共享决策对慢性疼痛患者阿片类药物处方的影响:回顾性队列研究
John C Licciardone1, Braden Van Alfen1, Michaela N Digilio1
1University of North Texas Health Science Center, Fort Worth, Texas.
The journal of pain
|April 14, 2024
概括
在慢性疼痛治疗中,共享决策 (SDM) 与阿片类药物处方增加有关. 更大的SDM与更频繁的阿片类药物使用相关,突出了医生在管理复杂的疼痛治疗讨论方面的培训需求.
科学领域:
- 疼痛管理 疼痛管理
- 医疗保健服务研究 医疗服务研究
- 医学教育 医学教育
背景情况:
- 在慢性疼痛管理指南中建议共享决策 (SDM).
- SDM对治疗慢性腰部疼痛的阿片类药物处方频率的影响需要进一步调查.
研究的目的:
- 评估SDM和阿片类药物处方频率在慢性腰痛患者之间的关联.
- 为了确定更大或更小的SDM是否会影响阿片类药物处方的可能性.
主要方法:
- 来自国家疼痛登记册的1478名参与者的回顾性队列研究.
- SDM使用患者参与和患者导向 (PPPO) 尺度进行测量.
- 使用概括估计方程,在12个月内每季度分析阿片类药物处方频率.
主要成果:
- 较高的PPPO评分 (较大的SDM) 与更频繁的阿片类药物处方有显著的关联 (β = .013,P < .001).
- 与较小的SDM (25.2%; OR, 1.55) 相比,遇到更大的SDM显示出更高的阿片类药物处方率 (34.3%).
- 这些关联在所有灵敏度分析中保持一致.
结论:
- 慢性疼痛管理中的SDM与更频繁的阿片类药物处方有关.
- 医生需要加强教育和培训,以导航关于阿片类药物治疗适当性的复杂患者对话.
- 需要进一步的研究来优化SDM在阿片类药物治疗慢性疼痛的背景下.
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