与通用医生访问慢性疼痛患者的疼痛相关的因素
Dinberu Shebeshi1, Samuel Allingham1, Janelle White1
1Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, Australia.
Journal of primary health care
|September 27, 2023
概括
患有慢性疼痛的患者如果经历严重疼痛,焦虑或压力,则更经常访问全科医生 (GP). 然而,较长的疼痛持续时间与较少的GP访问有关.
科学领域:
- 疼痛管理 疼痛管理
- 一般的做法一般的做法
- 医疗保健服务研究 医疗服务研究
背景情况:
- 慢性疼痛 (CP) 显著影响患者的生活和医疗保健利用.
- 慢性疼痛患者经常咨询全科医生.
- 了解影响GP访问率的因素对于优化护理途径至关重要.
研究的目的:
- 调查与慢性疼痛 (CP) 成年患者中全科医生 (GP) 访问频率相关的因素.
- 确定患者特征和与疼痛相关的变量,与更高的全科医生咨询率相关联.
- 为医疗保健策略提供信息,以便在初级保健机构内管理慢性疼痛患者.
主要方法:
- 利用澳大利亚成人专业疼痛管理服务 (SPMS) 通过电子持续疼痛结果协作 (ePPOC) 的数据.
- 包括84,829名患有慢性疼痛 (持续时间>3个月) 的成年患者,在2015-2021年期间被转诊为SPMS.
- 采用统计分析来根据患者报告的结果和临床因素确定GP访问率.
主要成果:
- 严重的焦虑,压力,疼痛严重程度,疼痛干扰,疼痛灾难化和疼痛自我效能受损与增加的GP访问有关.
- 慢性疼痛的持续时间较长与GP访问率较低相关.
- 与轻度疼痛患者相比,严重疼痛患者的GP访问率高出1.22倍.
- 与非阿片类药物使用者相比,阿片类药物使用者访问全科医生的可能性是1.32倍.
结论:
- 患者报告的心理困扰和疼痛严重程度是慢性疼痛人群中GP利用的关键驱动因素.
- 疼痛持续时间和GP访问之间的反向关系需要进一步调查.
- 研究结果表明,全科医生在治疗慢性疼痛方面可能发挥作用,并强调需要进一步研究阿片类药物使用和初级保健相互作用.
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