Volberg Christian, Corzilius Julien, Maul Julian, Morin Astrid, Gschnell Martin
Klinik für Anästhesie und Intensivtherapie, Universitätsklinikum Marburg, Philipps-Universität Marburg, Marburg, Deutschland.
AG Ethik in der Medizin, Fachbereich 20, Dekanat Humanmedizin, Philipps-Universität Marburg, Marburg, Deutschland.
Schmerz. 2024 Oct;38(5):317-327. doi: 10.1007/s00482-023-00693-x. Epub 2023 Feb 8.
With the help of specialized outpatient palliative care teams (German abbreviation: SAPV), seriously ill and dying patients in Germany can be adequately cared for in their home environment until the end of their lives; however, there are no uniform standards or guidelines for well-executed pain management right now.
This approach serves as basic research in the field of public health research. This is intended to present which methods (use of different professional groups, use of pain medications, alternative medical treatment etc.) the individual SAPV teams use for pain management. From this it can be deduced which procedures can be considered particularly effective.
This cross-sectional study was conducted in May 2021. All German SAPV teams (n = 307) listed on the homepage of the German Association for Palliative Medicine (DGP) were contacted by post and invited to participate. A total of 175 teams (57%) responded to the request and were included in the evaluation. A descriptive data analysis was performed.
Pain management in the German outpatient care of palliative patients is based on several components. All common pain medications are used, but primarily metamizole (99.4%) as a non-opioid analgesic, morphine (98.3%) from the opiate series and pregabalin (96.6%) as a co-analgesic are mainly prescribed. If pain therapy fails, 22.5% of the SAPV teams perform palliative sedation for symptom control on a regular basis.
This cross-sectional study is the first of its kind to provide a general overview of the treatment options for pain management in German outpatient palliative care. In comparison with international studies, the question arises as to whether uniform therapy schemes and a reduction in the medication available in the individual SAPV teams could lead to an improvement in patient care.
在专业门诊姑息治疗团队(德语缩写:SAPV)的帮助下,德国的重症和临终患者能够在其家中得到充分照料直至生命结束;然而,目前尚无关于有效疼痛管理的统一标准或指南。
本研究方法是公共卫生研究领域的基础研究。旨在呈现各个SAPV团队用于疼痛管理的方法(不同专业组的使用、止痛药物的使用、替代医学治疗等)。由此可以推断出哪些程序可被视为特别有效。
本横断面研究于2021年5月进行。通过邮寄方式联系了德国姑息医学协会(DGP)主页上列出的所有德国SAPV团队(n = 307),并邀请其参与。共有175个团队(57%)回复了邀请并纳入评估。进行了描述性数据分析。
德国姑息患者门诊护理中的疼痛管理基于多个组成部分。所有常用的止痛药物都有使用,但主要使用非甾体抗炎药安乃近(99.4%)、阿片类的吗啡(98.3%)以及作为辅助镇痛药的普瑞巴林(96.6%)。如果疼痛治疗失败,22.5%的SAPV团队会定期进行姑息性镇静以控制症状。
本横断面研究首次全面概述了德国门诊姑息治疗中疼痛管理的治疗选择。与国际研究相比,出现了一个问题,即统一的治疗方案以及减少各个SAPV团队可用的药物是否会改善患者护理。