A pilot study to investigate adherence to long-acting opioids among patients with advanced lung cancer.
A pilot study to investigate adherence to long-acting opioids among patients with advanced lung cancer.
复制标题
一项初步研究旨在调查晚期肺癌患者对长效阿片类药物的依从性。
DOI：
--
复制
发表时间：
2013
影响因子：
2.8
通讯作者：
J. Temel
中科院分区：
文献类型：
--
作者：
J. Yoong;L. Traeger;E. Gallagher;W. Pirl;J. Greer;J. Temel
背景
不受控制的疼痛在晚期癌症患者中仍然普遍存在，并与生活质量下降和医疗保健利用率增加有关。对镇痛药的依从性差可能是疼痛管理的一个可改变的障碍。
目的
该初步研究旨在确定评估晚期肺癌患者自我报告的长效（LA）阿片类药物依从性的可行性/效用，并探索依从性的发生率和相关性。
方法
在门诊胸肿瘤门诊就诊的诊断为晚期肺癌并接受当前LA阿片类药物治疗方案的连续性患者在其门诊访视期间完成了一份简短的问卷。受试者报告了过去4周内LA阿片类药物依从性（0%-100%）和其LA阿片类药物治疗方案的知识，并完成了患者健康问卷-2（PHQ-2）抑郁筛查。通过电子健康记录审查确认人口统计学和临床信息。
结果
54名合格患者接近达到我们的目标样本（n=50;入组=92.6%）。自我报告的LA阿片类药物依从性为85.4%（标准差[SD]=21.0）。28%的人报告药物使用频率与规定的每日频率不匹配。较低的依从性与不准确的频率（p=0.004），积极的抑郁症筛查（p=0.005）和年龄较大（p=0.04）相关。
结论
我们的结果证明了将LA阿片类药物依从性的自我报告评估整合到胸部肿瘤诊所的可行性。患者报告了高依从性，但超过四分之一的患者没有准确报告每日剂量的处方频率。了解LA阿片类药物治疗方案可能是晚期癌症患者依从性的关键指标。
BACKGROUND
Uncontrolled pain remains prevalent in patients with advanced cancer and has been associated with worse quality of life and greater health care utilization. Poor adherence to analgesics may represent a modifiable barrier to pain management.
OBJECTIVE
This pilot study aimed to establish feasibility/utility of evaluating self-reported adherence to long-acting (LA) opioids in patients with advanced lung cancer, and to explore rates and correlates of adherence.
METHODS
Consecutive patients attending an ambulatory thoracic oncology clinic with a diagnosis of advanced lung cancer and a current LA opioid regimen were approached to complete a brief questionnaire during their clinic visit. Participants reported LA opioid adherence during the past 4 weeks (0%-100%) and knowledge of their LA opioid regimen, and completed the Patient Health Questionnaire-2 (PHQ-2) depression screen. Demographic and clinical information were confirmed via electronic health record review.
RESULTS
Fifty-four eligible patients were approached to reach our target sample (n=50; enrollment=92.6%). Self-reported adherence to LA opioids was 85.4% (standard deviation [SD]=21.0). Twenty-eight percent reported a frequency of medication use that did not match the prescribed daily frequency. Lower adherence was associated with inaccurate frequency (p=0.004), positive depression screen (p=0.005), and older age (p=0.04).
CONCLUSIONS
Our results demonstrate the feasibility of integrating self-report assessments of LA opioid adherence into a thoracic oncology clinic. Patients reported high adherence, but more than one-quarter did not accurately report the prescribed frequency of daily doses. Understanding of LA opioid regimens may be a critical indicator of adherence in patients with advanced cancer.
克服癌症疼痛管理的障碍：制度变革模型。
影响因子：
4.7
作者：
Sun,VirginiaChih-Yi;Borneman,Tami;Ferrell,Betty;Piper,Barbara;Koczywas,Marianna;Choi,Kyong
通讯作者：
Choi,Kyong
影响因子：
158.5
作者：
CLEELAND, CS;GONIN, R;PANDYA, KJ
通讯作者：
PANDYA, KJ