Lumish Rachel, Goga Joshana K, Brandt Nicole J
J Gerontol Nurs. 2018 Jan 1;44(1):9-14. doi: 10.3928/00989134-20171213-04.
The use of opioid drug therapy in older adults has increased over the past decade. Although use of opioid drugs may be clinically warranted, ongoing use needs to be monitored closely to evaluate risks and benefits, especially with the potential for adverse events and misuse. An opioid drug deprescribing protocol would provide clinicians with a method to assess an individual's need for opioid agents, as well as a systematic process to taper opioid drug therapy when deemed appropriate. Although more than 60 studies have reported methods for deprescribing, there is currently no established guideline for discontinuing opioid medications. The U.S. Department of Veterans Affairs has developed an algorithm to assist clinicians with opioid drug discontinuation decision making. As efforts to discontinue opioid drugs for chronic non-cancer pain in older adults continue to expand, nurses, as an integral part of the inter-professional team, will play a key role in monitoring and assessing patients' pain and care plans. [Journal of Gerontological Nursing, 44(1), 9-14.].
在过去十年中，老年人使用阿片类药物治疗的情况有所增加。虽然使用阿片类药物在临床上可能是必要的，但需要密切监测其持续使用情况，以评估风险和益处，尤其是考虑到潜在的不良事件和滥用情况。阿片类药物减停方案将为临床医生提供一种方法，来评估个体对阿片类药物的需求，以及在认为适当时逐步减少阿片类药物治疗的系统流程。尽管已有60多项研究报告了减停方法，但目前尚无关于停用阿片类药物的既定指南。美国退伍军人事务部已开发出一种算法，以协助临床医生进行阿片类药物停用决策。随着老年人慢性非癌性疼痛停用阿片类药物的努力不断扩大，护士作为跨专业团队的重要组成部分，将在监测和评估患者疼痛及护理计划方面发挥关键作用。[《老年护理杂志》，44(1)，9 - 14。]
