Shared decision-making in the selection of outpatient analgesics for older individuals in the emergency department.
Shared decision-making in the selection of outpatient analgesics for older individuals in the emergency department.
复制标题
DOI：
10.1111/jgs.12207
复制
发表时间：
2013-05
影响因子：
6.3
通讯作者：
Platts-Mills TF
中科院分区：
文献类型：
--
作者：
Isaacs CG;Kistler C;Hunold KM;Pereira GF;Buchbinder M;Weaver MA;McLean SA;Platts-Mills TF
旨在评估老年患者对选择在家服用的急性肌肉骨骼疼痛镇痛药的共同决策的看法与 1) 患者对镇痛药的满意度和 2) 一周内疼痛评分的变化之间的关系。横断面研究。单一学术急诊科。 65 岁或以上患有急性肌肉骨骼疼痛的人士。评估了共同决策的两个组成部分：1）向患者提供有关药物选择的信息； 2) 患者参与镇痛药的选择。对镇痛药的最佳满意度被定义为“非常”满意。在急诊室和一周后使用 0 到 10 等级评估疼痛评分。在通过电话联系的 159 名患者中，111 名患者符合所有资格标准并完成了调查。一半 (52%) 的患者报告收到有关止痛药物选择的信息，三分之一 (31%) 报告参与了镇痛药物的选择。收到信息的患者比没有收到信息的患者更有可能对止痛药表现出最佳满意度（67% vs. 34%；p<0.001）。参与决策的患者也更有可能报告对镇痛药的最佳满意度（71% vs. 43%；p<0.01），并且疼痛评分平均下降幅度更大（4.1 vs. 2.9；p=0.05）。在调整测量的混杂因素后，报告收到信息的患者仍然更有可能报告对镇痛药的最佳满意度（63% vs. 38%；p=0.04）。这些结果提供了初步证据，表明老年急性肌肉骨骼疼痛患者在镇痛选择方面的共同决策可能会改善预后。
To assess the relationship between older patients’ perceptions of shared decision making in the selection of an analgesic to take at home for acute musculoskeletal pain and 1) patient satisfaction with the analgesic and 2) changes in pain scores at one week. Cross-sectional study. Single academic emergency department. Individuals age 65 or older with acute musculoskeletal pain. Two components of shared decision making were assessed: 1) information provided to the patient about the medication choice; and 2) patient participation in the selection of the analgesic. Optimal satisfaction with the analgesic was defined as being “a lot” satisfied. Pain scores were assessed in the ED and at one week using a 0-to-10 scale. Of 159 patients reached by phone, 111 patients met all eligibility criteria and completed the survey. Half (52%) of patients reported receiving information about pain medication options, and one third (31%) reported participating in the analgesic selection. Patients who received information were more likely to report optimal satisfaction with the pain medication than those who did not (67% vs. 34%; p<0.001). Patients who participated in the decision were also more likely to report optimal satisfaction with the analgesic (71% vs. 43%; p<0.01) and had a greater average decrease in pain score (4.1 vs. 2.9; p=0.05). After adjusting for measured confounders, patients who reported receiving information remained more likely to report optimal satisfaction with the analgesic (63% vs. 38%; p=0.04). These results provide preliminary evidence that shared decision making in analgesic selection for older patients with acute musculoskeletal pain may improve outcomes.
登录
查看更多内容
影响因子：
6.3
作者：
Hwang U;Richardson LD;Harris B;Morrison RS
通讯作者：
Morrison RS
影响因子：
6.2
作者：
Platts-Mills, Timothy F.;Esserman, Denise A.;McLean, Samuel A.
通讯作者：
McLean, Samuel A.
影响因子：
--
作者：
Solomon, Daniel H.;Rassen, Jeremy A.;Schneeweiss, Sebastian
通讯作者：
Schneeweiss, Sebastian
影响因子：
4
作者：
Gregorian, Razmic S., Jr.;Gasik, Alexander;Kavanagh, Shane
通讯作者：
Kavanagh, Shane
影响因子：
4.4
作者：
Pines, Jesse M.;Shofer, Frances S.;Mills, Angela M.
通讯作者：
Mills, Angela M.