协作护理模式改善疼痛和减少阿片类药物的使用在初级保健:一个系统审查
Sarah Cercone Heavey1,2, Jacob Bleasdale3, Eve A Rosenfeld4,5
1Department of Community Health & Health Behavior, School of Public Health & Health Professions, State University of New York at Buffalo, Buffalo, NY, 14214, USA. scheavey@buffalo.edu.
Journal of general internal medicine
|August 14, 2023
概括
协作护理管理 (CCM) 对慢性疼痛和阿片类药物使用有希望,改善疼痛结果并帮助布普伦诺芬治疗. 需要进一步的研究来优化CCM干预措施以获得更好的结果.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 疼痛管理 疼痛管理
- 成 药物 药物 药物 药物
背景情况:
- 协作护理管理 (CCM) 是一种基于证据的模型,旨在改善分散的医疗保健和患者结果.
- 对于慢性疼痛和阿片类药物使用障碍,CCM的使用不足.
- 本系统性审查评估了关于CCM的科学文献,以评估与疼痛相关的结果和与阿片类药物相关的行为.
研究的目的:
- 系统地审查有关慢性疼痛和阿片类药物使用的协作护理管理 (CCM) 方法的现有文献.
- 评估CCM干预措施对疼痛相关结果和阿片类药物相关行为的影响.
- 评估当前的CCM应用程序与既定的护理原则的一致性.
主要方法:
- 对1995年1月1日至2022年10月31日期间发表的同行评审文章进行了系统审查.
- 在主要的数据库中进行了搜索:Cochrane,Embase,PsycINFO和PubMed.
- 在选摘要和完整文本后,包括了18项研究,使用以患者为中心的综合行为健康护理原则和任务清单进行评估.
主要成果:
- 在11项研究中,CCM干预措施在与疼痛相关的结果 (例如,疼痛严重程度,活动干扰) 中显示出统计学上显著的改善,尽管效果大小有所不同.
- CCM在向与阿片类药物相关的行为 (n=4) 中表现出成功,包括减少阿片类药物剂量和促进阿片类药物使用障碍 (n=2) 的布普伦诺芬治疗.
- 干预措施经常使用CCM来解决心理健康作为疼痛管理策略 (n=10),与CCM模型的整体调整适度.
结论:
- CCM是一种有前途的方法,可以增强与疼痛相关的结果,并支持阿片类药物使用障碍的布普伦诺芬治疗.
- 需要进行额外的严格研究,以确定最佳的CCM组件,并最大限度地提高干预的有效性.
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