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PLoS One. 2014 May 14;9(5):e96717. doi: 10.1371/journal.pone.0096717. eCollection 2014.

Opposite drug prescription and cost trajectories following integrative and conventional care for pain--a case-control study.

Author information

1
Karolinska Institutet, Department of Neurobiology Care Sciences and Society, Division of Nursing, Research Group Integrative Care, Huddinge, Sweden; I C - The Integrative Care Science Center, Järna, Sweden.
2
Centre for Applied Biostatistics, Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden.
3
Division Integrative Health Promotion, University of Applied Sciences and Arts, Coburg, Germany; Generation Research Program, Ludwig-Maximilians-University, Bad Tölz, Germany; Brain, Mind & Healing Program, Samueli Institute, Alexandria, Virginia, United States of America.

Abstract

OBJECTIVES:

Pharmacotherapy may have a limited role in long-term pain management. Comparative trajectories of drug prescriptions and costs, two quality-of-care indicators for pain conditions, are largely unknown subsequent to conventional or integrative care (IC) management. The objectives of this study were to compare prescribed defined daily doses (DDD) and cost of first line drugs for pain patients referred to conventional or anthroposophic IC in Stockholm County, Sweden.

METHODS:

In this retrospective high quality registry case-control study, IC and conventional care patients were identified through inpatient care registries and matched on pain diagnosis (ICD-10: M79), age, gender and socio-demographics. National drug registry data was used to investigate changes in DDD and costs from 90/180 days before, to 90/180 days after, index visits to IC and conventional care. The primary selected drug category was analgesics, complemented by musculo-skeletal system drugs (e.g. anti-inflammatories, muscle relaxants) and psycholeptics (e.g. hypnotics, sedatives).

RESULTS:

After index care visits, conventional care pain patients (n = 1050) compared to IC patients (n = 213), were prescribed significantly more analgesics. The average (95% CI) group difference was 15.2 (6.0 to 24.3), p = 0.001, DDD/patient after 90 days; and 21.5 (7.4 to 35.6), p = 0.003, DDD/patient after 180 days. The cost of the prescribed and sold analgesics was significantly higher for conventional care after 90 days: euro/patient 10.7 (1.3 to 20.0), p = 0.025. Changes in drug prescription and costs for the other drug categories were not significantly different between groups.

CONCLUSIONS:

Drug prescriptions and costs of analgesics increased following conventional care and decreased following IC, indicating potentially fewer adverse drug events and beneficial societal cost savings with IC.

PMID:
24827981
PMCID:
PMC4020818
DOI:
10.1371/journal.pone.0096717
[Indexed for MEDLINE]
Free PMC Article

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