College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, MDC 56, Tampa, FL, 33612-3805, USA.
Faces of Courage, 10006 Cross Creek Blvd #519, Tampa, FL, 33647-2595, USA.
J Cancer Surviv. 2021 Aug;15(4):585-596. doi: 10.1007/s11764-020-00952-1. Epub 2021 Jan 6.
Prescription opioid medication can be of great benefit for cancer patients and survivors who suffer from cancer-related pain throughout their cancer care trajectory. However, the current opioid epidemic has influenced how such medications are perceived. The purpose of this study was to explore the perceptions of opioid use and misuse in cancer survivorship within the context of the opioid epidemic.
pt?>A qualitative study using a semi-structured interview was conducted with a purposive sample of health care professionals (n = 24), community-level stakeholders (n = 6), and cancer survivors (n = 25) using applied thematic analysis techniques.
Crosscutting themes include (1) fear of addiction and living with poorly managed pain, (2) the importance of good patient/provider communication and the need for education around the use/handling/disposal of prescription opioid medication, (3) preference for nonopioid alternatives for pain management, (4) cancer survivors perceived to be low risk for developing opioid use disorder (include inconsistent screening), and (5) impact of policies aimed at curbing the opioid epidemic on cancer survivors.
This study illustrates the intersecting and sometimes conflicting assumptions surrounding the use of opioids analgesics in the management of cancer pain among survivors embedded within the national discourse of the opioid epidemic.
A system of integrated cancer care using psychosocial screening, opioid risk mitigation tools, opioid treatment agreements, and specialist expertise that cancer care providers can rely on to monitor POM use in conjunction with patient-centered communication to empower patients informed decision making in managing their cancer pain could address this critical gap in survivorship care.
处方类阿片类药物对于在癌症诊疗全程中遭受癌因性疼痛的癌症患者和幸存者具有重要的治疗作用。然而，当前的阿片类药物滥用危机改变了人们对这类药物的看法。本研究旨在探讨在阿片类药物滥用危机背景下，癌症幸存者对阿片类药物使用和滥用的看法。
采用半结构式访谈法，对医疗保健专业人员（n=24）、社区利益相关者（n=6）和癌症幸存者（n=25）进行了一项有针对性的定性研究，采用应用主题分析技术。
贯穿全文的主题包括：（1）对成瘾和疼痛管理不善的恐惧；（2）良好的医患沟通的重要性，以及对处方类阿片类药物使用/处理/处置的教育需求；（3）对非阿片类药物替代物用于疼痛管理的偏好；（4）癌症幸存者被认为发生阿片类药物使用障碍的风险较低（包括筛查不一致）；（5）旨在遏制阿片类药物滥用危机的政策对癌症幸存者的影响。
本研究阐明了在全国性的阿片类药物滥用危机背景下，围绕癌症幸存者癌因性疼痛管理中使用阿片类药物镇痛剂的交叉且有时相互冲突的假设。
采用包含心理社会筛查、阿片类药物风险缓解工具、阿片类药物治疗协议和专科专家的综合癌症护理系统，以及癌症护理提供者可以依靠的以患者为中心的沟通来监测 POM 使用，使患者能够在知情的情况下做出决策，以管理其癌症疼痛，这可能会解决这一关键的生存护理差距。
