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医疗服务提供者对管理癌症疼痛患者和非医疗性阿片类药物使用的态度、信念及感知信心。

Health Care Provider Attitudes, Beliefs, and Perceived Confidence in Managing Patients With Cancer Pain and Nonmedical Opioid Use.

作者信息

Arthur Joseph, Edwards Tonya, Lu Zhanni, Hui David, Fellman Bryan, Bruera Eduardo

机构信息

Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer, Houston, Texas, USA.

Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer, Houston, Texas, USA.

出版信息

J Pain Symptom Manage. 2021 Jan;61(1):128-135.e6. doi: 10.1016/j.jpainsymman.2020.06.040. Epub 2020 Jul 6.

Abstract

CONTEXT

Health care provider education is an effective strategy to improve knowledge and competencies in opioid-prescribing practices. However, there are very few studies regarding this among providers of patients with cancer pain and nonmedical opioid use (NMOU). The aim of our study was to assess participants' attitudes, beliefs, and self-perceived confidence in caring for patients with cancer pain and NMOU before and after attending an opioid educational seminar on the use and nonmedical use of opioids in patients with cancer.

METHODS

An anonymous cross-sectional survey was conducted among health care providers who attended an opioid educational event in April 2018 and May 2019.

RESULTS

The overall response rate was 63% (129 of 206). Approximately 72% of participants had concerns about NMOU in patients with cancer, 69% felt that such patients are frequently underdetected, and 63% felt that cancer pain is frequently undertreated. At baseline, only 23% reported adequate knowledge and 35% reported confidence in caring for patients with cancer with NMOU-related issues. Among those who completed both the preseminar and postseminar surveys, these numbers improved significantly at the end of the seminar (26% vs. 71% and 43% vs. 84%, respectively; all P < 0.001).

CONCLUSION

Most health care providers expressed concerns about underdetection of NMOU and undertreatment of pain among patients with cancer. Many self-reported knowledge and confidence deficits in caring for patients with cancer with NMOU. Seminar participation was associated with an increase in the number of participants with self-perceived knowledge and confidence. Future studies are needed to ascertain the impact of such opioid educational events on patient care practices.

摘要

背景

医疗服务提供者教育是提高阿片类药物处方实践知识和能力的有效策略。然而,在癌症疼痛患者和非医疗用阿片类药物(NMOU)使用者的医疗服务提供者中,关于这方面的研究非常少。我们研究的目的是评估参与者在参加关于癌症患者阿片类药物使用和非医疗使用的教育研讨会之前和之后,对护理癌症疼痛患者和NMOU患者的态度、信念和自我感知的信心。

方法

对参加2018年4月和2019年5月阿片类药物教育活动的医疗服务提供者进行了一项匿名横断面调查。

结果

总体回复率为63%(206人中的129人)。约72%的参与者担心癌症患者中的NMOU,69%的人认为此类患者经常未被检测到,63%的人认为癌症疼痛经常治疗不足。在基线时,只有23%的人报告有足够的知识,35%的人报告对护理有NMOU相关问题的癌症患者有信心。在完成研讨会前和研讨会后调查的人中,这些数字在研讨会结束时显著改善(分别为26%对71%和43%对84%;所有P<0.001)。

结论

大多数医疗服务提供者对癌症患者中NMOU检测不足和疼痛治疗不足表示担忧。许多人自我报告在护理有NMOU的癌症患者方面知识和信心不足。参加研讨会与自我感知知识和信心的参与者数量增加有关。需要进一步的研究来确定此类阿片类药物教育活动对患者护理实践的影响。

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