Aljassem Annas, Spickler Michael, Kapur Nandita
Department of Physical Medicine and Rehabilitation, Oakland University William Beaumont School of Medicine, Royal Oak, MI, United States.
Department of Physical Medicine and Rehabilitation, Corwell Health William Beaumont University Hospital, Royal Oak, MI, United States.
Front Rehabil Sci. 2024 May 2;5:1373857. doi: 10.3389/fresc.2024.1373857. eCollection 2024.
Palliative care is a growing medical specialty focusing on providing compassionate and holistic management for those facing life-threatening diseases. These patients frequently present with physical, functional, emotional, and psychosocial problems that require comprehensive interdisciplinary management. However, there is a substantial opportunity to improve care for patients in palliative care who also have a substance use disorder (SUD). These opportunities include direct provision of SUD treatments by specialist palliative care providers and the integration of physical medicine and rehabilitation services. The purpose of this article is to examine the misunderstood and underutilized interaction between palliative care and SUDs, as well as describing the unique opportunities provided by physical medicine and rehabilitation providers to achieve a patient's palliative care goals and optimize overall quality of life. Substance Use Disorder is a chronic, often relapsing, illness that is relevant to palliative care practice due to the potential for significant morbidity and mortality through organ failure, chronic infections, and overdose syndromes. In traditional palliative care practice, it has been observed that past or current SUD diagnoses are often left untreated, resulting in increased distress, and exacerbating an already complex medical situation. Furthermore, many of these patients also experience physical, functional, or psychosocial changes that, when left untreated, will worsen distress and quality of life. To provide more comprehensive and successful palliative care for patients with SUD, the authors recommend an increased emphasis on specialist palliative care training in SUD management, proactive integration of rehabilitation services into the palliative care team, and consistent advocacy for these steps in various arenas. Combined, these actions can improve the care team's ability to provide a holistic, patient-centered approach that can have substantial positive outcomes for patients, health systems, and society.
姑息治疗是一个不断发展的医学专业，专注于为面临危及生命疾病的患者提供富有同情心的整体管理。这些患者经常出现身体、功能、情感和心理社会问题，需要综合的跨学科管理。然而，对于同时患有物质使用障碍（SUD）的姑息治疗患者，改善护理仍有很大的机会。这些机会包括由专科姑息治疗提供者直接提供SUD治疗，以及整合物理医学和康复服务。本文的目的是探讨姑息治疗与SUD之间被误解和未充分利用的相互作用，并描述物理医学和康复提供者为实现患者的姑息治疗目标和优化整体生活质量所提供的独特机会。物质使用障碍是一种慢性、通常会复发的疾病，由于器官衰竭、慢性感染和过量综合征导致的重大发病率和死亡率，与姑息治疗实践相关。在传统的姑息治疗实践中，人们观察到过去或当前的SUD诊断往往得不到治疗，导致痛苦加剧，并使本已复杂的医疗状况恶化。此外，许多这些患者还经历身体、功能或心理社会变化，如果不加以治疗，将使痛苦和生活质量恶化。为了为患有SUD的患者提供更全面、更成功的姑息治疗，作者建议加强对SUD管理方面的专科姑息治疗培训，将康复服务积极纳入姑息治疗团队，并在各个领域持续倡导这些措施。综合起来，这些行动可以提高护理团队提供以患者为中心的整体方法的能力，这对患者、卫生系统和社会都能产生重大的积极成果。
