Bialas Patric, Drescher Beate, Gottschling Sven, Juckenhöfel Stephanie, Konietzke Dieter, Kuntz Wolfgang, Kühne-Adler Isabell, Merl-Ripplinger Heidi, Preisegger Diether, Schneider Kathrein, Strauß Manfred, Welsch Patrick, Häuser Winfried
Schmerzambulanz, Universitätskliniken des Saarlandes, Homburg/Saar, Deutschland.
Schmerzmedizinische Praxis am Kleinen Markt Saarlouis, Saarlouis, Deutschland.
Schmerz. 2019 Oct;33(5):399-406. doi: 10.1007/s00482-019-0383-1.
There are uncertainties among physicians with respect to the indications, selection of drugs, effectiveness and safety of cannabis-based medicines for chronic pain.
All statutory health insurance pain physicians in Saarland were asked to complete a self-developed questionnaire assessing their experiences with cannabis-based medicines, which they prescribed between 10 March 2017 and 30 November 2018 for adult patients with chronic cancer and non-cancer pain.
All statutory health insurance pain physicians participated in the survey and 13 out of 20 reported having prescribed cannabis-based medicines. The most frequent reasons for prescriptions in 136 patients (1.9% of the patients of the institutions) were failure of established treatment (73%) and desire of the patient (63%). In 35% of patients the type of pain was nociceptive, in 34% neuropathic, in 29% nociceptive and neuropathic and in 13% nociplastic. Dronabinol was prescribed for 95% of the patients and 71% were responders (clinically relevant reduction of pain or of other symptoms). In 29% of patients treatment was terminated due to either a lack of efficacy or adverse events.
Statutory health insurance pain physicians in Saarland were reluctant to prescribe cannabis-based medicines. Dronabinol was effective and well-tolerated in the majority of the highly selected patients.
对于基于大麻的药物用于慢性疼痛的适应症、药物选择、有效性和安全性，医生们存在不确定性。
邀请了萨尔州所有法定医疗保险的疼痛科医生填写一份自行设计的问卷，以评估他们在2017年3月10日至2018年11月30日期间为成年慢性癌症和非癌症疼痛患者开具基于大麻的药物的经验。
所有法定医疗保险的疼痛科医生都参与了调查，20名医生中有13名报告开具过基于大麻的药物。在136名患者（占机构患者的1.9%）中，最常见的处方原因是既定治疗失败（73%）和患者的意愿（63%）。35%的患者疼痛类型为伤害性疼痛，34%为神经性疼痛，29%为伤害性和神经性疼痛，13%为神经病理性疼痛。95%的患者使用了屈大麻酚，71%的患者有反应（疼痛或其他症状有临床相关减轻）。29%的患者因疗效不佳或不良事件而终止治疗。
萨尔州法定医疗保险的疼痛科医生不愿开具基于大麻的药物。屈大麻酚在大多数经过严格挑选的患者中有效且耐受性良好。
