关于同时出现的慢性疼痛和阿片类药物使用障碍的护理知识的当前状态:范围审查
Léonie Archambault1,2, Karine Bertrand3, Marc O Martel4
1Université de Sherbrooke and Douglas Research Center, Montréal, Quebec, Canada.
Journal of clinical nursing
|March 27, 2024
概括
治疗同时发生的慢性疼痛和阿片类药物使用障碍 (OUD) 需要综合策略. 证据支持阿片类激素治疗与疗法和协作护理模型相结合,以有效管理.
科学领域:
- 疼痛管理 疼痛管理
- 成 药物 药物 药物 药物
- 精神病学是一个精神病学.
背景情况:
- 阿片类药物使用障碍 (OUD) 经常与慢性疼痛并发,使患者的护理复杂化.
- 对这些双重诊断的有效评估和治疗策略具有挑战性.
- 本综述综合了当前关于管理同时出现的慢性疼痛和OUD的知识.
研究的目的:
- 确定和审查现有的治疗方法,同时出现的慢性疼痛和OUD.
- 为患有这两种疾病的患者探索各种服务提供模式.
- 突出基于证据的实践和科学文献中的知识差距.
主要方法:
- 在六个主要科学数据库中进行了全面的范围审查.
- 搜索是在2022年6月进行的,没有时间限制.
- PRISMA-ScR检查清单指导了报告发现的情况.
主要成果:
- 包括47篇关于慢性疼痛和OUD管理的出版物.
- 阿片类激素治疗 (OAT),如甲和布普伦诺芬/纳洛,显示有效性.
- 建议将OAT与行为疗法 (例如,MBRE,CBT) 和综合护理模式结合起来.
结论:
- 在基于证据的护理中存在差距,用于同时出现的慢性疼痛和OUD.
- 解决生物心理社会维度和跨学科合作的综合治疗是关键.
- 解决诸如隔离工作,治疗费用和耻辱等障碍对于服务改善至关重要.
相关概念视频
Analgesia and Pain Management
614
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...
614
Opioid Analgesics: Morphine and Other Natural Cogeners
244
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...
244
Chronic Pancreatitis II: Collaborative Care
86
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:
86
Opioid Analgesics: Synthetic and Semisynthetic Opioids
287
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...
287
Opioid Receptors: Overview
776
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,...
776
Documentation in Long-Term and Home Healthcare Setting
888
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
888


