Nonpharmacologic Treatments for Opioid Reduction in Patients With Advanced Chronic Kidney Disease.
Nonpharmacologic Treatments for Opioid Reduction in Patients With Advanced Chronic Kidney Disease.
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DOI：
10.1016/j.semnephrol.2021.02.007
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发表时间：
2021-01
影响因子：
3.3
通讯作者：
Cukor, Daniel
中科院分区：
文献类型：
--
作者：
Brintz, Carrie E.;Cheatle, Martin D.;Dember, Laura M.;Heapy, Alicia A.;Jhamb, Manisha;Shallcross, Amanda J.;Steel, Jennifer L.;Kimmel, Paul L.;Cukor, Daniel
阿片类镇痛药对晚期慢性肾病（CKD）和终末期肾病（ESKD）患者存在严重健康相关损害的风险。在患有慢性非癌性疼痛的一般人群中，有一些证据表明阿片类药物减少或停药与疼痛结局改善相关;然而，突然减少阿片类药物或不提供支持性干预可能导致身体和心理伤害以及阿片类药物使用的复发。有新的证据表明，非药物治疗，如心理社会干预，针灸和跨学科疼痛管理计划是支持持续性疼痛患者减少阿片类药物剂量的有效方法，但这一领域的研究仍然相对较新。本综述描述了非药物干预支持阿片类药物减少非CKD疼痛患者的现有证据，并讨论了现有证据在使用阿片类药物治疗疼痛的晚期CKD患者中的应用。
Opioid analgesics carry risk for serious health-related harms in patients with advanced chronic kidney disease (CKD) and end-stage kidney disease (ESKD). In the general population with chronic noncancer pain, there is some evidence that opioid reduction or discontinuation is associated with improved pain outcomes; however, tapering opioids abruptly or without providing supportive interventions can lead to physical and psychological harms and relapse of opioid use. There is emerging evidence that non-pharmacological treatments such as psychosocial interventions, acupuncture, and interdisciplinary pain management programs are effective approaches to support opioid dose reduction in patients experiencing persistent pain, but research in this area is still relatively new. This review describes the current evidence for non-pharmacological interventions to support opioid reduction in non-CKD patients with pain and discusses the application of the available evidence to patients with advanced CKD who are prescribed opioids to manage pain.
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影响因子：
2.6
作者：
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通讯作者：
George, Logan L.
DOI：
10.1080/00207144.2013.841471
发表时间：
2014-01-02
影响因子：
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DOI：
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2008-11-01
影响因子：
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影响因子：
6.2
作者：
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DOI：
10.1001/jama.2016.2323
发表时间：
2016-03-22
期刊：
JAMA
影响因子：
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作者：
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通讯作者：
Turner JA