利用初级保健,让服用阿片类药物的患者参与慢性疼痛心理干预
Annals of family medicine
|January 25, 2024
概括
阿片类药物处方没有影响入读慢性疼痛初级保健心理干预的情况. 这表明,在初级保健中提供这种治疗可能会增加吸收率,特别是在女性身上,但对于男性来说,需要采取参与策略.
科学领域:
- 疼痛管理 疼痛管理
- 主要护理医学 医疗保健
- 心理干预 心理干预
背景情况:
- 慢性疼痛是初级保健中普遍存在的问题,通常通过阿片类药物处方来管理.
- 过度使用阿片类药物导致过量服用和死亡,需要替代治疗.
- 心理干预是有效的,但在慢性疼痛和痛苦方面未得到充分利用.
研究的目的:
- 为了确定阿片类药物处方是否影响患者参与慢性疼痛短期心理干预.
- 评估在阿片类药物患者的初级保健环境中提供心理干预的可行性.
主要方法:
- 试点随机临床试验 (RCT) 数据的二次分析.
- 涉及220名患有慢性疼痛的患者进行了5次心理干预.
- 电子健康记录被审查以确定阿片类和非阿片类止痛药处方.
主要成果:
- 在注册者 (18.3%) 和非注册者 (20%) 之间,阿片类药物处方率没有显著差异.
- 吗啡毫克相当剂量或非阿片类药物疼痛处方率没有显著差异.
- 虽然女性无论使用阿片类药物都显示出相似的入学率,但没有使用阿片类药物的男性入学,而非25%的非入学男性有阿片类药物处方.
结论:
- 所有患者的阿片类药物处方与参加心理干预的患者数量无关.
- 初级保健机构可能会为服用阿片类药物的慢性疼痛患者,特别是女性,促进参与心理治疗.
- 需要进一步的研究来改善所有阿片类药物使用者,特别是男性的心理干预参与度.
相关概念视频
01:25Analgesia and Pain Management
623
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
623
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
250
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
250
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
300
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
300
01:29Chronic Pancreatitis II: Collaborative Care
92
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
92
01:22Opioid Receptors: Overview
836
Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
836
01:17Drug Dependence
1.0K
Medications are typically administered to achieve therapeutic effects. Some drugs can modify an individual's mood and perception, frequently resulting in various enjoyable experiences. However, this can result in drug dependency, a condition marked by continuous drug use despite potential negative consequences. Drug dependency primarily falls into two categories: psychological and physical dependence. Psychological dependence occurs when the pleasurable feelings induced by the drug...
1.0K