Perez Jordi, Olivier Sara, Rampakakis Emmanouil, Borod Manuel, Shir Yoram
Cancer Pain Clinic, Division of Supportive and Palliative Care, McGill University Health Centre, Montreal, QC, Canada; Alan Edwards Pain Management Unit, McGill University Health Centre, Montreal, QC, Canada.
Cancer Pain Clinic, Division of Supportive and Palliative Care, McGill University Health Centre, Montreal, QC, Canada.
Pain Res Manag. 2016;2016:2157950. doi: 10.1155/2016/2157950. Epub 2016 Mar 31.
Context. The McGill University Health Center (MUHC) Cancer Pain Clinic offers an interdisciplinary approach to cancer pain management for patients. The core team includes a nurse clinician specialist in oncology and palliative care, a palliativist, an anaesthetist, and a radiation oncologist. This tailored approach includes pharmacological and nonpharmacological therapies offered concurrently in an interdisciplinary fashion. Objectives. Description of the interdisciplinary MUHC cancer pain approach and analysis of treatments and outcomes. Methods. A retrospective analysis of new outpatients completing two subsequent visits (baseline and follow-ups: FU1, FU2) was conducted. Variables included (a) symptom severity measured by the Edmonton Symptom Assessment Scale, (b) pain and disability measured with the Brief Pain Inventory, and (c) analgesic plan implementation including pharmacological and nonpharmacological therapies. Results. 71 charts were reviewed. Significant pain relief was achieved consistently at FU1 and FU2. The average pain severity decreased by 2 points between initial assessment and FU2. More than half (53%) of patients responded with a pain reduction greater than 30%. Severity of other symptoms (i.e., fatigue, nausea, depression, and anxiety) and disability also decreased significantly at FU2. The total consumption of opioids remained stable; however, the consumption of short acting preparations decreased by 52% whereas the prescription of nonopioid agents increased. Beyond drug management, 60% of patients received other analgesic therapies, being the most common interventional pain procedures and psychosocial approaches. Conclusion. The MUHC interdisciplinary approach to cancer pain management provides meaningful relief of pain and other cancer-related symptoms and decreases patients' disability.
背景。麦吉尔大学健康中心（MUHC）癌症疼痛诊所为患者提供癌症疼痛管理的跨学科方法。核心团队包括一名肿瘤学和姑息治疗护士临床专家、一名姑息治疗医生、一名麻醉师和一名放射肿瘤学家。这种量身定制的方法包括以跨学科方式同时提供的药物和非药物疗法。目的。描述MUHC癌症疼痛的跨学科方法，并分析治疗方法和结果。方法。对完成两次后续就诊（基线和随访：FU1、FU2）的新门诊患者进行回顾性分析。变量包括：（a）通过埃德蒙顿症状评估量表测量的症状严重程度；（b）用简明疼痛量表测量的疼痛和残疾情况；（c）镇痛计划的实施情况，包括药物和非药物疗法。结果。共审查了71份病历。在FU1和FU2时均持续实现了显著的疼痛缓解。从初始评估到FU2，平均疼痛严重程度下降了2分。超过一半（53%）的患者疼痛减轻超过30%。在FU2时，其他症状（即疲劳、恶心、抑郁和焦虑）的严重程度以及残疾情况也显著下降。阿片类药物的总消耗量保持稳定；然而，短效制剂的消耗量下降了52%，而非阿片类药物的处方量增加。除药物管理外，60%的患者接受了其他镇痛疗法，最常见的是介入性疼痛治疗和心理社会方法。结论。MUHC癌症疼痛管理的跨学科方法能有效缓解疼痛和其他与癌症相关的症状，并减少患者的残疾情况。
