Center for Health Care Evaluation, Veterans Affairs Palo Alto Health Care System, 795 Willow Road (152), Menlo Park, CA 94025, USA.
Curr Pain Headache Rep. 2011 Apr;15(2):137-43. doi: 10.1007/s11916-010-0172-0.
Pain is one of the most common reasons that patients seek treatment from health care professionals, often their primary care providers. One tool for treating pain is opioid therapy, and opioid prescriptions have increased dramatically in recent years in the United States. This article will review recent research about opioids that is most relevant to treating chronic pain in the context of a typical primary care practice. It will focus on four key practices that providers can engage in before and during the course of opioid therapy that we believe will enhance the likelihood that opioids, when used, are an effective tool for pain management: avoiding sole reliance on opioids; using adequate opioid doses to address pain; mitigating the risk of opioid misuse by patients; and fostering collaborative relationships for treating complex patients.
疼痛是患者向医疗保健专业人员寻求治疗的最常见原因之一,通常是他们的初级保健提供者。治疗疼痛的一种工具是阿片类药物治疗,近年来,美国的阿片类药物处方数量大幅增加。本文将回顾与在典型初级保健实践中治疗慢性疼痛相关的阿片类药物的最新研究。它将重点关注提供者在开始和进行阿片类药物治疗之前和期间可以采取的四项关键实践,我们相信这些实践将提高阿片类药物在使用时成为有效疼痛管理工具的可能性:避免仅依赖阿片类药物;使用足够的阿片类药物剂量来解决疼痛;减轻患者滥用阿片类药物的风险;以及为治疗复杂患者建立合作关系。