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关于阿片类药物益处与风险的联合医疗预约与提高患者管理慢性疼痛的信心相关。

A Shared Medical Appointment on the Benefits and Risks of Opioids Is Associated With Improved Patient Confidence in Managing Chronic Pain.

作者信息

Romanelli Robert J, Dolginsky Marina, Byakina Yuliya, Bronstein Deborah, Wilson Sandra

机构信息

Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA.

Pharmacy Doctoral Program, University of California San Francisco, San Francisco, CA, USA.

出版信息

J Patient Exp. 2017 Sep;4(3):144-151. doi: 10.1177/2374373517706837. Epub 2017 May 8.

Abstract

OBJECTIVES

To evaluate a shared medical appointment (SMA) on opioids in the treatment of chronic pain.

RESEARCH DESIGN

This prospective study was conducted at an ambulatory clinic within a health-care delivery system. The SMA is a single 90-minute encounter, led by a physician. We included adult patients who attended the SMA and completed an immediate pre-post survey. Survey items were measured on a scale from 0 (worst) to 5 (best). Mean differences in pre-post responses were assessed by a paired test.

RESULTS

A total of 130 patients were included in the analysis. Patients showed improvements in confidence in self-managing pain (+0.44; 95% confidence interval [CI]: 0.29-0.59; < .001) and their providers' ability to help manage pain (+0.28; 95% CI: 0.14-0.43; < .001). Most patients (81%) were very/extremely satisfied with the SMA.

CONCLUSIONS

An SMA on the benefits and risks of opioids was associated with prompt improvements in patients' confidence in self-managing pain and in their health-care providers' ability to help manage pain. Such confidence can lay the foundation for increased patient engagement and activation in pain management.

摘要

目的

评估关于阿片类药物治疗慢性疼痛的共享医疗预约(SMA)。

研究设计

这项前瞻性研究在一个医疗保健系统内的门诊诊所进行。SMA是由一名医生主导的单次90分钟的会诊。我们纳入了参加SMA并完成即时前后调查的成年患者。调查项目的评分范围为0(最差)至5(最佳)。前后反应的平均差异通过配对检验进行评估。

结果

共有130名患者纳入分析。患者在自我管理疼痛的信心方面有所改善(+0.44;95%置信区间[CI]:0.29 - 0.59;P <.001),在其医疗服务提供者帮助管理疼痛的能力方面也有所改善(+0.28;95% CI:0.14 - 0.43;P <.001)。大多数患者(81%)对SMA非常/极其满意。

结论

关于阿片类药物益处和风险的SMA与患者自我管理疼痛的信心以及其医疗服务提供者帮助管理疼痛的能力迅速改善相关。这种信心可为患者在疼痛管理中增强参与度和积极性奠定基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/857c/5593266/e354db83f234/10.1177_2374373517706837-fig1.jpg

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