与癌症相关的经济困难,疼痛和阿片类药物使用之间的关联
Courtney P Williams1,2, Sandra Olisakwe3, Joud El Dick3
1Division of General Internal Medicine & Population Science, University of Alabama at Birmingham, Birmingham, AL.
JCO oncology practice
|January 27, 2026
概括
面临经济困难的癌症患者在治疗期间面临中度至重度疼痛和增加阿片类药物使用的风险更高. 早期的财务查可以帮助识别有风险的个人,以便进行支持性干预.
科学领域:
- 在瘤学瘤学.
- 卫生经济学 卫生经济学
- 疼痛管理 疼痛管理
背景情况:
- 癌症相关的财务困难,源于高的自费费用,与治疗结果较差有关.
- 财务困难对疼痛强度等临床结果的具体影响尚不清楚.
研究的目的:
- 研究癌症治疗患者经历的经济困难和疼痛之间的关联.
- 检查癌症治疗期间经济困难和阿片类药物使用之间的关系.
主要方法:
- 一项回顾性队列研究分析了331名开始全身癌症治疗的患者的数据.
- 使用FACIT-COST仪器评估了经济困难,而每周通过远程症状监测监测疼痛.
- 用通用线性模型估计疼痛的相对风险 (RR) 和与经济困难相关的阿片类药物使用概率.
主要成果:
- 几乎一半的患者 (48%) 报告了经济困难.
- 经济困难的患者在6个月内出现中度/重度疼痛的风险增加了37% (RR, 1.37;95% CI,1.04至1.80).
- 经济困难与使用阿片类药物的可能性更高相关,无论疼痛的严重程度如何.
结论:
- 经济困难与癌症患者的疼痛增加和阿片类药物使用增加有显著的关联.
- 建议将财务查纳入临床实践,以识别有风险的患者.
- 金融导航和量身定制的疼痛管理等干预措施可以减轻经济困难的不良临床影响.
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