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[疼痛患者早期多学科综合评估的评价:一项随机对照研究的方案(PAIN2020)]

[Evaluation of an early interdisciplinary multimodal assessment for patients with pain : Protocol of a randomized controlled study (PAIN2020)].

作者信息

Kaiser Ulrike, Petzke Frank, Nagel Bernd, Marschall Ursula, Casser Hans-Raimund, Isenberg Thomas, Kohlmann Thomas, Lindena Gabriele

机构信息

Medizinische Fakultät und Universitäts SchmerzCentrum, Universitätsklinik Carl Gustav Carus Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland.

Universitätsmedizin Göttingen, Schmerzmedizin, Klinik für Anästhesiologie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.

出版信息

Schmerz. 2021 Aug;35(4):251-264. doi: 10.1007/s00482-020-00497-3.

DOI:10.1007/s00482-020-00497-3
PMID:32940745
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8302527/
Abstract

Health care provision for patients with pain and risk factors for chronicity is still insufficient and characterized in particular by over-, under- and misuse of existing approaches. The PAIN2020 project is funded by the German Federal Ministry of Health Care (Innovationsfonds 01NVF17049) and aims to improve health care delivery for this group of patients by implementing an early ambulatory diagnostic approach by a pain specialist, resulting in an improvement in pain and restored or maintained function. A randomized clinical trial in 31 facilities Germany-wide will identify eligible patients and guide them into early specialized pain diagnostics. The interventional arm provides an interdisciplinary multimodal assessment, delivered by pain medicine specialists, physiotherapists and clinical psychologists. The control arm contains a single assessment by a pain specialist. Patients and caregivers receive detailed recommendations for evidence-based interventions tailored to the needs of the individual patient. Two evaluation approaches will be merged. The first requires a net sample size of 3840 patients, assessed (admission) and followed-up (3 and 6 months) by clinical data (German Pain Questionnaire, additional scales) and analyzed by a multi-level approach. In a second evaluation arm the clinical data of the included patients will be supplemented by secondary data from a statutory health insurance (BARMER) and compared to a sample of policyholders not addressed by the study. Data analyses will be performed by an external evaluation institute. The project started in April 2018.

摘要

为患有疼痛及慢性疾病风险因素的患者提供的医疗服务仍然不足,其特点尤其表现为对现有方法的过度、不足及不当使用。PAIN2020项目由德国联邦卫生部资助(创新基金01NVF17049),旨在通过疼痛专科医生实施早期门诊诊断方法,改善这组患者的医疗服务,从而缓解疼痛并恢复或维持功能。在德国全国31个机构进行的一项随机临床试验将确定符合条件的患者,并引导他们接受早期专科疼痛诊断。干预组提供由疼痛医学专家、物理治疗师和临床心理学家进行的多学科多模式评估。对照组由疼痛专科医生进行单一评估。患者和护理人员会收到针对个体患者需求量身定制的循证干预详细建议。将合并两种评估方法。第一种方法要求净样本量为3840名患者,通过临床数据(德国疼痛问卷、附加量表)进行评估(入院时)和随访(3个月和6个月),并采用多层次方法进行分析。在第二个评估组中,纳入患者的临床数据将由法定健康保险(BARMER)的二次数据补充,并与未纳入该研究的投保人样本进行比较。数据分析将由外部评估机构进行。该项目于2018年4月启动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8958/8302527/eaecd9a2d672/482_2020_497_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8958/8302527/93507eff23be/482_2020_497_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8958/8302527/a143c881394a/482_2020_497_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8958/8302527/7bf469cc826b/482_2020_497_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8958/8302527/eaecd9a2d672/482_2020_497_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8958/8302527/93507eff23be/482_2020_497_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8958/8302527/a143c881394a/482_2020_497_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8958/8302527/7bf469cc826b/482_2020_497_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8958/8302527/eaecd9a2d672/482_2020_497_Fig4_HTML.jpg

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本文引用的文献

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[Cross-sectoral interdisciplinary multimodal pain therapy : Recommendations on structural and process parameters of the ad hoc commission "Interdisciplinary Multimodal Pain Therapy" of the German Pain Society (Deutsche Schmerzgesellschaft e.  V.)].[跨部门跨学科多模式疼痛治疗:德国疼痛协会(Deutsche Schmerzgesellschaft e. V.)“跨学科多模式疼痛治疗”特别委员会的结构和流程参数建议]
Schmerz. 2019 Jun;33(3):191-203. doi: 10.1007/s00482-019-0374-2.
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[Interdisciplinary multimodal assessment and risk-tailored pathways for patients with back pain : Prospective evaluation of an integrated healthcare delivery project].[腰痛患者的跨学科多模式评估及风险定制路径:一项综合医疗服务项目的前瞻性评估]
Schmerz. 2019 Apr;33(2):116-127. doi: 10.1007/s00482-018-0348-9.
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一项干预措施是如何起作用的?-英文版:以PAIN 2.0为例,为预防复发性或持续性疼痛的复杂干预措施建立效果模型。
Schmerz. 2025 Jan 21. doi: 10.1007/s00482-024-00860-8.
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[How does an intervention work?-German Version. : Development of an effect model for a complex intervention to prevent recurring or persistent pain using the example of PAIN 2.0].[干预如何起作用?-德文版。:以PAIN 2.0为例,开发一种用于预防复发性或持续性疼痛的复杂干预措施的效果模型]
Schmerz. 2025 Feb;39(1):23-34. doi: 10.1007/s00482-024-00854-6. Epub 2025 Jan 21.
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[Interprofessional and interdisciplinary collaboration in the implementation of health services research in pain medicine].[疼痛医学中卫生服务研究实施的跨专业和跨学科合作]
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