Patient preferences for acute pain treatment
Patient preferences for acute pain treatment
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DOI：
10.1093/bja/aeh123
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发表时间：
2004-05-01
影响因子：
9.8
通讯作者：
Chen, C
中科院分区：
文献类型：
--
作者：
Gan, TJ;Lubarsky, DA;Chen, C
背景资料。急性疼痛的最佳治疗取决于个人愿意在治疗副作用和疼痛控制之间进行权衡。研究的目的是调查患者在多大程度上愿意做出这些权衡。50名接受腹部大手术的患者入选并完成了手术前后的访谈。测量包括疼痛体验问卷和自适应联合分析(ACA)访谈。术后疼痛缓解率在70%~80%之间。82%的人报告至少有一种中度或严重的副作用。ACA结果显示，疼痛疗效和副作用类型/严重程度具有几乎相同的“重要性”分数。患者愿意为了不同或较轻的副作用而折衷疼痛效果的意愿不同。我们得出的结论是，人们对不同的副作用有不同的相对偏好，并愿意在缓解疼痛和/或较少令人烦恼和/或较不严重的副作用之间进行权衡，但程度不同。因此，医生应该考虑将副作用比麻醉药少的止痛药作为首选。我们的研究表明，需要平衡止痛和副作用，以便患者实现最佳的疼痛控制。
Background. Optimal treatment for acute pain is a function of an individual's willingness to make trade-offs between treatment side effects and pain control. The objective was to investigate the degree to which patients are willing to make these trade-offs.Methods. Fifty patients undergoing major abdominal surgery were enrolled and completed interviews before and after surgery. Measures included an experience with pain questionnaire and an adaptive conjoint analysis (ACA) interview.Results. Percentage of pain relief obtained post-surgery was between 70 and 80%. Eight-two per cent reported at least one moderate or severe side effect. ACA results demonstrated that pain efficacy and side effect type/severity have almost equal 'importance' scores. Patients varied in their willingness to trade-off pain efficacy for different or milder side effects.Conclusions. We conclude that people have different relative preferences for different side effects and are willing to trade-off pain relief for less upsetting and/or less severe side effects but to different degrees. Thus, physicians should consider offering pain medications with fewer side effects than narcotics as a first choice. Our study indicates the need to balance analgesia and side effects in order for patients to achieve optimal pain control.