Mayoral Rojals Víctor, Canós Verdecho Ángeles, Soler López Begoña
Pain Unit, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, 08907 Barcelona, Spain.
Pain Unit, Hospital Universitari i Politécnic La Fe, 46026 Valencia, Spain.
J Clin Med. 2022 Jun 22;11(13):3586. doi: 10.3390/jcm11133586.
A multicenter cross-sectional study was designed to assess the quality of treatment of 1190 patients with chronic pain at the time of referral to a specialized pain unit. A total of 119 physicians from 77 pain units throughout Spain collected 23 indicators of the quality of care from 10 consecutive clinical records of chronic pain patients (5 men, 5 women). Degenerative spinal diseases (38.6%) and lumbosciatic pain (29.8%) were the most common etiologies. At the time of referral to the pain unit, 9.8% of patients were not receiving any analgesic treatment. Treatment was modified in 88.1% of the patients by adding adjuvant drugs, adding opioids or increasing the doses of analgesic medications, and using analgesic techniques. Women had higher percentages of osteoarthritis, headache and fibromyalgia as the cause of pain, longer duration of pain and severe pain intensity, and a higher proportion of changes in the diagnosis of the underlying condition with which they had been referred to the pain unit. Improvements should be made in the patient management and referral protocols not only in the clinics prior to patient referral to the pain unit, but also in the pain units themselves.
一项多中心横断面研究旨在评估1190例慢性疼痛患者转诊至专业疼痛科时的治疗质量。来自西班牙各地77个疼痛科的119名医生从10例连续的慢性疼痛患者（5名男性，5名女性）临床记录中收集了23项护理质量指标。退行性脊柱疾病（38.6%）和腰腿痛（29.8%）是最常见的病因。在转诊至疼痛科时，9.8%的患者未接受任何镇痛治疗。88.1%的患者通过添加辅助药物、添加阿片类药物或增加镇痛药物剂量以及采用镇痛技术对治疗进行了调整。女性因骨关节炎、头痛和纤维肌痛导致疼痛的比例更高，疼痛持续时间更长，疼痛强度更严重，并且转诊至疼痛科时其基础疾病诊断改变的比例更高。不仅在患者转诊至疼痛科之前的诊所，而且在疼痛科本身，患者管理和转诊方案都应加以改进。
