Pain clinic definitions in the medical literature and U.S. state laws: an integrative systematic review and comparison.
Pain clinic definitions in the medical literature and U.S. state laws: an integrative systematic review and comparison.
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DOI：
10.1186/s13011-018-0153-6
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发表时间：
2018-05-22
期刊：
影响因子：
--
通讯作者：
Watson DP
中科院分区：
文献类型：
--
作者：
Andraka-Christou B;Rager JB;Brown-Podgorski B;Silverman RD;Watson DP
为了应对广泛的阿片类药物滥用，美国十个州已经实施了主要管理和治疗慢性疼痛的设施的法规，称为“疼痛诊所”。诊所福尔斯是否属于一个国家的疼痛诊所的定义决定了它在多大程度上受到监督。目前还不清楚国家疼痛诊所的定义是否是医学文献中的定义模型，潜在的差异导致医学文献中的科学和专业指导意见与实际疼痛诊所实践之间的差异。找出差异可以帮助各国设计更符合医学文献中建议的最佳做法的法律。我们进行了一项综合性系统评价，以使用学术医学文献创建疼痛临床定义的分类。然后，我们确定了现有的美国国家疼痛诊所的法规和条例，并比较了发达国家的分类使用内容分析方法，以了解在何种程度上反映在国家政策的医学文献的定义。在医学文献中，我们确定了八类疼痛诊所定义：1）患者病例组合; 2）单一模式治疗; 3）多学科治疗; 4）跨学科治疗; 5）提供者监督; 6）提供者组成; 7）营销;和8）结果。我们确定了10个有疼痛诊所法律的州。州法律主要包括以下定义类别：患者病例组合;单一模式治疗和营销。医学文献中常见的一些定义类别，如多学科治疗和跨学科治疗，很少出现在州法律定义中。据我们所知，这是第一项研究，以制定一个分类的疼痛诊所的定义，并确定疼痛诊所的定义之间的差异，在美国国家法律和医学文献。未来的工作应探讨不同的法律的疼痛诊所的定义对供应商的决策和国家一级的健康结果的影响。
In response to widespread opioid misuse, ten U.S. states have implemented regulations for facilities that primarily manage and treat chronic pain, called “pain clinics.” Whether a clinic falls into a state’s pain clinic definition determines the extent to which it is subject to oversight. It is unclear whether state pain clinic definitions model those found in the medical literature, and potential differences lead to discrepancies between scientific and professionally guided advice found in the medical literature and actual pain clinic practice. Identifying discrepancies could assist states to design laws that are more compatible with best practices suggested in the medical literature. We conducted an integrative systematic review to create a taxonomy of pain clinic definitions using academic medical literature. We then identified existing U.S. state pain clinic statutes and regulations and compared the developed taxonomy using a content analysis approach to understand the extent to which medical literature definitions are reflected in state policy. In the medical literature, we identified eight categories of pain clinic definitions: 1) patient case mix; 2) single-modality treatment; 3) multidisciplinary treatment; 4) interdisciplinary treatment; 5) provider supervision; 6) provider composition; 7) marketing; and 8) outcome. We identified ten states with pain clinic laws. State laws primarily include the following definitional categories: patient case mix; single-modality treatment, and marketing. Some definitional categories commonly found in the medical literature, such as multidisciplinary treatment and interdisciplinary treatment, rarely appear in state law definitions. This is the first study to our knowledge to develop a taxonomy of pain clinic definitions and to identify differences between pain clinic definitions in U.S. state law and medical literature. Future work should explore the impact of different legal pain clinic definitions on provider decision-making and state-level health outcomes.
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影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
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9.7
作者：
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通讯作者：
Hockenberry, Jason M.
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de Meij, Nelleke;van Grotel, Marloes;van Kleef, Maarten
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van Kleef, Maarten
影响因子：
2.3
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2.8
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