魁北克家庭医生治疗慢性非癌性疼痛的阿片类药物处方实践和培训需求。
Opioid Prescribing Practices and Training Needs of Québec Family Physicians for Chronic Noncancer Pain.
机构信息
Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Campus de Longueuil, 150 place Charles-Le Moyne, Room 200, Longueuil, QC, Canada J4K 0A8.
Direction des Risques Biologiques et de la Santé au Travail, Institut National de Santé Publique du Québec, 190 Crémazie Est., Montréal, QC, Canada H2P 1E2.
出版信息
Pain Res Manag. 2017;2017:1365910. doi: 10.1155/2017/1365910. Epub 2017 Jul 31.
AIM
To examine medical practices and training needs of Québec family physicians with respect to pain management and opioid prescription for chronic noncancer pain (CNCP).
METHODOLOGY
An online survey was carried out in 2016.
RESULTS
Of 636 respondents (43.0% men; 54.3% ≥ 50 years old), 15.2% and 70.9% felt very or somewhat confident that they could properly prescribe opioids for CNCP. Concerns related to abuse (72.5% strongly/somewhat agree), dependence (73.2%), and lack of support (75.4%) were the main barriers reported. Only 19.7% always/often screened their patients for risks of abuse and dependence using a screening tool. About two-thirds of participants (65.7%) had recently (last five years) taken part in continuing education programs on opioid use for CNCP and 73.4% on CNCP management. Patient evaluation and differential diagnoses of chronic pain syndromes were rated as a top priority for further training.
CONCLUSIONS
This study provides insights into Québec family physicians' concerns, practices, and needs with respect to the management of CNCP. Physicians' difficulties around the application of strategies to mitigate the problem of opioid abuse and addiction are worrying. The need to better train physicians in the field of pain and addiction cannot be emphasized enough.
目的
调查魁北克家庭医生在慢性非癌性疼痛（CNCP）的疼痛管理和阿片类药物处方方面的医疗实践和培训需求。
方法
2016 年进行了在线调查。
结果
在 636 名受访者中（43.0%为男性；54.3%≥50 岁），15.2%和 70.9%的受访者非常有信心或有些信心能够正确开具阿片类药物治疗 CNCP。滥用（72.5%强烈/有些同意）、依赖（73.2%）和缺乏支持（75.4%）是报告的主要障碍。只有 19.7%的人经常/经常使用筛查工具对患者的滥用和依赖风险进行筛查。大约三分之二的参与者（65.7%）最近（过去五年）参加了关于阿片类药物治疗 CNCP 和 CNCP 管理的继续教育课程，73.4%的人参加了关于 CNCP 管理的继续教育课程。对患者的评估和慢性疼痛综合征的鉴别诊断被评为进一步培训的首要任务。
结论
本研究深入了解了魁北克家庭医生在 CNCP 管理方面的关注点、实践和需求。医生在应用减轻阿片类药物滥用和成瘾问题的策略方面遇到困难令人担忧。强调需要加强对医生在疼痛和成瘾领域的培训是非常重要的。
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