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在综合癌症中心中,比较实现个性化疼痛目标的指标。

Comparison of Indicators for Achievement of Pain Control With a Personalized Pain Goal in a Comprehensive Cancer Center.

机构信息

Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan.

Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan; Division of Biomarker Discovery, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center Hospital East, Kashiwa, Japan.

出版信息

J Pain Symptom Manage. 2018 Apr;55(4):1159-1164. doi: 10.1016/j.jpainsymman.2017.12.476. Epub 2017 Dec 15.

Abstract

CONTEXT

The achievement of a personalized pain goal (PPG) is advocated as an individualized pain relief indicator.

OBJECTIVES

Pain relief indicators, including PPG, pain intensity (PI), and interference with daily activities (interference), were compared herein.

METHODS

This was a single-center cross-sectional study. Adult patients with cancer on opioid medications who visited the outpatient clinic at the National Cancer Center Hospital East between March and September 2015 were consecutively enrolled. Patients conducted a self-report questionnaire, including reports of average PI, interference, PPG, and the need for further analgesic treatment. We compared the proportion of patients achieving PPG (PI ≤ PPG) and other pain relief indicators including PI ≤3 or interference ≤3 and the percentage of patients who did not need further analgesic treatment among those who fulfilled each pain relief indicator.

RESULTS

A total of 347 patients (median age 64; 38% females) were analyzed. Median (interquartile range [IQR]) of PPG, PI, and interference was 2 (IQR 1-3), 2 (IQR 1-4), and 2 (IQR 0-5), respectively. The proportion of patients achieving PPG was 45.3% and significantly lower than those with PI ≤3 (69.0%; P < 0.001) and interference ≤3 (70.2%; P < 0.001). Eighty percent of patients achieving PPG did not need further analgesic treatment, whereas 70.8% of patients with PI ≤3 (P < 0.001) and 73.3% with interference ≤3 did need further analgesic treatment (P < 0.001).

CONCLUSION

The achievement of PPG was a stricter pain relief indicator than PI and interference and may reflect a real need for pain control.

摘要

背景

实现个性化疼痛目标(PPG)被提倡作为个体化疼痛缓解的指标。

目的

比较疼痛缓解指标,包括 PPG、疼痛强度(PI)和日常活动干扰(干扰)。

方法

这是一项单中心横断面研究。2015 年 3 月至 9 月期间,连续纳入在国立癌症中心医院东部门诊就诊的使用阿片类药物的癌症成年患者。患者进行了自我报告问卷,包括平均 PI、干扰、PPG 和进一步镇痛治疗的需求报告。我们比较了达到 PPG(PI≤PPG)和其他疼痛缓解指标(包括 PI≤3 或干扰≤3)的患者比例,以及在满足每个疼痛缓解指标的患者中,不需要进一步镇痛治疗的患者比例。

结果

共分析了 347 例患者(中位数年龄 64 岁;38%为女性)。PPG、PI 和干扰的中位数(四分位距 [IQR])分别为 2(IQR 1-3)、2(IQR 1-4)和 2(IQR 0-5)。达到 PPG 的患者比例为 45.3%,明显低于 PI≤3 的患者(69.0%;P<0.001)和干扰≤3 的患者(70.2%;P<0.001)。达到 PPG 的 80%的患者不需要进一步的镇痛治疗,而 PI≤3 的患者中 70.8%(P<0.001)和干扰≤3 的患者中 73.3%需要进一步的镇痛治疗(P<0.001)。

结论

与 PI 和干扰相比,达到 PPG 是更严格的疼痛缓解指标,可能反映了对疼痛控制的真正需求。

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