10-year follow-up of chronic non-malignant pain patients: Opioid use, health related quality of life and health care utilization
10-year follow-up of chronic non-malignant pain patients: Opioid use, health related quality of life and health care utilization
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DOI：
10.1016/j.ejpain.2005.06.001
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发表时间：
2006-07-01
影响因子：
3.6
通讯作者：
Hojsted, Jette
中科院分区：
文献类型：
--
作者：
Jensen, Marianne K.;Thomsen, Annemarie B.;Hojsted, Jette
背景：在丹麦，阿片类药物多年来一直被广泛用于治疗非恶性疼痛，但耐受性和对健康相关生活质量的影响等长期后果仍不清楚。目的：对慢性疼痛患者在多学科疼痛中心治疗10年后的依从性、阿片类药物剂量递增、与健康相关的生活质量、焦虑、抑郁、应对策略和卫生保健利用情况进行评估。方法：从病历、邮寄问卷和中央医院登记簿中收集信息。结果：仅有少数患者出现阿片类药物剂量增加。阿片类药物剂量的增加和减少几乎同样频繁。在那些服用长效阿片类药物出院的人中，60%的人在随访时仍在接受这种治疗。28%的患者在从疼痛中心出院后开始阿片类药物治疗。职业状况被确定为未来阿片类药物使用的决定因素。阿片类药物使用者的健康相关生活质量较低，抑郁的发生率较高，并且更频繁地使用“灾难”和“希望和祈祷”等应对策略。辅助性止痛药被高度停用。多学科疼痛治疗减少了入院人数和住院天数。结论：我们建议未来对阿片类药物治疗的研究不要只关注生物学问题。阿片类药物的影响需要在更复杂的背景下看待，其中包括与健康有关的生活质量、抑郁症和各种应对策略的作用等后果。(C)2005年国际疼痛研究协会欧洲分会联合会。爱思唯尔有限公司出版。保留所有权利。
Background: In Denmark, opioids have been used liberally for many years in the treatment of non-malignant pain, but long-term consequences as tolerance and influence on health related quality of life remain unknown. Aim: Adherence to medical treatment, opioid dose escalation, health related quality of life, anxiety, depression, coping strategies and health care utilization were evaluated in chronic pain patients 10 years after treatment in a multidisciplinary pain centre. Methods: Information was gathered from medical records, postal questionnaires and a central hospital register. Results: Opioid dose escalation occurred in only a few patients. Increase and decrease in opioid dose were almost equally frequent. Sixty percent of those discharged on long acting opioids were still on that treatment at follow-up. Twenty-eight percent of the patients initiated opioid treatment after discharge from the pain centre. Occupational status was identified as a determining factor for future opioid use. Opioid users had a lower health related quality of life, higher occurrence of depression and more frequent use of coping strategies like 'Catastrophizing' and 'Hoping and Praying'. Adjuvant analgesics were highly discontinued. Multidisciplinary pain treatment reduced the number of hospital admissions and in-hospital days. Conclusion: We recommend that future research on opioid treatment does not only focus on biological issues. The effect of opioids needs to be viewed in a much more complex context where consequences like health related quality of life, depression and the role of various coping strategies are included. (c) 2005 European Federation of Chapters of the International Association for the Study of Pain. Published by Elsevier Ltd. All rights reserved.