在初级保健中远程护理的慢性疼痛协作管理:一个随机临床试验
Kurt Kroenke1, Erin E Krebs2, Jingwei Wu3
1VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, Indiana2Department of Medicine, Indiana University School of Medicine, Indianapolis3Regenstrief Institute, Indianapolis, Indiana.
JAMA
|July 17, 2014
概括
远程医疗干预显著改善了初级保健患者的慢性肌肉骨疼痛. 这种协作管理方法优化了非阿片类止痛药,导致更好的疼痛评分和患者的治疗结果.
科学领域:
- 疼痛管理 疼痛管理
- 远程医疗服务是远程医疗服务.
- 初级保健研究研究初级保健研究
背景情况:
- 慢性肌肉骨疼痛是一种广泛,昂贵和致残的疾病.
- 很少有临床试验研究了在初级保健机构内治疗慢性疼痛的干预措施.
- 为了优化疼痛护理效率 (SCOPE) 的逐步护理研究解决了这一差距.
研究的目的:
- 评估远程护理干预措施对治疗慢性疼痛的有效性.
- 为了比较通过电话交付的协作护理管理方法与通常的护理.
主要方法:
- 一项随机试验涉及250名患有慢性肌肉骨疼痛的患者 (≥3个月,简要疼痛目录 (BPI) 评分≥5).
- 患者被分配到12个月的远程护理干预组或常规护理组.
- 这项干预使用了自动症状监测和对止痛药的算法引导阶段性护理方法.
主要成果:
- 远程医疗干预组在12个月后的BPI得分显著降低,与常规护理相比 (-1.02分).
- 干预组的患者实现至少30%的疼痛改善的可能性几乎是干预组的两倍.
- 二次结果,包括疼痛严重程度和整体改善,也有利于干预组.
结论:
- 远程护理协作管理有效地改善了初级保健中的慢性肌肉骨疼痛.
- 干预的成功与通过逐步护理算法和监测优化非阿片类止痛药的效果有关.
- 这种方法为提高初级保健机构疼痛管理提供了一个有希望的策略.
相关概念视频
Methods of Documentation VI: Case Management Model
1.0K
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
For example, a patient with a chronic...
1.0K
Analgesia and Pain Management
3.1K
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
3.1K
Chronic Obstructive Pulmonary Disease-V: Management
3.4K
Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
Smoking Cessation
3.4K
Chronic Pancreatitis II: Collaborative Care
517
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
517
Peripheral Artery Disease III: Interprofessional Care
606
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
606


