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Opioid use for Chronic Pain Management in Italy: Results from the Orthopedic Instant Pain Survey Project

机译:阿片类药物在意大利慢性疼痛管理中的应用:骨科即时疼痛调查项目的结果

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摘要

Pain is a common symptom in orthopedic patients, but is managed sub-optimally, partly due to scarce opioid use in severe cases. The aim of the Orthopedic Instant Pain Survey (POIS) was to evaluate changes in pain management in Italian orthopedic practice 2 years after a legislative change (Law 38/2010) simplifying opioid access for pain control. A web-based survey on the knowledge of this law and trends observed in clinical practice for severe pain treatment was administered to 143 Italian orthopedic specialists. In total, 101 (70%) respondents showed a high level of knowledge. Nevertheless, 54.5% stated that they do not use opioids for severe osteo-articular pain management. Main barriers to opioid use are fear of adverse events (61.4%), especially nausea/vomiting and constipation, and patient resistance (29.7%). A modest knowledge of pain classification was also demonstrated. Opioid use remains very limited in Italian orthopedic practice. Physicians’ fear of side effects showed poor knowledge of strategies for effective management of opioid-related adverse events, such as combined oral prolonged-release oxycodonealoxone. Continuing educational programs could improve delivery of evidence-based pain management.
机译:疼痛是骨科患者的常见症状,但治疗效果欠佳,部分原因是在严重情况下很少使用阿片类药物。骨科即时疼痛调查(POIS)的目的是评估立法变更后两年(第38/2010号法律)简化了用于控制疼痛的阿片类药物的使用后,意大利骨科实践中疼痛管理的变化。对143名意大利骨科专家进行了基于网络的有关此法知识和在临床实践中观察到的严重疼痛治疗趋势的调查。共有101位(70%)受访者表示高水平的知识。尽管如此,仍有54.5%的人表示他们不使用阿片类药物治疗严重的骨关​​节疼痛。使用阿片类药物的主要障碍是对不良事件的恐惧(61.4%),尤其是恶心/呕吐和便秘,以及患者的抵抗力(29.7%)。还显示了对疼痛分类的一些了解。阿片类药物的使用在意大利整形外科中仍然非常有限。医师对副作用的恐惧表明对有效处理阿片类药物相关不良事件(例如口服口服缓释羟考酮/纳洛酮联合疗法)的策略了解甚少。继续教育计划可以改善基于证据的疼痛管理。

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