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基层医疗中心慢性疼痛的阿片类止痛药处方:疼痛接受度、疼痛强度、抑郁症状、疼痛灾难化、性别和年龄的作用。

Opioid Pain Medication Prescription for Chronic Pain in Primary Care Centers: The Roles of Pain Acceptance, Pain Intensity, Depressive Symptoms, Pain Catastrophizing, Sex, and Age.

机构信息

Instituto de Investigación Biomédica de Málaga, Facultad de Psicología, Andalucía Tech, Universidad de Málaga, 29071 Málaga, Spain.

Instituto Universitario de Lisboa (ISCTE-IUL), Cis-IUL, Av. das Forças Armadas, 1649-026 Lisboa, Portugal.

出版信息

Int J Environ Res Public Health. 2020 Sep 3;17(17):6428. doi: 10.3390/ijerph17176428.

Abstract

: Psychological factors of patients may influence physicians' decisions on prescribing opioid analgesics. However, few studies have sought to identify these factors. The present study had a double objective: (1) To identify the individual factors that differentiate patients who had been prescribed opioids for the management of chronic back pain from those who had not been prescribed opioids and (2) to determine which factors make significant and independent contributions to the prediction of opioid prescribing. : A total of 675 patients from four primary care centers were included in the sample. Variables included sex, age, pain intensity, depressive symptoms, pain catastrophizing, and pain acceptance. : Although no differences were found between men and women, participants with chronic noncancer pain who were prescribed opioids were older, reported higher levels of pain intensity and depressive symptoms, and reported lower levels of pain-acceptance. An independent association was found between pain intensity and depressive symptoms and opioid prescribing. : The findings suggest that patient factors influence physicians' decisions on prescribing opioids. It may be useful for primary care physicians to be aware of the potential of these factors to bias their treatment decisions.

摘要

患者的心理因素可能会影响医生开具阿片类镇痛药的决定。然而,很少有研究试图确定这些因素。本研究有两个目的:(1)确定将阿片类药物用于治疗慢性背痛的患者与未开具阿片类药物的患者之间存在差异的个体因素;(2)确定哪些因素对阿片类药物的开具具有显著且独立的预测作用。研究共纳入了来自四个初级保健中心的 675 名患者。变量包括性别、年龄、疼痛强度、抑郁症状、疼痛灾难化和疼痛接受程度。尽管男女之间没有差异,但被开具阿片类药物的慢性非癌痛患者年龄更大,报告的疼痛强度和抑郁症状水平更高,疼痛接受程度更低。疼痛强度和抑郁症状与阿片类药物的开具存在独立关联。研究结果表明,患者因素会影响医生开具阿片类药物的决定。初级保健医生了解这些因素可能会影响他们的治疗决策是有益的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a1b/7503487/965685613b69/ijerph-17-06428-g001.jpg

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