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基于微信应用程序的强化教育可提高门诊癌症相关疼痛阿片滴定治疗的质量:一项随机对照研究。

WeChat app-based reinforced education improves the quality of opioid titration treatment of cancer-related pain in outpatients: a randomized control study.

机构信息

Department of Pain Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Department of Anesthesiology, Yuyao people's Hospital, Ningbo, China.

出版信息

BMC Cancer. 2020 Sep 4;20(1):852. doi: 10.1186/s12885-020-07270-w.

Abstract

BACKGROUND

As inadequate pain communication contributes to difficulties in optimizing outcomes of outpatients, we investigated the effect of reinforced education using WeChat App to the opioid titration treatment of cancer-related pain in the outpatient setting.

METHODS

We conducted a prospective study to compare reinforced education using Wechat with care as usual from February to December 2019. Patients in the reinforced education group received reinforced education via Wechat, while those in the control group received care as usual. Effect measurements for both groups are carried out with questionnaires at the baseline and 3 days later. Questionnaires include pain intensity (NRS), treatment-related adverse events, cancer-related quality of life (QOL), sleep (PSQI), satisfaction, anxiety (GAD-7) and depression (PHQ-9). Number of patients whose NRS reduced to less than three points in 24 h was the primary outcomes. Secondary outcomes included treatment-related adverse events, cancer-related quality of life, sleep, satisfaction, anxiety and depression.

RESULTS

Although there was no significant difference regarding pain intensity (NRS) between the two groups at 72 h, the rate of NRS that reduced to less than three points in 24 h was significantly higher in the Wechat group than in the control group. Patients' satisfaction was significantly higher in the Wechat group than in the control group. There was no significant difference between the two groups regarding the other findings at 72 h, including pain intensity (NRS), cancer-related quality of life (QOL), anxiety (GAD-7), depression (PHQ-9), and sleep (PSQI). However, no significant difference was found between the two groups for constipation, nausea, vomiting, dizziness, somnolence, pruritus, loss of consciousness, and death.

CONCLUSIONS

Our results indicated that receiving instructions delivered by Wechat resulted an increased number of patients with good pain control and better satisfaction. The study provided insight into the effectiveness of the reinforced education using a Wechat app delivered by a doctor to outpatients in the titration treatment of cancer-related pain.

TRIAL REGISTRATION

This study was registered at chictr.org (Registration number: ChiCTR1900021150 , Date of Registration: January 30, 2019).

摘要

背景

由于疼痛沟通不充分导致门诊患者的治疗效果优化存在困难,我们研究了强化微信应用程序教育对门诊癌症相关疼痛阿片类药物滴定治疗的影响。

方法

我们进行了一项前瞻性研究,比较了强化微信教育组和常规护理组(2019 年 2 月至 12 月)。强化微信教育组患者通过微信接受强化教育,而对照组患者接受常规护理。两组患者在基线和 3 天后通过问卷进行效果测量。问卷包括疼痛强度(NRS)、治疗相关不良事件、癌症相关生活质量(QOL)、睡眠(PSQI)、满意度、焦虑(GAD-7)和抑郁(PHQ-9)。NRS 在 24 小时内降低至 3 分以下的患者人数为主要结局。次要结局包括治疗相关不良事件、癌症相关生活质量、睡眠、满意度、焦虑和抑郁。

结果

虽然在 72 小时时两组患者的疼痛强度(NRS)没有显著差异,但微信组 NRS 在 24 小时内降低至 3 分以下的比例明显高于对照组。微信组患者满意度明显高于对照组。在 72 小时时,两组其他发现(疼痛强度(NRS)、癌症相关生活质量(QOL)、焦虑(GAD-7)、抑郁(PHQ-9)和睡眠(PSQI))没有显著差异。然而,两组在便秘、恶心、呕吐、头晕、嗜睡、瘙痒、意识丧失和死亡方面无显著差异。

结论

我们的结果表明,接受微信提供的指导可使更多患者获得良好的疼痛控制和更高的满意度。该研究为医生通过微信应用程序向门诊患者提供强化教育在癌症相关疼痛滴定治疗中的效果提供了新的认识。

试验注册

本研究在中国临床试验注册中心注册(注册号:ChiCTR1900021150,注册日期:2019 年 1 月 30 日)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55e9/7487525/129550b3ba76/12885_2020_7270_Fig1_HTML.jpg

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