A Clinical Trial of a Program for Pain Management and Opioid Reduction During Pregnancy.
A Clinical Trial of a Program for Pain Management and Opioid Reduction During Pregnancy.
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怀孕期间疼痛管理和阿片类药物减少计划的临床试验。
DOI：
10.1007/s43032-021-00701-4
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Guille,Constance
中科院分区：
文献类型：
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作者：
Shapiro,Mary;Sujan,AyeshaC;Guille,Constance
很大一部分孕妇使用处方类阿片。然而，长期使用阿片类药物治疗疼痛缺乏疗效，加上这些药物在一般情况下和怀孕期间的风险增加，表明这些药物的风险可能超过继续使用的益处。虽然研究尚未评估治疗妊娠期间慢性疼痛的非药物方法，但对妊娠期以外的一般人群进行的研究表明，认知行为疗法（CBT）是一种有效的非药物治疗方法。因此，本研究的目的是评估CBT对慢性疼痛的有效性，并在处方阿片类药物滥用的孕妇中共同决定减少处方阿片类药物剂量。这项研究是一项为期8周的开放标签CBT慢性疼痛临床试验，并共同决定处方阿片类药物剂量减少。参与者包括20名年龄在18至45岁之间的孕妇的临床样本，这些孕妇滥用阿片类药物，但不符合DSM-IV阿片类药物使用障碍或其他物质使用障碍的标准。与基线相比，在8周时，参与者的平均处方阿片类吗啡等效剂量，处方阿片类药物滥用，最严重疼痛评分以及一般活动和工作中的疼痛干扰显著减少。他们没有报告其他疼痛评级或功能领域的改善。这项研究提供了关于CBT对慢性疼痛的初步疗效的有价值的信息，并在滥用处方阿片类药物的孕妇中进行了共同决策。ClinicalTrials.gov：NCT02804152
A substantial proportion of pregnant women use prescription opioids. However, the lack of efficacy of chronic prescription opioid use for pain, combined with an increased risk of these medications in general and during pregnancy, suggests that the risks of these medications may outweigh the benefits of continued use. Though research has not evaluated non-pharmacological approaches to treat chronic pain during pregnancy, research conducted with the general population outside of pregnancy suggests that cognitive behavioral therapy (CBT) is an effective, non-pharmacological treatment. Therefore, the purpose of this study was to evaluate the effectiveness of CBT for chronic pain paired with shared decision-making for prescription opioid dose reduction among pregnant women with prescription opioid misuse. The study was an open-label, 8-week clinical trial of CBT for chronic pain and shared decision-making for prescription opioid dose reduction. Participants included a clinical sample of 20 pregnant women between the ages of 18 and 45 years who were misusing opioids but did not meet DSM-IV criteria for an opioid use disorder or other substance use disorder. Compared to baseline, at 8 weeks, participants had significant reductions in average prescription opioid morphine equivalent dose, prescription opioid misuse, worst pain ratings, and pain interference in general activity and at work. They did not report improvement in other pain ratings or areas of functioning. This study provides valuable information regarding the preliminary efficacy of CBT for chronic pain paired with shared decision-making among pregnant women misusing prescription opioids. ClinicalTrials.gov: NCT02804152