Pain services and palliative medicine - an integrated approach to pain management in the cancer patient
Pain services and palliative medicine - an integrated approach to pain management in the cancer patient
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DOI：
10.1177/2049463714548768
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发表时间：
2014-11-01
影响因子：
1.8
通讯作者：
Kane, Christopher M.
中科院分区：
文献类型：
--
作者：
O'Brien, Tony;Kane, Christopher M.
绝大多数癌症患者在患病期间都会经历疼痛。值得庆幸的是，在大多数情况下，根据每个患者的独特需求，始终如一地应用镇痛指南，将带来令人满意的结果。这些指南建议熟练使用镇痛药物，通常与一系列可能需要的辅助治疗结合使用。尽管这些策略的一致和合理的应用，它被认为是一个小的，但显着比例的癌症患者继续经历更难治性疼痛。此外，这些患者可能会经历过多的不必要的剂量限制性副作用与他们的镇痛药物，有时甚至在低剂量。所有这些患者更复杂和难治性疼痛综合征需要更全面的审查，许多将需要介入治疗和/或辅助方法。遗憾的是，这些服务的提供和获取情况各不相同。即使在姑息医学和疼痛服务在同一区域共存的情况下，这两种服务之间的整合也可能很差。每个专业领域都有一套独特的技能和能力，但也有相当多的重叠。通过在这两个专业领域之间建立更正式的关系，患者护理和结果将得到加强。
The vast majority of cancer patients will experience pain during the course of their illness. Thankfully, in most instances, the consistent application of analgesic guidelines, tailored to the unique needs of each individual patient, will deliver a satisfactory outcome. These guidelines recommend the skilled use of analgesic medications, often in conjunction with a range of adjuvant therapies as may be required. Despite the consistent and rational application of such strategies, it is recognised that a small but significant proportion of cancer patients continue to experience more refractory pain. In addition, these patients may experience a plethora of unwanted dose-limiting side effects associated with their analgesic medication, sometimes even at low dose. All such patients with more complex and refractory pain syndromes require a more comprehensive review and many will require interventional therapy and/or adjuvant approaches. Unfortunately, the availability and accessibility of such services are variable. Even in circumstances in which palliative medicine and pain services co-exist in the same region, there may be poor integration between the two services. Each specialty area holds a unique set of skills and competencies, yet there is considerable overlap. Patient care and outcomes will be enhanced by establishing more formal relationships between these two specialty areas.