Department of Pharmacy, China-Japan Friendship Hospital, Beijing, China.
Department of Pain Management, China-Japan Friendship Hospital, Beijing, China.
J Pain Symptom Manage. 2021 Aug;62(2):286-292. doi: 10.1016/j.jpainsymman.2020.12.012. Epub 2020 Dec 18.
The management of cancer pain has gained attention in China since the proposal of the three-step analgesic ladder in 1986 and has been further improved after the Chinese Ministry of Health launched the campaign for "Good Pain Management Ward" in 2011. The Beijing Pain Management Center for Quality Control and Improvement was formed with the intent to improve the quality of pain management by various means such as providing continuing medical education (CME) and conducting evaluation in Beijing, the capital of China.
The objective of this study was to investigate the impact of CME on cancer pain treatment in hospitals in Beijing, China.
The Beijing Pain Management Center for Quality Control and Improvement carried out annual CME on cancer pain treatment for physicians in Beijing in February from 2016 to 2019. The quality of cancer pain treatment in these hospitals was evaluated in August 2015, 2017 and 2019 by using an evaluation instrument containing eight domains. The evaluation results were retrospectively reviewed to assess the impact of CME.
After annual CME for four successive years, a significant increase in evaluation scores for cancer pain treatment was observed in the participating hospitals. The increased trend varied widely both among the levels of hospitals (secondary and two tiers of tertiary hospitals) and among evaluation domains. These hospitals scored lowest in domains related to opioid tolerance, ongoing care, and risk of nonsteroidal anti-inflammatory drugs in the last evaluation.
CME significantly improved the quality of cancer pain treatment in the participating hospitals. Thus, standard CME courses may be adopted to improve the quality of cancer pain treatment by other regions in China and other countries.
自 1986 年提出三步止痛阶梯以来，中国对癌症疼痛管理给予了关注，并在 2011 年卫生部开展“癌痛规范化治疗示范病房”活动后进一步得到改善。北京疼痛质量控制与改进中心成立的目的是通过提供继续医学教育（CME）和在北京进行评估等多种方式来提高疼痛管理质量。
本研究旨在调查 CME 对中国北京医院癌症疼痛治疗的影响。
北京疼痛质量控制与改进中心于 2016 年至 2019 年 2 月，每年对北京的医生进行癌症疼痛治疗的 CME。2015 年 8 月、2017 年和 2019 年，使用包含 8 个领域的评估工具评估这些医院的癌症疼痛治疗质量。回顾性审查评估结果，以评估 CME 的影响。
经过连续四年的年度 CME，参与医院的癌症疼痛治疗评估得分显著提高。在医院级别（二级和三级医院的两个级别）和评估领域方面，这种增长趋势差异很大。这些医院在最后一次评估中，在与阿片类药物耐受、持续治疗和非甾体抗炎药风险相关的领域得分最低。
CME 显著提高了参与医院的癌症疼痛治疗质量。因此，标准的 CME 课程可以被中国其他地区和其他国家采用，以提高癌症疼痛治疗质量。
