Joranson D E, Gilson A M
Pain & Policy Studies Group, Comprehensive Cancer Center, University of Wisconsin, Madison, USA.
J Am Pharm Assoc (Wash). 2001 Mar-Apr;41(2):213-20. doi: 10.1016/s1086-5802(16)31232-3.
To assess Wisconsin pharmacists' knowledge of and attitudes toward the use of opioid analgesics in the management of chronic cancer and noncancer pain, and to explore the potential for these beliefs to interfere with pharmacist dispensing, the last link of the distribution chain of controlled substances to patients.
Mail survey.
Urban and rural pharmacies, long-term care facilities, hospitals, and outpatient clinics in Wisconsin in 1998.
Representative sample of Wisconsin pharmacists.
None.
Responses to self-administered questionnaires.
Although most respondents were knowledgeable about the issues addressed in this study, there were important exceptions. Not all pharmacists knew what constitutes legitimate dispensing practices for controlled substances under federal or state policy in emergencies or for patients with terminal illnesses, and many were unaware of the important distinctions among addiction, physical dependence, and tolerance. Many respondents did not view the chronic prescribing/dispensing of opioids for more than several months to patients with chronic pain of malignant or nonmalignant origin as a lawful and acceptable medical practice; this was especially true when the patient had a history of opioid abuse.
Pharmacists play a pivotal role in ensuring patient access to medications. Viewed in the context of federal and state controlled substances policies, our findings suggest that the incorrect knowledge and inappropriate attitudes of some pharmacists could contribute to a failure to dispense valid prescriptions for opioid analgesics to patients in pain.
评估威斯康星州药剂师对使用阿片类镇痛药治疗慢性癌症疼痛和非癌症疼痛的知识及态度，并探讨这些观念干扰药剂师配药的可能性，药剂师配药是管制药品向患者分销链的最后一环。
邮寄调查。
1998年威斯康星州的城乡药店、长期护理机构、医院和门诊诊所。
威斯康星州药剂师的代表性样本。
无。
对自行填写问卷的回答。
尽管大多数受访者了解本研究中涉及的问题，但也有重要的例外情况。并非所有药剂师都知道在紧急情况下或针对绝症患者，根据联邦或州政策，什么构成管制药品的合法配药做法，而且许多人并未意识到成瘾、身体依赖和耐受性之间的重要区别。许多受访者不认为对患有恶性或非恶性慢性疼痛的患者长期（超过数月）开具/配给阿片类药物是一种合法且可接受的医疗行为；当患者有阿片类药物滥用史时尤其如此。
药剂师在确保患者获得药物方面发挥着关键作用。从联邦和州管制药品政策的背景来看，我们的研究结果表明，一些药剂师的错误知识和不恰当态度可能导致无法为疼痛患者配给有效的阿片类镇痛药处方。
