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疼痛诊所中短期和长期使用阿片类药物治疗非癌性疼痛患者的临床结局比较。

Comparison of the Clinical Outcomes between Short-term and Long-term Opioid Users with Noncancer Pain at Pain Clinics.

作者信息

Sani Asween R, Zin Che Suraya

机构信息

Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University Malaysia (IIUM), Kuantan, Pahang, Malaysia.

出版信息

J Pharm Bioallied Sci. 2020 Nov;12(Suppl 2):S728-S732. doi: 10.4103/jpbs.JPBS_284_19. Epub 2020 Nov 5.

Abstract

INTRODUCTION

The clinical use of opioids for long-term for noncancer pain indications remains a controversy. More studies are needed for evidence-based guidelines in noncancer pain management involving opioids. The primary objective of this study was to investigate the clinical outcomes of the short-term and long-term opioid use among patients with noncancer pain.

MATERIALS AND METHODS

This is a retrospective cross-sectional study where patients (aged ≥18 years) with noncancer pain treated with opioids were recruited from three pain clinics in Malaysia. Data on patients' opioid use were collected from prescription records. The individual days covered with opioids per patient were calculated and based on this, patients were classified as short-term (<90 days) or long-term (≥90 days) opioid user. Outcome measures included pain intensity and pain interference with daily activities assessed by Brief Pain Inventory - Short Form (BPI-SF), health-related quality of life (HRQoL) assessed by 36-Item Short Form Health Survey version 2 (SF-36v2). These measures were compared between short-term and long-term opioid users.

RESULTS

Of the 61 noncancer pain patients recruited, 49.2% ( = 30/61) were short-term and 50.8% ( = 31/61) were long-term opioid users. There were no statistically significant differences in the mean scores of pain intensity, pain interference with daily activities, and HRQoL between short-term and long-term opioid users in this study.

CONCLUSION

Findings of this study imply that long-term opioid therapy does not provide significant pain relief or improvement in patients' functional capability and HRQoL in noncancer pain patients. Future prospective studies with larger sample sizes are needed to support the findings of this study.

摘要

引言

阿片类药物用于非癌性疼痛的长期临床应用仍存在争议。在涉及阿片类药物的非癌性疼痛管理中,需要更多研究来制定循证指南。本研究的主要目的是调查非癌性疼痛患者短期和长期使用阿片类药物的临床结果。

材料与方法

这是一项回顾性横断面研究,从马来西亚的三家疼痛诊所招募了接受阿片类药物治疗的非癌性疼痛患者(年龄≥18岁)。从处方记录中收集患者使用阿片类药物的数据。计算每位患者使用阿片类药物的天数,并据此将患者分为短期(<90天)或长期(≥90天)阿片类药物使用者。结果指标包括通过简明疼痛问卷简表(BPI-SF)评估的疼痛强度和疼痛对日常活动的干扰,以及通过健康调查简表第2版(SF-36v2)评估的健康相关生活质量(HRQoL)。对短期和长期阿片类药物使用者的这些指标进行了比较。

结果

在招募的61名非癌性疼痛患者中,49.2%(=30/61)为短期阿片类药物使用者,50.8%(=31/61)为长期阿片类药物使用者。在本研究中,短期和长期阿片类药物使用者在疼痛强度、疼痛对日常活动的干扰以及HRQoL的平均得分上没有统计学显著差异。

结论

本研究结果表明,长期阿片类药物治疗并不能为非癌性疼痛患者提供显著的疼痛缓解,也不能改善患者的功能能力和HRQoL。需要未来进行更大样本量的前瞻性研究来支持本研究的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3f2/8021069/2f8164b3e231/JPBS-12-728-g001.jpg

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