柔軟なケアプランを備えたコミュニティの学際的な疼痛管理プログラムにおける個別化されたオピオイドの減量:結果,患者の維持,およびフォローアップ
Susan M Ferron1, Alfred L Clavel2, Georgia E Panopoulos3
1HealthPartners Riverway Pain Clinic, Anoka, Minnesota. ORCID: https://orcid.org/0009-0000-3531-8527.
Journal of opioid management
|September 5, 2025
まとめ
慢性非悪性疼痛 (CNMP) 患者における多分野性疼痛管理プログラムにより,オピオイド使用が効果的に減少し,同時に疼痛制御が改善されました. 多くの患者が長期にわたってオピオイドの投与を中止した.
科学分野:
- 痛みの管理
- 公衆衛生
- 薬理学について
背景:
- 慢性非悪性疼痛 (CNMP) の管理は困難であり,しばしば長期オピオイド治療が伴う.
- オピオイドの減量には 痛みのコントロールと依存の軽減を 慎重に検討する必要があります
- インターディシピナリ 疼痛管理 (IPM) プログラムは 慢性的な痛みに対する包括的なアプローチを提供します
研究 の 目的:
- CNMPの個別化されたオピオイドの減量による外来IPMプログラムの有効性を評価する.
- 疼痛管理の改善とオピオイド使用の減少を評価する
- IPMプログラム内の患者保持率を決定する.
主な方法:
- 300人の患者 (オピオイドと非オピオイドのコホート) の遡及的なコホート研究.
- 介入: 柔軟で患者特有のIPMで,個別化されたオピオイドの減少.
- 痛みの強度,痛みの干渉,理学療法指標,患者の留置,オピオイド使用のフォローアップ (≥3年).
主要な成果:
- 痛みの強度,干渉,そして理学療法の結果の有意な改善は,両方のコホートで観察されました.
- オピオイド治療を受けたすべての患者はプログラム中に使用量を減らし,三分の二はオピオイドを中止しました.
- 長期追跡におけるオピオイド使用率の高い保持率 (90. 9%) と持続的な減少率 (15. 8%)
結論:
- 柔軟で患者中心のIPMプログラムはCNMPを効果的に管理し,オピオイド依存症を大幅に軽減します.
- IPM内の個別化されたオピオイドの減少は,重要なオピオイド停止を促進します.
- IPMプログラムは慢性疼痛の患者にとって 高い患者保留率と長期的な利益を示しています
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