Max M B
National Institutes of Health, Bethesda, Maryland.
Ann Intern Med. 1990 Dec 1;113(11):885-9. doi: 10.7326/0003-4819-113-11-885.
Frequent undertreatment of analgesic-responsive acute pain and chronic cancer pain persists, despite intensive efforts to provide clinicians with information about analgesics. A set of background factors must be addressed in interventions to improve pain treatment: Traditional patterns of clinician and patient interaction on the ward, quality assurance, and drug regulatory practices do not support prompt recognition and treatment of pain. Possible interventions to modify these patterns of daily practice include monitoring and displaying patient pain ratings routinely, making available educational tools to assist optimal drug ordering, encouraging patients to communicate about unrelieved pain, reviewing quality assurance of pain treatment regimens, increasing behavioral research into analgesic prescribing, and selectively modifying narcotics regulatory practices.
尽管已付出巨大努力向临床医生提供有关镇痛药的信息,但对镇痛反应性急性疼痛和慢性癌痛的治疗不足现象仍然频繁存在。在改善疼痛治疗的干预措施中,必须解决一系列背景因素:病房中医护人员与患者互动的传统模式、质量保证以及药品监管措施均不利于对疼痛的及时识别与治疗。改变这些日常诊疗模式的可能干预措施包括:常规监测并展示患者的疼痛评分、提供教育工具以协助优化药物处方、鼓励患者交流未缓解的疼痛、审查疼痛治疗方案的质量保证、加强镇痛药处方行为研究,以及有选择地调整麻醉药品监管措施。