在识别非医疗性阿片类药物使用时,CAGE-AID问卷的缺陷 - - 两起案件的报告
Jaya Amaram-Davila1, Patricia Bramati1, Laura Gammon2
1Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Annals of palliative medicine
|September 11, 2023
概括
在癌症患者中,CAGE-AID查工具可能无法准确识别非医疗性阿片类药物使用 (NMOU) 风险. 临床评估与查一起,对于有效的疼痛管理和风险评估至关重要.
科学领域:
- 在瘤学瘤学.
- 疼痛管理 疼痛管理
- 成 药物 药物 药物 药物
背景情况:
- 该CAGE-AID问卷选物质使用障碍和非医疗类阿片类药物使用 (NMOU).
- 疼痛管理指南建议在开始服用阿片类药物之前,对所有患者 (包括癌症患者) 进行CAGE-AID.
- 这项研究强调了CAGE-AID在准确评估癌症患者的NMOU风险方面的局限性.
研究的目的:
- 评估CAGE-AID问卷在识别癌症患者非医疗性阿片类药物使用 (NMOU) 风险方面的准确性.
- 提出案例研究,证明CAGE-AID结果与患者实际使用阿片类药物的行为之间的差异.
- 强调需要与查工具一起进行全面的临床评估.
主要方法:
- 两名癌症患者的回顾性病例审查,他们患有无法控制的疼痛.
- 对CAGE-AID问卷结果的分析和对阿片类药物使用行为的临床观察.
- 查工具结果与患者管理和结果的比较.
主要成果:
- 案例1:转移性前列腺癌患者的CAGE-AID阳性得分最初延迟了阿片类药物定位,但最终没有显示NMOU.
- 案例2:转移性胆管癌患者的负CAGE-AID得分与涉及阿片类药物寻求行为有关,导致违背医疗建议出院.
- 这些案例说明了CAGE-AID工具在这个人群中的潜在错误阳性和负面结果.
结论:
- 仅仅CAGE-AID问卷是不足以准确评估癌症患者的NMOU风险.
- 有效的风险评估需要将查工具与对患者行为和疼痛机制的彻底临床评估相结合.
- 需要进一步的研究来完善癌症疼痛管理中NMOU的查方法.
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