title: [Opioid therapy in patients with back pain. Claims data analysis for patient group characterization, influence on opioid therapy and work disability].
abstract: This study features an analysis of the analgesic therapy of patients with back pain focusing on opioid administration. Using claims data of a German statutory health insurance fund the analysis focuses on prescription patterns, the association between opioids and antiemetics as well as between opioid therapy and work disability. Based on typical diagnosis patterns three types of back pain could be identified: (other) specific back pain (46.0%), pain due to spinal disc diseases (23.5%) and non-specific back pain. The proportion of patients receiving continuous opioid therapy ranged between 24.3% and 48.8%. The prescription of antiemetics was associated with a higher chance of continuous opioid therapy (odds ratio [OR] 1.93; 95% confidence interval [CI] 1.79-2.08). The chance of continuous opioid therapy was higher in pain patients with spinal disc diseases and patients with (other) specific back pain (OR 1.62 and 1.76, respectively; 95% CI 1.56-1.69 and 1.69-1.83, respectively). Continuous opioid therapy appears to increase the probability of a lower number of days off work due to disability (incidence rate ratio [IRR] 0.76; 95% CI 0.70-0.84). Adequate prospective studies should test if the associations found can be confirmed.
authors.affiliation: IGES-Institut GmbH, Berlin. Ariane.Hoer@iges.de
authors.forename: A
authors.initials: A
authors.lastname: Höer
authors.forename: A
authors.initials: A
authors.lastname: Freytag
authors.forename: G
authors.initials: G
authors.lastname: Schiffhorst
authors.forename: S
authors.initials: S
authors.lastname: Schellhammer
authors.forename: M
authors.initials: M
authors.lastname: Thiede
authors.forename: G
authors.initials: G
authors.lastname: Glaeske
authors.forename: B
authors.initials: B
authors.lastname: Häussler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000932:Antiemetics / Q000627:therapeutic use; D001416:Back Pain / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D015897:Comorbidity; D004185:Disability Evaluation; D004359:Drug Therapy, Combination; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D005858:Germany; D006801:Humans; D007345:Insurance Claim Review; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D010147:Pain Measurement / Q000187:drug effects; D010818:Practice Patterns, Physicians'; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D000932:Antiemetics