Opioid Management: Initiating, Monitoring, and Tapering.
Opioid Management: Initiating, Monitoring, and Tapering.
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阿片类药物管理：启动、监测和逐渐减少。
DOI：
10.1016/j.pmr.2020.01.006
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发表时间：
2020
影响因子：
1.7
通讯作者：
Hooten,WMichael
中科院分区：
文献类型：
--
作者：
Hooten,WMichael
已经发表了许多针对阿片类药物安全使用治疗慢性疼痛的指南，但在最佳实践建议的临床应用方面仍然存在重大挑战。这篇文章的目的是描述一个实用的方法来临床护理成人慢性疼痛接受长期阿片类药物治疗。将强调护理的三个关键组成部分，包括(1)在开始阿片类药物治疗之前进行医疗和心理健康评估；(2)长期阿片类药物治疗过程中的临床监测；(3)控制阿片类药物逐渐减少的临床考虑和策略。本综述中提出的实用方法可能是在日常临床实践中实施最佳实践建议的一小步。然而，迫切需要正在进行的研究，以进一步阐明长期阿片类药物治疗在治疗慢性疼痛中的最佳作用。
Numerous guidelines targeting the safe use of opioids for chronic pain have been published but substantial challenges persist in the clinical application of best practice recommendations. The purpose of this article is to describe a pragmatic approach to the clinical care of adults with chronic pain receiving long-term opioid therapy. Three key components of care will emphasized including (1) the medical and mental health assessment prior to initiating opioid therapy; (2) clinical surveillance during the course of long-term opioid therapy; and (3) clinical considerations and strategies governing opioid tapering. The pragmatic approaches set forth in this review could be one small step toward operationalizing best practice recommendations for implementation in daily clinical practice. However, a pressing need exists for ongoing research to further clarify the optimal role that long-term opioid therapy has in the treatment of chronic pain.