McCarberg Bill H, Nicholson Bruce D, Todd Knox H, Palmer Trish, Penles Leslie
University of California, San Diego, CA, USA.
Am J Ther. 2008 Jul-Aug;15(4):312-20. doi: 10.1097/MJT.0b013e31818164f2.
Pain is one of the most common medical complaints, but despite its prevalence, many individuals still suffer with unrelieved or undertreated pain. This marketing research survey was designed to determine the physical, psychological, and economic impact pain has on the lives of individuals suffering with pain and to identify the unmet needs of patients who have taken opioid medications to treat their pain. In addition, the survey sought to address the challenges physicians face when treating patients with pain. Pain sufferers were recruited through e-mail invitation to an Internet survey; 173,854 invitations were sent out, 22,018 people responded (12.7%), and 606 met the criteria for inclusion in the survey as pain sufferers. Of these, 359 people had moderate to moderately severe chronic pain and 247 people had moderate to moderately severe acute pain. Additionally, physicians currently treating pain were recruited through e-mail and postal mail invitations and 492 met eligibility criteria: 241 specialists (orthopedic or general surgeons, pain specialists or anesthesiologists), 125 primary care, and 126 emergency medicine physicians. Results of this survey supported what many physicians observe in their practice and hear from their patients, that pain has a negative impact on daily activities in the majority of pain sufferers. Many chronic pain sufferers reported that pain had deleterious effects on their mental health, employment status, sleep, and personal relationships. The impact of pain on patient quality of life and the unmet needs in pain management were recognized by the majority of physicians surveyed, with inadequate pain control, end-of-dose pain, and side effects associated with increased dosing reported as negative factors influencing their choice of pain medication. In conclusion, effective communication between physicians and patients is encouraged to not only improve overall pain management but also to establish shared treatment goals with functional outcomes.
疼痛是最常见的医疗诉求之一,但尽管其普遍存在,许多人仍饱受未缓解或治疗不足的疼痛之苦。这项市场调研旨在确定疼痛对疼痛患者生活的身体、心理和经济影响,并找出服用阿片类药物治疗疼痛的患者未满足的需求。此外,该调研还试图解决医生在治疗疼痛患者时面临的挑战。通过电子邮件邀请疼痛患者参与一项网络调查;共发出173,854份邀请,22,018人回复(回复率为12.7%),其中606人符合作为疼痛患者纳入调查的标准。在这些人中,359人患有中度至中度严重的慢性疼痛,247人患有中度至中度严重的急性疼痛。此外,通过电子邮件和邮政信件邀请目前正在治疗疼痛的医生,492人符合资格标准:241名专科医生(骨科或普通外科医生、疼痛专科医生或麻醉医生)、125名初级保健医生和126名急诊医学医生。这项调查的结果证实了许多医生在临床实践中观察到的以及从患者那里听到的情况,即疼痛对大多数疼痛患者的日常活动有负面影响。许多慢性疼痛患者报告称,疼痛对他们的心理健康、就业状况、睡眠和人际关系产生了有害影响。大多数接受调查的医生认识到疼痛对患者生活质量的影响以及疼痛管理中未满足的需求,报告称疼痛控制不足、剂量末期疼痛以及与增加剂量相关的副作用是影响他们选择疼痛药物的负面因素。总之,鼓励医生与患者之间进行有效的沟通,不仅要改善整体疼痛管理,还要确立具有功能结果的共同治疗目标。