Saag Kenneth G, Olivieri Jason J, Patino Fausto, Mikuls Ted R, Allison Jeroan J, MacLean Catherine H
Center for Education and Research on Therapeutics of Musculoskeletal Disorders, University of Alabama at Birmingham, 35294-3296, USA.
Arthritis Rheum. 2004 Jun 15;51(3):337-49. doi: 10.1002/art.20422.
To develop systematically validated quality indicators (QIs) addressing analgesic safety.
A comprehensive literature review of existing quality measures, clinical guidelines, and evidence supporting potential QIs concerning nonselective (traditional) nonsteroidal anti-inflammatory drugs (NSAIDs) and newer cyclooxygenase 2-selective NSAIDs was undertaken. An expert panel then validated or refuted potential indicators utilizing a proven methodology.
Eleven potential QIs were proposed. After panel review, 8 were judged to be valid; an additional 10 were proposed by the panel, of which 7 were rated as valid. Quality indicators focused upon informing patients about risk, NSAID choice and gastrointestinal prophylaxis, and side effect monitoring.
The 15 validated indicators were combined, where appropriate, to yield 10 validated processes of care indicators for the safe use of NSAIDs. These indicators developed by literature review and finalized by our expert panel process can serve as a basis to compare the quality of analgesic use provided by health care providers and delivery systems.
制定经过系统验证的、针对镇痛安全性的质量指标(QIs)。
对现有的质量衡量标准、临床指南以及支持有关非选择性(传统)非甾体抗炎药(NSAIDs)和新型环氧化酶2选择性NSAIDs潜在质量指标的证据进行了全面的文献综述。然后,一个专家小组利用一种经过验证的方法对潜在指标进行了验证或反驳。
提出了11个潜在的质量指标。经过小组审查,8个被判定为有效;小组又提出了另外10个,其中7个被评定为有效。质量指标侧重于告知患者风险、NSAID的选择和胃肠道预防以及副作用监测。
将15个经过验证的指标在适当情况下进行合并,得出10个经过验证的NSAIDs安全使用护理过程指标。这些通过文献综述制定并经我们专家小组程序最终确定的指标,可作为比较医疗服务提供者和医疗系统所提供镇痛使用质量的基础。