Utility assessments of opioid treatment for chronic pain
Utility assessments of opioid treatment for chronic pain
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DOI：
10.1046/j.1526-4637.2002.02045.x
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发表时间：
2002-09-01
期刊：
影响因子：
3.1
通讯作者：
Gourlay, G
中科院分区：
文献类型：
--
作者：
Schmier, JK;Palmer, CS;Gourlay, G
客观的。主要研究目的是评估癌症和非癌症慢性疼痛患者对疼痛治疗结果的偏好。次要目标是评估他们的生活质量。方法。患有癌症或非癌症慢性疼痛的患者使用计算机完成了一次访谈，以估计与疼痛治疗相关的健康状态的效用或偏好评级。访谈是使用联合分析方法设计的。健康状态由四个属性（疼痛控制的有效性、副作用、副作用严重程度和阿片类药物给药途径）及其水平来表征，并且假设每个属性持续 14 天。参与者还完成了与健康相关的生活质量和人口调查问卷。结果。患有非癌症慢性疼痛的参与者 (N = 96) 的平均偏好评分范围从最高 0.87（疼痛控制良好，无副作用）到最低 0.18（疼痛控制不佳，伴有严重情绪变化/改变、严重呼吸抑制或严重呕吐）。患有癌症疼痛的参与者 (N = 25) 的平均偏好评分相似，范围从最高 0.89（疼痛控制良好，无副作用）到最低 0.19（疼痛控制不佳，伴有严重呼吸抑制或严重呕吐）。结果证实了之前的研究结果，即慢性疼痛对患者具有严重的、多方面的影响，并且慢性疼痛患者的生活质量是观察到的所有医疗状况中最低的。结论。这项研究从患者的角度对治疗耐受性和疾病症状表现之间的平衡提供了有价值的评估。提高患者对治疗结果偏好的认识可能会导致治疗选择的改进、更好的依从性和最终的治疗成功。
Objective. The primary study objective was to assess preferences for pain treatment outcomes among patients with cancer and noncancer chronic pain. A secondary objective was to assess their quality of life.Methods. Patients with cancer or noncancer chronic pain completed an interview using a computer to estimate utilities, or preference ratings, for health states related to pain treatment. The interview was devised using conjoint analysis methodology. Health states were characterized by four attributes (effectiveness of pain control, side effects, side effect severity, and opioid route of administration) and their levels, and each was assumed to last for a 14-day period. Participants also completed health-related quality of life and demographic questionnaires.Results. Mean preference ratings for participants with noncancer chronic pain (N = 96) ranged from a high of 0.87 (well-controlled pain with no side effects) to a low of 0.18 (poorly controlled pain with severe mood changes/alterations, severe respiratory depression, or severe vomiting). Mean preference ratings for participants with cancer pain (N = 25) were similar and ranged from a high of 0.89 (well-controlled pain with no side effects) to a low of 0.19 (poorly controlled pain with severe respiratory depression or severe vomiting). Results confirmed previous findings that chronic pain has a severe, multidimensional impact on patients, and that the quality of life of persons with chronic pain is among the lowest observed for any medical condition.Conclusions. This study provides a valuable assessment, from the patient's perspective, of the balance between treatment tolerability and manifestation of disease symptoms. Heightened awareness of patients preferences for treatment outcomes may lead to improved selection of treatments, better adherence, and ultimate treatment success.