Boston College, William F. Connell School of Nursing, Chestnut Hill, Massachusetts, USA.
Boston College, William F. Connell School of Nursing, Chestnut Hill, Massachusetts, USA.
J Pain Symptom Manage. 2021 Feb;61(2):395-415. doi: 10.1016/j.jpainsymman.2020.08.015. Epub 2020 Aug 19.
The prevalence of chronic pain in cancer survivors is double that of the general U.S.
Opioids have been the foundation of cancer pain management for decades; however, there is a paucity of literature on long-term opioid therapy (LTOT) in cancer survivors. An understanding of factors related to LTOT use in cancer survivors is needed to address chronic pain and balance opioid harms in the expanding population of cancer survivors.
To analyze the research of LTOT utilization and factors associated with persistent opioid use in cancer survivors.
A five-stage integrative review process was adapted from Whittemore and Knafl. Data sources searched included Web of Science, PubMed, Embase, Cochrane, and Google Scholar. Quantitative research studies from 2010 to present related to cancer survivors managed on LTOT were included. Editorials, reviews, or abstracts were excluded.
After reviewing 315 articles, 21 articles were included. We found that there were several definitions of LTOT in the reviewed studies, but the duration of opioid use (i.e., more than three months after completion of curative treatment) was the most common. The reviewed literature describes a relationship between LTOT and important biopsychosocial factors (cancer type, socioeconomic factors, and comorbidities).
The studies in this review shed light on the factors associated with LTOT in cancer survivors. LTOT was common in certain populations of cancer survivors and those with a collection of patient-specific characteristics. This review suggests that there is a critical need for specialized research on chronic cancer pain and opioid safety in cancer survivors.
癌症幸存者慢性疼痛的患病率是美国普通人群的两倍。
几十年来，阿片类药物一直是癌症疼痛管理的基础；然而，关于癌症幸存者长期使用阿片类药物（LTOT）的文献很少。为了解决癌症幸存者的慢性疼痛问题，并平衡不断扩大的癌症幸存者群体中阿片类药物的危害，需要了解与癌症幸存者 LTOT 使用相关的因素。
分析 LTOT 利用和与癌症幸存者持续使用阿片类药物相关的因素的研究。
采用 Whittemore 和 Knafl 的五阶段综合审查过程。搜索的数据源包括 Web of Science、PubMed、Embase、Cochrane 和 Google Scholar。纳入了与 LTOT 管理的癌症幸存者相关的 2010 年至今的定量研究。排除社论、评论或摘要。
在审查了 315 篇文章后，纳入了 21 篇文章。我们发现，在已审查的研究中有几种 LTOT 的定义，但最常见的是阿片类药物使用的持续时间（即，在根治性治疗完成后超过三个月）。已审查的文献描述了 LTOT 与重要的生物心理社会因素（癌症类型、社会经济因素和合并症）之间的关系。
本综述中的研究揭示了与癌症幸存者 LTOT 相关的因素。LTOT 在某些癌症幸存者人群中很常见，这些人群具有一系列特定于患者的特征。该综述表明，迫切需要对癌症幸存者的慢性癌症疼痛和阿片类药物安全性进行专门研究。
