Painful neuropathic disorders: an analysis of the Régie de l'Assurance Maladie du Québec database
- PMID: 17372632
- PMCID: PMC2670723
- DOI: 10.1155/2007/713835
Painful neuropathic disorders: an analysis of the Régie de l'Assurance Maladie du Québec database
Abstract
Background/objective: Painful neuropathic disorders (PNDs) refer to neurological disorders involving nerves in which pain is a predominant symptom. In most cases, PNDs involve the peripheral nerves. Treatment of PNDs is likely to use large health care resources. However, little is known about the economic burden of PNDs in Canada.
Method: The present study was performed using data from a random sample of patients covered by the Régie de l'Assurance Maladie du Quebec drug plan. Subjects with a diagnosis of a peripheral PND were identified. Comorbidities, pain-related medication use and resource utilization were compared between PND patients and control patients without PNDs matched for age and sex in a 1:1 ratio.
Results: A total of 4912 patients with PNDs were identified. A higher level of comorbidities was found in the PND group (Von Korff chronic disease score 3.91 versus 2.54; P<0.001). The proportion of users of pain-related medications was significantly higher in the PND cohort than in the control group (chi-squared; P<0.001). The average annual number of physician visits was also significantly higher in the PND group than in the control group (14.7 versus 6.4; P<0.001). From a health ministry perspective, costs of health care resources were significantly higher in the PND group (4,163 dollars versus 1,846 dollars; P<0.001). The proportion of potentially inappropriate medications was 34% among those 65 years of age or older.
Conclusions: PNDs are associated with a higher level of comorbidities, higher medical resources utilization and higher health care costs than non-PND conditions.
HISTORIQUE ET OBJECTIFS :: Les troubles de douleur neuropathique (TDN) désignent les troubles neurologiques d’origine nerveuse dont la douleur est le principal symptôme. Dans la plupart des cas, les TDN touchent les nerfs périphériques. Selon toute probabilité, il faut faire grand usage des ressources de santé pour les traiter. Cependant, on ne sait pas grand-chose du fardeau économique que représentent les TDN au Canada.
MÉTHODOLOGIE :: Pour effectuer la présente étude, on a fait appel aux données d’un échantillon aléatoire de patients couverts par le régime d’assurance-médicaments de la Régie de l’assurance maladie du Québec. On a repéré les sujets atteints de TDN périphériques diagnostiqués. On a ensuite comparé les comorbidités, le recours aux médicaments reliés à la douleur et l’utilisation des ressources entre les patients souffrant de TDN et un groupe témoin ne souffrant pas de telles douleurs, appariés selon l’âge et le sexe, dans un ratio de un pour un.
RÉSULTATS :: On a repéré un total de 4 912 patients atteints de TDN. On a constaté un taux plus élevé de comorbidités au sein de ce groupe (indice de maladie chronique de Von Korff: 3,91 par rapport à 2,54; P<0,001). La proportion d’utilisateurs de médicaments reliés à la douleur était considérablement plus élevée au sein de la cohorte souffrant de TDN que du groupe témoin (χ2; P<0,001). Le nombre annuel moyen de consultations chez le médecin était également beaucoup plus élevé au sein du groupe souffrant de TDN que du groupe témoin (14,7 par rapport à 6,4; P<0,001). Du point de vue du ministère de la Santé, les coûts de ressources de santé étaient considérablement plus élevés au sein du groupe souffrant de TDN (4 163 $ par rapport à 1 846 $; P<0,001). La proportion de médicaments potentiellement inappropriée était de 34 % chez les patients de 65 ans ou plus.
CONCLUSIONS :: Les TDN s’associent à un fort taux de comorbidités, à une plus forte utilisation des ressources médicales et à des coûts de santé plus élevés que les douleurs d’autre origine.
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