Kratz Anna L, F Murphy John, Kalpakjian Claire Z, Chen Philip
Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI.
Clin J Pain. 2018 Apr;34(4):357-365. doi: 10.1097/AJP.0000000000000550.
There is little information about whether use of pain self-management skills that are common targets of psychosocial interventions for pain are associated with reduced reliance on pain medications. The aim of this study was to test whether higher chronic pain acceptance, which is a readily modified pain self-management approach, is related to lower use of pain medications (eg, opioid medications, and gabapentinoids) in a sample with chronic pain and spinal cord injury (SCI).
This is a cross-sectional survey study of pain medication use, pain severity and distribution (Brief Pain Inventory [BPI]), depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]), and chronic pain acceptance (Chronic Pain Acceptance Questionnaire [CPAQ]) administered to a sample of 120 adults with chronic pain and SCI.
Regression results indicated that, above and beyond the effects of pain intensity, pain distribution, and depressive symptoms, higher pain acceptance was related to lower use of all types of pain medications, and lower odds of using opioid medications or gabapentinoids. Pain intensity was not related to pain medication use, but greater pain distribution was related to using more pain medications in general and to greater odds of using gabapentinoids.
Findings from this study indicate that those with chronic pain and SCI who have a more accepting orientation to pain are less reliant on pain medications, and thereby experience lower risks associated with medication consumption. Longitudinal, daily process, and clinical trial studies are needed to better understand the association between pain acceptance and pain medication consumption.
关于疼痛自我管理技能（心理社会疼痛干预的常见目标）的使用是否与减少对止痛药物的依赖相关，目前信息较少。本研究的目的是测试更高的慢性疼痛接纳度（一种易于调整的疼痛自我管理方法）是否与慢性疼痛和脊髓损伤（SCI）样本中较低的止痛药物（如阿片类药物和加巴喷丁类药物）使用相关。
这是一项横断面调查研究，对120名患有慢性疼痛和SCI的成年人样本进行了止痛药物使用、疼痛严重程度和分布（简明疼痛量表[BPI]）、抑郁症状（患者健康问卷-9[PHQ-9]）以及慢性疼痛接纳度（慢性疼痛接纳问卷[CPAQ]）的调查。
回归结果表明，除疼痛强度、疼痛分布和抑郁症状的影响外，更高的疼痛接纳度与所有类型止痛药物的较低使用以及使用阿片类药物或加巴喷丁类药物的较低几率相关。疼痛强度与止痛药物使用无关，但更大的疼痛分布通常与使用更多的止痛药物以及使用加巴喷丁类药物的更高几率相关。
本研究结果表明，对疼痛有更接纳态度的慢性疼痛和SCI患者对止痛药物的依赖程度较低，因此药物消费相关风险也较低。需要进行纵向、日常过程和临床试验研究，以更好地理解疼痛接纳度与止痛药物消费之间的关联。
