Edelman Linda S, Hemmert Rachael
J Gerontol Nurs. 2019 Sep 1;45(9):5-10. doi: 10.3928/00989134-20190813-02.
Older adults living in long-term care (LTC) settings experience a higher incidence of chronic pain than those living in the community and are prescribed opioids at approximately twice the rate. Opioids are effective in managing pain in LTC residents, who are often not candidates for nonopioid pharmacological or nonpharmacological therapies. The recent Centers for Disease Control and Prevention guideline for opioid stewardship recommends conservative opioid prescribing and discourages long-term opioid use for chronic pain management, raising concern that pain may not be adequately treated for LTC residents. The Society for Post-Acute and Long-Term Care Medicine recently published a policy statement that addresses responsible opioid stewardship in LTC. The current article describes clinical guidelines and standards that can guide LTC nurses in assessing, treating, and monitoring opioid use so that residents have diminished pain without significant adverse events. [Journal of Gerontological Nursing, 45(9), 5-10.].
与居住在社区的老年人相比,住在长期护理(LTC)机构中的老年人慢性疼痛发病率更高,且开具阿片类药物的比例约为前者的两倍。阿片类药物对管理LTC机构居民的疼痛有效,这些居民往往不适合接受非阿片类药物或非药物治疗。美国疾病控制与预防中心最近发布的阿片类药物管理指南建议谨慎开具阿片类药物,并不鼓励长期使用阿片类药物来管理慢性疼痛,这引发了人们对LTC机构居民疼痛可能无法得到充分治疗的担忧。急性后和长期护理医学协会最近发表了一项政策声明,阐述了LTC机构中负责任的阿片类药物管理。本文介绍了临床指南和标准,可指导LTC机构护士评估、治疗和监测阿片类药物的使用,从而使居民疼痛减轻且无重大不良事件发生。[《老年护理杂志》,45(9),5 - 10。]