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疼痛管理的共同决策与协作护理模式:现有证据的范围综述

Shared Decision-Making and Collaborative Care Models for Pain Management: A Scoping Review of Existing Evidence.

作者信息

Omaki Elise, Fitzgerald Megan, Iyer Diksha, Shields Wendy, Castillo Renan

机构信息

Elise Omaki, MHS, Megan Fitzgerald, MPH, Diksha Iyer, Wendy Shields, PhD, MPH and Renan Castillo, PhD, MS, Johns Hopkins Center for Injury Research & Policy, Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

出版信息

J Pain Palliat Care Pharmacother. 2024 Dec;38(4):394-405. doi: 10.1080/15360288.2024.2400925. Epub 2024 Sep 12.

Abstract

This article aims to summarize the existing evidence on shared decision-making and collaborative care models for acute and chronic pain management. We searched the PubMed database for articles published between 1980 and 2023 and scanned included articles' references to identify additional sources. Two reviewers independently screened titles and abstracts. Studies met inclusion criteria if they implemented or evaluated shared decision-making or collaborative care interventions in patients with acute or chronic pain. A total of 690 articles were reviewed, with 32 full text articles meeting inclusion criteria. Most studies assessed changes in prescription opioid quantities and patient-reported pain levels. Secondary measures generally included patient satisfaction, 30-day refill rate, and use of non-opioid analgesics. Shared decision-making and collaborative care models are promising interventions to improve pain management. These interventions are effective at reducing opioid consumption among acute and chronic pain patients without compromising patient-reported pain levels. There is further research needed to evaluate how shared decision-making and collaborative care interventions impact patient-centered outcomes such as patient satisfaction, quality of life, and patient-provider communication.

摘要

本文旨在总结关于急性和慢性疼痛管理中共同决策和协作护理模式的现有证据。我们在PubMed数据库中搜索了1980年至2023年发表的文章,并浏览了纳入文章的参考文献以识别其他来源。两名评审员独立筛选标题和摘要。如果研究对急性或慢性疼痛患者实施或评估了共同决策或协作护理干预措施,则这些研究符合纳入标准。共审查了690篇文章,其中32篇全文文章符合纳入标准。大多数研究评估了处方阿片类药物数量的变化以及患者报告的疼痛程度。次要指标通常包括患者满意度、30天再填充率和非阿片类镇痛药的使用。共同决策和协作护理模式是改善疼痛管理的有前景的干预措施。这些干预措施在不影响患者报告的疼痛程度的情况下,有效减少了急性和慢性疼痛患者的阿片类药物消费量。需要进一步研究来评估共同决策和协作护理干预措施如何影响以患者为中心的结果,如患者满意度、生活质量和患者与提供者之间的沟通。

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