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[屈大麻酚在难治性神经性疼痛治疗中的应用:多学科疼痛中心随访患者的反馈]

[Use of dronabinol in the treatment of resistant neuropathic pain: Feedback from patients followed in a multidisciplinary pain center].

作者信息

Richet E, Ferret L, Gaboriau L, Charpentier P, Dujardin L, Fulcrand J, Boursier A

机构信息

Pharmacie clinique, Pôle 8 Cancérologie et spécialités médicales, Centre hospitalier de Valenciennes, 114, avenue Desandrouin, 59300 Valenciennes, France.

Centre régional de pharmacovigilance Nord Pas de Calais, Centre hospitalier universitaire de Lille, rue Michel-Polonowski, 59000 Lille, France.

出版信息

Ann Pharm Fr. 2023 Jun;81(4):720-729. doi: 10.1016/j.pharma.2022.12.005. Epub 2022 Dec 10.

Abstract

INTRODUCTION

Dronabinol is a drug composed of synthetic delta-9-tetrahydrocannabinol. In France, dronabinol requires a named Temporary Utilisation Authorisation (TUA), for the treatment of refractory neuropathic pain. Few data currently exist concerning its efficacy and tolerance. We present our feedback on its use for chronic pain patients, the multidisciplinary supervision and the monitoring set up by the clinical pharmacist.

METHOD

This retrospective monocentric study presents Patients Global Impression of Change and tolerance data from patients treated with dronabinol in a pain center between October 2020 and July 2021. We present their satisfaction towards the care process.

RESULTS

Nineteen patients were treated with dronabinol during the study period. - The clinical pharmacist issued 180 advices for patients and doctors. Patients reported a positive impact of the telephone follow-up carried out by the clinical pharmacist. - 75% (n=9/12) of patients who continued treatment for more than 3 months reported improvement in their health. - 74% (n=14/19) of patients had at least one adverse event, six patients needed to discontinue the treatment.

DISCUSSION-CONCLUSION: Dronabinol represents an alternative that can improve the quality of life of some patients suffering from refractory neuropathic pain. Nevertheless, as with any medicine, its initiation requires a rigorous evaluation of the benefit-risk balance. The close collaboration between the physician and the clinical pharmacist allows a secure management patients and makes this complex drug circuit easer.

摘要

引言

屈大麻酚是一种由合成的δ-9-四氢大麻酚组成的药物。在法国,屈大麻酚需要有特定的临时使用授权(TUA)才能用于治疗难治性神经性疼痛。目前关于其疗效和耐受性的数据很少。我们介绍了我们在将其用于慢性疼痛患者方面的经验反馈,以及临床药师所进行的多学科监督和监测情况。

方法

这项回顾性单中心研究呈现了2020年10月至2021年7月期间在一个疼痛中心接受屈大麻酚治疗的患者的整体变化印象和耐受性数据。我们展示了他们对护理过程的满意度。

结果

在研究期间,有19名患者接受了屈大麻酚治疗。- 临床药师为患者和医生提供了180条建议。患者报告称临床药师进行的电话随访产生了积极影响。- 在持续治疗超过3个月的患者中,75%(n = 9/12)报告健康状况有所改善。- 74%(n = 14/19)的患者至少出现了一次不良事件,6名患者需要停止治疗。

讨论 - 结论:屈大麻酚是一种可以改善一些难治性神经性疼痛患者生活质量的替代药物。然而,与任何药物一样,开始使用它需要对获益 - 风险平衡进行严格评估。医生和临床药师之间的密切合作可以确保对患者进行安全管理,并使这种复杂的药物治疗流程更加顺畅。

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