St. Vincent's Hospital, Sydney, New South Wales, Australia.
Arthritis Care Res (Hoboken). 2011 Sep;63(9):1280-6. doi: 10.1002/acr.20514.
To explore the key motivators behind selection of analgesics (nonsteroidal antiinflammatory drugs [NSAIDs], acetaminophen, and complementary medications [CMs]) by patients with osteoarthritis (OA).
We performed a qualitative study in which in-depth semistructured interviews were conducted with 15 OA patients recruited from 4 general practices in Sydney, Australia. Patients were ages ≥65 years, and were currently taking or had recently taken an NSAID for OA.
Three key themes emerged from the data: reliance, routine, and pill load. Patients were strongly reliant upon NSAIDs because they consistently satisfied their needs. By contrast, they were much less reliant upon acetaminophen because of uncertainty or skepticism about its effectiveness. They were not reliant upon CMs but were willing to take them indefinitely because they were perceived as being without risk. Many patients took an NSAID as well as CMs as part of a "daily routine." By contrast, patients had difficulty developing a routine around using acetaminophen at the recommended maximum dose because of the implicit frequency of dosing required and an aversion to the associated "pill load."
The results highlight the importance of exploring the perceptions and preferences of patients with regard to analgesics for OA. Clinician advice regarding analgesia for OA should take account of the possible reliance of the patient upon an NSAID, their medicine routines, and their potential concern about the pill load associated, in particular, with acetaminophen.
探索骨关节炎（OA）患者选择镇痛药（非甾体抗炎药[NSAIDs]、对乙酰氨基酚和补充药物[CMs]）的关键动机。
我们进行了一项定性研究，对 15 名从澳大利亚悉尼的 4 家普通诊所招募的 OA 患者进行了深入的半结构化访谈。患者年龄≥65 岁，目前正在服用或最近服用 NSAID 治疗 OA。
从数据中出现了三个关键主题：依赖、常规和药物负担。患者强烈依赖 NSAIDs，因为它们始终满足他们的需求。相比之下，他们对乙酰氨基酚的依赖程度要低得多，因为他们对其疗效存在不确定性或怀疑。他们不依赖 CMs，但愿意无限期服用，因为它们被认为没有风险。许多患者将 NSAID 和 CMs 作为“日常惯例”的一部分服用。相比之下，由于所需的给药频率隐含且对相关的“药物负担”感到厌恶，患者很难按照推荐的最大剂量常规使用乙酰氨基酚。
结果强调了探讨患者对 OA 镇痛药的看法和偏好的重要性。临床医生在 OA 疼痛治疗方面的建议应考虑到患者对 NSAID 的可能依赖、他们的用药常规以及他们对与乙酰氨基酚相关的药物负担的潜在担忧。
