When ESKD complicates the management of pain.

When ESKD complicates the management of pain.
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DOI:
10.1111/sdi.12881
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发表时间:
2020-05
影响因子:
1.6
通讯作者:
Liebschutz J
Liebschutz J
中科院分区:
医学3区
文献类型:
--
作者:
Jhamb M;Tucker L;Liebschutz J

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疼痛是终末期肾病(ESKD)患者报告的最常见症状之一,并对他们的健康相关生活质量(HRQOL)、透析依从性、医疗保健利用率和死亡率产生负面影响。有许多与患者相关和与卫生系统相关的障碍,使得治疗这些患者的疼痛非常具有挑战性。此外,有效和安全的非阿片类止痛药选择的有限导致了这一人群中阿片类药物的过度使用。我们提出了一个疼痛评估和定制治疗的框架,使用非药理学和药理学方法来优化疼痛管理和阿片类药物的使用。此外,我们建议进行系统水平的改变,以改善ESKD患者的护理协调和疼痛管理。
Pain is one of the most common symptoms reported by patients with end-stage kidney disease (ESKD) and negatively impacts their health-related quality of life (HRQOL), dialysis adherence, healthcare utilization, and mortality. There are a number of patient-related and health system-related barriers that make it very challenging to treat pain in these patients. Moreover, the limited availability of efficacious and safe nonopiate analgesic options has led to over-use of opioids in this population. We propose a framework for pain assessment and tailored treatment using nonpharmacological and pharmacological approaches to optimize pain management and opioid use. Additionally, we recommend system-level changes to improve care coordination and pain management in ESKD patients.
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