Patient recommendations for opioid prescribing in the context of HIV care: findings from a set of public deliberations.
Patient recommendations for opioid prescribing in the context of HIV care: findings from a set of public deliberations.
复制标题
在艾滋病毒护理背景下患者对阿片类药物处方的建议：一系列公众审议的结果。
DOI：
10.1080/09540121.2019.1705962
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发表时间：
2020
期刊：
影响因子：
1.7
通讯作者：
Robinson-Papp,Jessica
中科院分区：
文献类型：
--
作者：
Scherer,Maya;Weiss,Linda;Kamler,Alexandra;George,Mary-Catherine;Navis,Allison;Gebhardt,Yves;Robinson-Papp,Jessica
人们普遍承认，阿片类药物流行病日益严重，过量死亡人数也随之增加，因此有必要重新审查与阿片类药物治疗慢性疼痛处方有关的过程和程序。然而，患者的观点，包括那些阿片类药物相关危害风险最高的患者，在这次复查中基本上缺失了。为了部分解决这一差距，我们对艾滋病毒护理背景下的阿片类药物处方进行了为期一天的公开审议。结果包括来自艾滋病毒感染者的建议和观点，详细说明了提供者如何最好地评估患者需求，就阿片类药物进行沟通，并降低滥用风险。与会者强调了与患者建立信任的重要性，并在决定是否开始或结束阿片类药物处方之前，了解广泛的患者病史。这种信任，加上对患者疼痛起源、药物使用史和其他治疗方法的了解，被认为是有效监测和疼痛管理以及促进积极健康结果的关键。确保将此类患者观点纳入安全阿片类药物处方指南的实施中可能有助于改善艾滋病毒感染者的护理结果和质量。
It is widely acknowledged that the growing opioid epidemic and associated increase in overdose deaths necessitates a reexamination of processes and procedures related to an opioid prescription for the treatment of chronic pain. However, the perspectives of patients, including those at the highest risk for opioid-related harms, are largely missing from this reexamination. To partially address the gap, we conducted a pair of one-day public deliberations on opioid prescribing in the context of HIV care. Results included recommendations and perspectives from people living with HIV that detail how providers can best assess patient needs, communicate regarding opioids, and reduce the risk of misuse. Participants emphasized the importance of building trust with patients and taking an extensive patient history prior to making decisions about whether to initiate or end an opioid prescription. This trust – together with an understanding of the origin of a patient’s pain, history of drug use and other therapies tried – was perceived as essential to effective monitoring and pain management, as well as promotion of positive health outcomes. Ensuring that such patient perspectives are incorporated into the operationalization of guidelines for safe opioid prescribing may help to improve outcomes and quality of care for people living with HIV.