Kim Min Jung, Kim Ji Yeon, Lim Yun Hee, Hong Sung Jun, Jeong Jae Hun, Choi Hey Ran, Park Sun Kyung, Kim Jung Eun, Lee Min Ki, Kim Jae Hun
Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea.
Department of Anesthesiology and Pain Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea.
Korean J Pain. 2022 Oct 1;35(4):475-487. doi: 10.3344/kjp.2022.35.4.475.
Use of opioids for chronic intractable pain is increasing globally, and their proper use can improve patients' quality of life. In contrast, opioid use disorders, such as abuse or addiction, caused by prescribing opioids, are a worldwide issue. This study aimed to understand current opioid prescribing patterns and pain physicians' experiences with opioid use in South Korea.
Pain physicians in 42 university hospitals in South Korea were asked to complete anonymous questionnaires regarding opioid prescriptions.
A total of 69 surveys were completed. Most pain physicians started prescribing opioids at a pain score of 7/10 and aimed to reduce pain by 50%. Most physicians (73.1%) actively explained the prescribed medications and possible side effects, and 61.2% of physicians preferred the prescription interval of 4 weeks. Immediate-release opioids were the most popular treatment for breakthrough pain (92.6%). The most common side effect encountered by physicians was constipation (43.3%), followed by nausea/vomiting (34.3%). Of the physicians, 56.5% replied that addiction and misuse prevalences were less than 5%. However, the most concerning side effect was addiction (33.0%).
The survey results showed that the prescribing patterns of pain physicians generally followed Korean guidelines. Physicians were most interested in the safety and effectiveness of opioid prescriptions. They were most concerned about respiratory depression and abuse or addiction. A significant number of physicians agreed that the NHIS regulations needed improvement for patient convenience and safe and effective treatment, though there were pros and cons of the NHIS restrictions on prescription conditions.
全球范围内,阿片类药物用于慢性顽固性疼痛的情况日益增多,合理使用可改善患者生活质量。相比之下,因开具阿片类药物导致的阿片类药物使用障碍,如滥用或成瘾,是一个全球性问题。本研究旨在了解韩国目前的阿片类药物处方模式以及疼痛科医生使用阿片类药物的经验。
邀请韩国42所大学医院的疼痛科医生填写关于阿片类药物处方的匿名问卷。
共完成69份调查问卷。大多数疼痛科医生在疼痛评分达到7/10时开始开具阿片类药物,目标是将疼痛减轻50%。大多数医生(73.1%)积极解释所开药物及可能的副作用,61.2%的医生倾向于4周的处方间隔。即释型阿片类药物是治疗爆发性疼痛最常用的药物(92.6%)。医生遇到的最常见副作用是便秘(43.3%),其次是恶心/呕吐(34.3%)。56.5%的医生回复称成瘾和滥用发生率低于5%。然而,最令人担忧的副作用是成瘾(33.0%)。
调查结果显示,疼痛科医生的处方模式总体上遵循韩国指南。医生最关注阿片类药物处方的安全性和有效性。他们最担心呼吸抑制以及滥用或成瘾。相当数量的医生认为,为方便患者以及实现安全有效的治疗,国家健康保险服务(NHIS)的规定需要改进,不过NHIS对处方条件的限制有利有弊。