危害与危害:重新考虑长期服用阿片类药物的患者的治疗方法
Pooja Lagisetty1,2, Stefan Kertesz3,4
1University of Michigan Medical School, Ann Arbor, MI, USA.
Substance abuse
|September 22, 2023
概括
临床医生应该权衡继续阿片类药物治疗的危害与停止治疗的危害. 这种以患者为中心的方法可以提高信任,并鼓励多模式疼痛管理,避免患者放弃.
科学领域:
- 疼痛管理 疼痛管理
- 临床实践指南 临床实践指南
背景情况:
- 2022年CDC指南鼓励对阿片类药物治疗进行风险效益分析.
- 目前的指导方针可能会在患者和提供者之间产生关于治疗慢性疼痛的阿片类药物治疗的矛盾.
- 这种不一致会导致患者通过单边的逐渐缩小或放弃而受到伤害.
研究的目的:
- 提出一个修订的框架来管理长期阿片类药物治疗的患者.
- 在临床决策中,将重点从"益处"转移到降低危害的模型.
- 改善患者与医疗服务提供者之间的沟通和信任.
主要方法:
- 评论讨论当前指南的含义.
- 关于修订的减少危害的决策框架的建议.
- 强调以患者为中心的讨论和共同决策.
主要成果:
- 目前以"好处"为重点的方法可能会导致患者和医疗服务提供者的分歧.
- 减少危害的框架可以减轻与阿片类药物治疗决策相关的风险.
- 这种方法可以培养信任,并促进对替代性疼痛治疗的参与.
结论:
- 提出了一个修订后的框架,权衡继续与停止的危害.
- 这种减少危害的模式可以改善患者与医疗服务提供者的关系.
- 它支持基于证据的多模式疼痛治疗,包括非阿片类药物选择.
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