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首页> 外文期刊>BMC Family Practice >Provider and patient perspectives on opioids and alternative treatments for managing chronic pain: a qualitative study
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Provider and patient perspectives on opioids and alternative treatments for managing chronic pain: a qualitative study

机译：提供者和患者对阿片类药物和替代疗法治疗慢性疼痛的观点：定性研究

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Background Current literature describes the limits and pitfalls of using opioid pharmacotherapy for chronic pain and the importance of identifying alternatives. The objective of this study was to identify the practical issues patients and providers face when accessing alternatives to opioids, and how multiple parties view these issues. Methods Qualitative data were gathered to evaluate the outcomes of acupuncture and chiropractic (A/C) services for chronic musculoskeletal pain (CMP) using structured interview guides among patients with CMP ( n =?90) and primary care providers (PCPs) ( n =?25) purposively sampled from a managed care health care system as well as from contracted community A/C providers ( n =?14). Focus groups and interviews were conducted patients with CMP with varying histories of A/C use. Plan PCPs and contracted A/C providers took part in individual interviews. All participants were asked about their experiences managing chronic pain and experience with and/or attitudes about A/C treatment. Audio recordings were transcribed and thematically coded. A summarized version of the focus group/interview guides is included in the Additional file 1 . Results We identified four themes around opioid use: (1) attitudes toward use of opioids to manage chronic pain; (2) the limited alternative options for chronic pain management; (3) the potential of A/C care as a tool to help manage pain; and (4) the complex system around chronic pain management. Despite widespread dissatisfaction with opioid medications for pain management, many practical barriers challenged access to other options. Most of the participants’ perceived A/C care as helpful for short term pain relief. We identified that problems with timing, expectations, and plan coverage limited A/C care potential for pain relief treatment. Conclusions These results suggest that education about realistic expectations for chronic pain management and therapy options, as well as making A/C care more easily accessible, might lead to more satisfaction for patients and providers, and provide important input to policy makers. Trial registration ClinicalTrials.gov NCT01345409 , date of registration 28/4/2011
机译：背景技术当前的文献描述了使用阿片类药物疗法治疗慢性疼痛的局限性和陷阱以及确定替代方案的重要性。这项研究的目的是确定患者和提供者在使用阿片类药物替代品时面临的实际问题，以及多方如何看待这些问题。方法收集定性数据，使用结构化访谈指南对CMP患者（n =？90）和基层医疗服务提供者（n = 9）进行针刺和整脊（A / C）服务对慢性肌肉骨骼疼痛（CMP）的效果进行评估。 25）目的是从管理式医疗体系以及合同社区A / C提供者那里抽样的（n = 14）。焦点小组和访谈是针对具有不同A / C使用历史的CMP患者进行的。计划中的PCP和合同的A / C提供者参加了个别采访。所有参与者均被问及他们处理慢性疼痛的经历以及对A / C治疗的经历和/或态度。录音被转录并按主题进行编码。附加文件1中包含焦点小组/面试指南的摘要。结果我们确定了与使用阿片类药物有关的四个主题：（1）使用阿片类药物治疗慢性疼痛的态度; （2）慢性疼痛管理的替代选择有限; （3）空调护理作为帮助缓解疼痛的工具的潜力; （4）围绕慢性疼痛管理的复杂系统。尽管人们对使用阿片类药物治疗疼痛普遍不满意，但许多实际障碍挑战了使用其他药物的可能性。大多数参与者认为空调护理有助于缓解短期疼痛。我们发现时间，期望和计划覆盖范围方面的问题限制了疼痛缓解治疗的A / C护理潜力。结论这些结果表明，对慢性疼痛管理和治疗选择的现实期望进行教育，以及使A / C护理更容易获得，这可能会使患者和提供者更加满意，并为决策者提供重要的信息。试用注册ClinicalTrials.gov NCT01345409，注册日期28/4/2011

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