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十大要点:姑息治疗临床医生应该了解的阿片类药物使用障碍。

Top Ten Tips Palliative Care Clinicians Should Know About Opioid Use Disorder.

机构信息

Palliative Care Service, Department of Medicine, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA.

Section of Palliative Care, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

出版信息

J Palliat Med. 2020 Sep;23(9):1250-1256. doi: 10.1089/jpm.2020.0409. Epub 2020 Jul 21.

Abstract

Since the prevalence of substance use disorders, and opioid use disorder (OUD) specifically, remains high and represents a public health crisis, it is critical that palliative care (PC) providers have a broad understanding of this class of chronic, yet treatable, diseases. Conceptualizing stigma associated with OUD, treatment modalities available, and educational opportunities are key factors in providing patient-centered care. A solid foundation of knowledge about OUD in the setting of serious illness is also crucial as PC providers often recommend or prescribe opioids for symptom management in patients who also have OUD. Furthermore, the PC interdisciplinary team is particularly well poised to care for patients suffering from OUD due to the inherently holistic approach already present in the specialty of PC. This article offers PC teams a framework for understanding the diagnosis and treatment of OUD, methods for performing risk stratification and monitoring, and an overview of opportunities to enhance our care of PC patients with OUD.

摘要

由于物质使用障碍的流行率,特别是阿片类药物使用障碍(OUD)的流行率仍然很高,并且构成了公共卫生危机,因此姑息治疗(PC)提供者对这一类慢性但可治疗的疾病有广泛的了解至关重要。概念化与 OUD 相关的污名、可用的治疗方式和教育机会是提供以患者为中心的护理的关键因素。在严重疾病的背景下,对 OUD 有坚实的基础知识也是至关重要的,因为 PC 提供者通常会为同时患有 OUD 的患者推荐或开阿片类药物来进行症状管理。此外,由于 PC 专业本身已经存在整体方法,因此 PC 跨学科团队特别适合照顾患有 OUD 的患者。本文为 PC 团队提供了一个框架,用于理解 OUD 的诊断和治疗、进行风险分层和监测的方法,以及概述了增强我们对患有 OUD 的 PC 患者护理的机会。

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