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药剂师对慢性疼痛患者的教育干预:系统评价和荟萃分析。

Educational interventions by pharmacists to patients with chronic pain: systematic review and meta-analysis.

机构信息

School of Health and Medicine, Lancaster University, Lancaster, UK.

出版信息

Clin J Pain. 2011 Sep;27(7):623-30. doi: 10.1097/AJP.0b013e31821b6be4.

Abstract

OBJECTIVE

We hypothesized that educational interventions delivered by pharmacists to patients with chronic pain might improve pain-related outcomes and sought to establish "proof of concept" for this hypothesis.

METHODS

We searched electronic databases and published literature for randomized studies that examined an educational intervention in relation to the management of chronic pain that was delivered by a pharmacist to an adult patient. Four studies were included that randomized 400 patients with chronic pain and which followed up patients between 1 and 16 weeks.

RESULTS

Patients receiving these interventions experienced statistically significant benefits in the following outcomes compared with controls: a reduction in average pain intensity of 0.5 on a 0 to 10 rating scale, a reduction in adverse effects by more than 50%, and an improvement in satisfaction with treatment equivalent to approximately 1 point on a 0 to 10 rating scale. The interventions neither had effect on reducing interference from pain on daily life, nor on improving self-efficacy.

DISCUSSION

Pharmacist-delivered educational interventions seem to reduce adverse events and improve satisfaction, but their clinical benefit on pain intensity is debatable. Our analysis suggests that the role of pharmacists may be important but a deeper understanding and evaluation of the active components of these interventions is needed within clinical trials before wider implementation into clinical practice can be recommended.

摘要

目的

我们假设药剂师为慢性疼痛患者提供的教育干预措施可能会改善与疼痛相关的结果,并试图为此假设提供“概念验证”。

方法

我们搜索了电子数据库和已发表的文献,以寻找关于药剂师为成年患者提供的与慢性疼痛管理相关的教育干预措施的随机研究。共纳入了四项研究,这些研究随机分配了 400 名慢性疼痛患者,随访时间为 1 至 16 周。

结果

与对照组相比,接受这些干预措施的患者在以下方面的结果有统计学显著改善:疼痛强度平均降低 0.5(0 至 10 评分),不良反应减少超过 50%,以及对治疗的满意度提高了约 1 分(0 至 10 评分)。这些干预措施既没有减少疼痛对日常生活的干扰,也没有提高自我效能感。

讨论

药剂师提供的教育干预措施似乎可以减少不良反应并提高满意度,但它们对疼痛强度的临床获益仍存在争议。我们的分析表明,药剂师的作用可能很重要,但需要在临床试验中更深入地了解和评估这些干预措施的有效成分,然后才能推荐更广泛地将其应用于临床实践。

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