstract：
OBJECTIVE: The increase in gabapentinoid prescribing is paralleling the increase in serious harms. To describe the low back pain workers compensation population whose management included a gabapentinoid between 2010 and 2017, and determine secular trends in, and factors associated with gabapentinoid use.
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.
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.
摘要：
目的：加巴喷丁类药物处方的增加与严重危害的增加平行。描述2010年至2017年间管理包括加巴喷丁的腰痛工人补偿人群，并确定长期趋势，以及与加巴喷丁使用相关的因素。
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。
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。
