CAM therapies among primary care patients using opioid therapy for chronic pain.
CAM therapies among primary care patients using opioid therapy for chronic pain.
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DOI：
10.1186/1472-6882-7-15
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发表时间：
2007-05-16
影响因子：
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通讯作者：
Fleming, Michael F
中科院分区：
文献类型：
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作者：
Fleming, Sara;Rabago, David P;Mundt, Marlon P;Fleming, Michael F
补充和替代医学 (CAM) 是一种越来越常见的治疗慢性疼痛综合征的疗法。然而;关于 CAM 疗法在接受长期阿片类药物治疗的初级保健患者中的使用和疗效的信息有限。对 908 名接受阿片类药物作为慢性疼痛主要治疗方法的初级保健患者进行了系统样本研究，对 CAM 疗法进行了调查。受试者完成了一份调查问卷，旨在评估 CAM 疗法在该人群中的利用率、疗效和成本。患者因各种疼痛问题接受治疗，包括腰痛（38.4%）、头痛（9.9%）和膝盖疼痛（6.5%）；疼痛的平均持续时间为16年。中位吗啡当量阿片类药物剂量为 41 毫克/天，平均剂量为 92 毫克/天。 44% 的样本报告在过去 12 个月内使用过 CAM 疗法。使用的疗法包括按摩疗法（27.3%，n = 248）、脊椎按摩治疗（17.8%，n = 162）、针灸（7.6%，n = 69）、瑜伽（6.1%，n = 55）、草药和补充剂（6.8%，n = 62）和增殖疗法（5.9%，n = 54）。 CAM 利用率与年龄、女性、性别、疼痛严重程度、收入、颈部和上背部疼痛诊断以及非法药物使用显着相关。医疗保险涵盖脊椎按摩疗法（81.8%）和增殖疗法（87.7%），而患者主要支付其他 CAM 疗法。超过一半的样本报告称一种或多种 CAM 疗法有帮助。这项研究表明 CAM 疗法被接受阿片类药物治疗慢性疼痛的患者广泛使用。是否可以通过引入此类疗法来减少阿片类药物仍有待研究。
Complementary and alternative medicine (CAM) is an increasingly common therapy used to treat chronic pain syndromes. However; there is limited information on the utilization and efficacy of CAM therapy in primary care patients receiving long-term opioid therapy. A survey of CAM therapy was conducted with a systematic sample of 908 primary care patients receiving opioids as a primary treatment method for chronic pain. Subjects completed a questionnaire designed to assess utilization, efficacy and costs of CAM therapies in this population. Patients were treated for a variety of pain problems including low back pain (38.4%), headaches (9.9%), and knee pain (6.5%); the average duration of pain was 16 years. The median morphine equivalent opioid dose was 41 mg/day, and the mean dose was 92 mg/day. Forty-four percent of the sample reported CAM therapy use in the past 12 months. Therapies utilized included massage therapy (27.3%, n = 248), chiropractic treatment (17.8%, n = 162), acupuncture (7.6%, n = 69), yoga (6.1%, n = 55), herbs and supplements (6.8%, n = 62), and prolotherapy (5.9%, n = 54). CAM utilization was significantly related to age female gender, pain severity income pain diagnosis of neck and upper back pain, and illicit drug use. Medical insurance covered chiropractic treatment (81.8%) and prolotherapy (87.7%), whereas patients primarily paid for other CAM therapies. Over half the sample reported that one or more of the CAM therapies were helpful. This study suggests CAM therapy is widely used by patients receiving opioids for chronic pain. Whether opioids can be reduced by introducing such therapies remains to be studied.