Memorial Sloan Kettering Cancer Center.
Lehigh Valley Health Network Cancer Institute.
Clin J Oncol Nurs. 2020 Apr 1;24(2):170-176. doi: 10.1188/20.CJON.170-176.
Opioids are commonly prescribed to manage cancer pain. Similar to the general population, patients with cancer are not excluded from the risk for opioid misuse and dependence. This situation can contribute to clinician reluctance to prescribe and manage pain using opioids.
The purpose of this article is to provide an overview of how opioid misuse may affect pain management in patients with cancer and to describe a comprehensive cancer center's approach to safely managing cancer pain.
Based on a literature review, the project team developed a stewardship program. Project components included selecting a validated screening tool for risk of opioid misuse, determining if a history of addiction affects pain management in patients with cancer, and establishing a task force to focus on the opioid crisis and to follow the Joint Commission's revised pain assessment and management standards.
The project established a hospitalwide opioid stewardship program. Through the use of a multidisciplinary, universal precautions approach to assessing misuse in all patients with cancer who are prescribed opioids, healthcare teams can potentially reduce risks associated with misuse while safely managing cancer pain.
阿片类药物常用于治疗癌症疼痛。与普通人群一样，癌症患者也不能免除阿片类药物滥用和依赖的风险。这种情况可能导致临床医生不愿意开阿片类药物来治疗和管理疼痛。
本文旨在概述阿片类药物滥用如何影响癌症患者的疼痛管理，并描述一家综合性癌症中心安全管理癌症疼痛的方法。
基于文献回顾，项目团队制定了一项管理计划。项目组成部分包括选择一种经验证的阿片类药物滥用风险筛查工具，确定是否有药物滥用史会影响癌症患者的疼痛管理，以及成立一个工作组，重点关注阿片类药物危机，并遵循联合委员会修订的疼痛评估和管理标准。
该项目建立了一个全院范围的阿片类药物管理计划。通过对所有开具阿片类药物的癌症患者进行多学科、普遍预防措施的滥用评估，医疗保健团队可以在安全管理癌症疼痛的同时，降低与滥用相关的风险。
