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首页> 外文期刊>International Journal of Biomedical Science >Adding Genetic Testing to Evidence-Based Guidelines to Determine the Safest and Most Effective Chronic Pain Treatment for Injured Workers
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Adding Genetic Testing to Evidence-Based Guidelines to Determine the Safest and Most Effective Chronic Pain Treatment for Injured Workers

机译：将遗传测试添加到循证指南中，以确定最安全，最有效的慢性受伤工人痛苦疗法

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Published guidelines for treating injured workers include the need for personalized treatment to manage chronic pain symptoms and increase functional status. However, they often fail to clarify how to objectively personalize these treatments. Further, certain patients need analgesic relief beyond the short term. In these cases, it is not sufficient or reasonable to utilize the typical broad protocol-based justifications for reduction of opioids and other medications in a haphazard manner based purely on poor response, without attempting to elucidate possible pharmacogenetic reasons for this. These guidelines acknowledge the problem of substance abuse and set forth methods for treatment and prevention. Although it has been established in the scientific community that an individual’s experience of pain and likelihood for addiction both have genetic components, genetic testing is not routinely included as part of the overall treatment plan for injured workers with chronic pain. Because decisions in cases of workplace injury should be based on scientific evidence, genetic testing results can add some objective information to the existing subjective and objective clinical data; help ascertain the efficacy and potential for toxicity of treatment; and therefore provide more information for accurate clinical decisions. We propose the addition of genetic testing to consensus guidelines for treating injured workers in order to improve patients’ functional status, increase productivity, improve safety of prescribing, decrease the likelihood of substance abuse, and save on overall healthcare costs.
机译：已发布的治疗受伤工人的指南包括需要进行个性化治疗以控制慢性疼痛症状并提高机能状态。但是，他们经常无法阐明如何客观地个性化这些治疗方法。此外，某些患者需要短期内的止痛药。在这些情况下，纯粹基于不良反应，以偶然的方式利用典型的基于广泛协议的理由减少阿片类药物和其他药物的使用是不够的或不合理的，而没有试图为此目的阐明可能的药理学原因。这些准则承认滥用药物的问题，并提出了治疗和预防的方法。尽管科学界已经确定，个人的痛苦经历和成瘾的可能性都具有遗传成分，但是对于患有慢性疼痛的受伤工人，基因检测通常不包括在总体治疗计划中。由于工作场所伤害案件的决策应基于科学证据，因此基因检测结果可以为现有的主观和客观临床数据增加一些客观信息;帮助确定治疗的功效和潜在毒性;因此，可以提供更多信息来进行准确的临床决策。我们建议在共识指南中增加基因检测以治疗受伤的工人，以改善患者的功能状态，提高生产率，提高处方安全性，减少药物滥用的可能性并节省总体医疗费用。

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