对恶性神经病痛的评估和治疗
Lillian Boehmer1, Belal Dakroub1, Glenn Pebanco1
1West Palm Beach VA Healthcare System, West Palm Beach, FL, USA.
The American journal of hospice & palliative care
|October 17, 2025
概括
临床药剂师指导治疗改善了退伍军人的癌症相关神经病痛 (CRNP). 以指导方针为导向的治疗显著降低了疼痛评分,提高了患者的功能,证明了息护理的价值.
科学领域:
- 在瘤学瘤学.
- 疼痛管理 疼痛管理
- 老年人药房 老年人药房
背景情况:
- 与癌症相关的神经病痛 (CRNP) 在识别,评估和治疗方面存在重大挑战.
- CRNP通常需要更高的止痛剂剂量,并且与较差的患者结果有关.
研究的目的:
- 评估CRNP在老兵门诊患者中指导治疗的有效性.
- 评估疼痛和息护理临床药剂师 (CPP) 对CRNP管理的影响.
主要方法:
- 对119名患有CRNP的资深门诊患者进行了回顾性图表审查.
- 对指南导向药物的分析,包括SNRIs,TCAs,抗药和混合机制阿片类药物.
- 主要结果:疼痛和PEG (疼痛,快乐和一般活动) 评分的变化;次要结果:MEDD,ED访问,药物趋势.
主要成果:
- 干预后观察到疼痛评分 (4.90至3.61) 和PEG评分 (6.34至4.53) 的显著改善 (P<0.001).
- 布普伦诺芬的使用量增加,而 gabapentin 的使用量减少.
- 紧急部门的访问减少了21%.
结论:
- 在CRNP的退伍军人中,CPP指导的,指南导向的疗法有效地改善了疼痛强度和功能.
- 在息治疗模式中,布普伦诺芬在降低老年患者多模式疼痛的药物负担方面表现有前途.
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