Department of Rehabilitation Medicine, Harborview Medical Center, University of Washington, Seattle, WA 98104, USA.
Clin J Pain. 2013 Apr;29(4):289-95. doi: 10.1097/AJP.0b013e3182527b74.
To understand the factors that contribute to patient and physician global outcome ratings and the extent to which receiving different doses of opioids or placebo might influence the importance of these factors better.
A secondary analysis was performed using data from a prospective, multicenter, double-blind placebo-controlled, and active-controlled parallel group dose-ranging study comparing the efficacy of oxymorphone extended release (ER) 20 mg (ER20, N=121); oxymorphone ER 40 mg (ER40, N=121); oxycodone controlled release 20 mg (Oxy20, N=125); and placebo (N=124) in a sample of patients with osteoarthritis. We performed 2 regression analyses to identify the predictors of pretreatment to posttreatment improvement in patient and physician global ratings of arthritis status.
Improvement in global ratings of arthritis status was strongly associated with a decrease in pain intensity. Pretreatment to posttreatment improvement in physical and psychological functioning made independent contributions to the prediction of both criterion variables.
The findings underscore the importance of change in pain intensity as a key correlate of ratings of global improvement. However, pain intensity is not the only important factor. In the current sample, improvement in both physical and psychological functioning made independent contributions to improvements in ratings of osteoarthritis status, supporting global ratings as assessing multicomponent domains. Overall, the findings suggest that when a patient or physician reports that the patient is "doing better," the patient is likely reporting less pain intensity and engaging in more physical activity and feeling better emotionally.
了解影响患者和医生整体结局评分的因素，以及接受不同剂量阿片类药物或安慰剂可能如何更好地影响这些因素的重要性。
使用来自一项前瞻性、多中心、双盲安慰剂对照、阳性药物对照平行分组剂量范围研究的数据进行二次分析，该研究比较了羟吗啡酮缓释片 20mg（ER20，N=121）；羟吗啡酮缓释片 40mg（ER40，N=121）；盐酸羟考酮控释片 20mg（Oxy20，N=125）和安慰剂（N=124）在骨关节炎患者样本中的疗效。我们进行了 2 项回归分析，以确定治疗前至治疗后患者和医生对关节炎状态整体评分改善的预测因素。
关节炎状态整体评分的改善与疼痛强度的降低密切相关。身体和心理功能的治疗前至治疗后改善对两个标准变量的预测均有独立贡献。
这些发现强调了疼痛强度作为整体改善评分的关键相关因素的重要性。然而，疼痛强度并不是唯一重要的因素。在当前样本中，身体和心理功能的改善均对关节炎状态评分的改善有独立贡献，支持整体评分评估多成分领域。总体而言，这些发现表明，当患者或医生报告患者“情况好转”时，患者可能报告疼痛强度降低，身体活动增加，情绪改善。
