Engeser P, Kuate Fokan E, Laux G, Szecsenyi J, Krug K, Leutgeb R
Abteilung Allgemeinmedizin und Versorgungsforschung, Universitätsklinikum Heidelberg, Voßstr. 2/37, 69115, Heidelberg, Deutschland.
Schmerz. 2016 Jun;30(3):266-72. doi: 10.1007/s00482-016-0110-0.
In line with the increased life expectancy of people in Germany, the probability of falling ill with a malignant disease is continuously increasing. About 480,000 people in Germany contract cancer every year. One of the most important symptoms of a malignant disease is pain. Between 40 and 100% of patients with advanced cancer suffer from pain. The aim of this investigation is to show how German general practitioners care for these patients using analgetics.
The data were extracted from the CONTENT database (CONTinuous morbidity registration Epidemiologic NeTwork) of the Department of General Practice and Health Services Research at the University Hospital in Heidelberg. This database has data from more than 200,000 patients and more than 3 million physician/patient contacts. The prescriptions were classified using the ATC code.
Patients experiencing pain from cancer received all kinds of analgetic drugs. The data comprises 9752 prescriptions for 1362 patients. There were 4975 (51.1 %) prescriptions for Class 1 analgesics, 929 (9.5 %) for Class 2 analgetics and 1918 (19.7 %) prescriptions for Class 3 analgetics. Coanalgetics were prescribed 1930 (19.7 %) times. 1,167 patients (85.7 %) were treated in the correct manner according to the guidelines of the World Health Organisation and 195 (14.3 %) were not.
Most GPs in Germany follow the principles of WHO structured pain therapy. However, further improvement of the results may be achieved through intensive training of colleagues.
随着德国人均预期寿命的增加，患恶性疾病的概率也在持续上升。德国每年约有48万人患癌症。恶性疾病最重要的症状之一是疼痛。40%至100%的晚期癌症患者遭受疼痛折磨。本研究的目的是展示德国全科医生如何使用镇痛药治疗这些患者。
数据取自海德堡大学医院全科与卫生服务研究部的CONTENT数据库（连续发病率登记流行病学网络）。该数据库包含20多万患者的数据以及300多万次医患接触记录。处方按照解剖学治疗学及化学分类系统（ATC）编码进行分类。
癌症疼痛患者接受了各类镇痛药治疗。数据包括1362名患者的9752张处方。一级镇痛药处方有4975张（51.1%），二级镇痛药处方有929张（9.5%），三级镇痛药处方有1918张（19.7%）。辅助镇痛药处方开具了1930次（19.7%）。1167名患者（85.7%）按照世界卫生组织的指南接受了正确治疗，195名患者（14.3%）未接受正确治疗。
德国大多数全科医生遵循世界卫生组织结构化疼痛治疗原则。然而，通过对同行进行强化培训，可能会进一步改善治疗效果。
