通过基于群体的干预减少慢性疼痛的阿片类药物使用:随机临床试验
Harbinder K Sandhu1, Katie Booth1, Andrea D Furlan2,3,4
1Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
JAMA
|May 23, 2023
概括
在慢性非恶性疼痛患者中,以小组为基础的自我管理干预显著减少了阿片类药物的使用. 然而,与通常的护理相比,它没有改善疼痛对日常生活活动的干扰.
科学领域:
- 治疗疼痛
- 片使用障碍
- 行为医学
背景情况:
- 使用阿片类药物治疗慢性非恶性疼痛具有重大风险.
- 需要有效的策略来减少阿片类药物依赖并改善患者的治疗结果.
研究的目的:
- 评估一项多组分,以小组为基础的自我管理干预措施,以减少慢性非恶性疼痛的阿片类药物使用.
- 评估干预对疼痛相关残疾的影响.
主要方法:
- 这是一项多中心随机临床试验,
- 参与者接受了通常的护理或12个月的干预,包括小组会议,基于技能的学习和1对1的支持.
- 主要结局包括阿片类药物停药率和患者报告结果测量信息系统疼痛干扰得分.
主要成果:
- 干预组的阿片类药物戒断率在12个月后显著增加 (29%对比7%).
- 在干预组和常规治疗组之间没有观察到疼痛干扰得分的统计学显著差异.
- 干预组的严重不良事件略高,一些参与者出现了阿片类药物戒断症状.
结论:
- 一个以小组为基础的教育干预措施显著减少了患者在慢性非恶性疼痛中报告的阿片类药物使用.
- 这种干预措施并没有改善对日常生活活动的感知疼痛干扰.
- 可能需要进一步研究以优化阿片类药物减少和功能改善的干预措施.
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