Jamison Robert N, Sheehan Kerry Anne, Scanlan Elizabeth, Matthews Michele, Ross Edgar L
Pain Management Center, Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, Massachusetts.
Pain Management Center, Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, Massachusetts; Pharmacy Practice, MCPHS University, Boston, Massachusetts.
J Opioid Manag. 2014 Nov-Dec;10(6):375-82. doi: 10.5055/jom.2014.0234.
There is growing concern of medication misuse and noncompliance among patients with chronic pain prescribed opioids for pain. The aim of this survey was to obtain information from primary care providers (PCPs) about their perception of prescribing opioids for patients with chronic pain.
PCPs were invited to complete a packet of questionnaires about attitudes and concerns about opioids for chronic pain. These questionnaires included 1) General Health Questionnaire, 2) Test of Opioid Knowledge (TOK), 3) Opioid Therapy Provider Survey, and 4) Concerns About Analgesic Prescription Questionnaire.
Fifty-six (N = 56) PCPs from eight centers participated in this study. In general, the PCPs showed adequate opioid knowledge on the KOT and their general health was unrelated to prescription attitudes. Most expressed concern about medication misuse (89 percent) and felt that managing patients with chronic pain was stressful (84 percent). Most were worried about addiction (82 percent) and less than half felt that they were sufficiently trained in prescribing opioids (46 percent). Younger providers felt more reluctant to prescribe opioids, experienced more stress in managing patients with pain, had less overall confidence in managing patients with pain, and worried more about opioid dependence than older providers (p < 0.05). Younger providers were also less knowledgeable about opioids, but opioid knowledge was not found to be related to concerns about analgesic prescriptions.
This study indicates a general concern and reluctance of primary care physicians to manage the prescribing of opioids among their patients with chronic pain and younger providers expressed more concern about opioids than older providers.
对于开具阿片类药物治疗慢性疼痛的患者,药物滥用和不依从的问题日益受到关注。本次调查的目的是从初级保健提供者(PCP)处获取有关他们对为慢性疼痛患者开具阿片类药物的看法的信息。
邀请PCP完成一组关于对慢性疼痛使用阿片类药物的态度和担忧的问卷。这些问卷包括:1)一般健康问卷,2)阿片类药物知识测试(TOK),3)阿片类药物治疗提供者调查,以及4)镇痛处方担忧问卷。
来自八个中心的56名PCP参与了本研究。总体而言,PCP在阿片类药物知识测试中表现出足够的知识,并且他们的总体健康状况与处方态度无关。大多数人对药物滥用表示担忧(89%),并认为管理慢性疼痛患者压力很大(84%)。大多数人担心成瘾(82%),不到一半的人觉得自己在开具阿片类药物方面受过充分培训(46%)。与年长的提供者相比,年轻的提供者更不愿意开具阿片类药物,在管理疼痛患者时经历更多压力,对管理疼痛患者的总体信心较低,并且更担心阿片类药物依赖(p < 0.05)。年轻的提供者对阿片类药物的了解也较少,但未发现阿片类药物知识与镇痛处方担忧之间存在关联。
本研究表明初级保健医生普遍关注并不愿管理其慢性疼痛患者的阿片类药物处方,并且年轻的提供者比年长的提供者对阿片类药物表达了更多担忧。