癌性疼痛規(guī)范化治療課件

癌痛規(guī)范化和個體化評估廣東省中醫(yī)院李勇Valadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL●●●2019年最新調(diào)查研究CancermedicineORIGINALRESEARCHCurrentpracticesincancerpainmanagementinAsia:asurveyofpatientsandphysiciansacross10countries10個亞洲地區(qū)醫(yī)生與患者癌痛管理現(xiàn)狀調(diào)查yong-chulkim,etal.CancerMedicine.2019.EpubaheadofprintValadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL●●●研究目的調(diào)査亞洲目前癌痛管理現(xiàn)狀,其中包括癌痛對癌癥患者生活質(zhì)量景響患者描述癌痛情況≯醫(yī)生對癌癥患者癌痛評估情況阿片類藥物使用情況yong-chulkim,etal.CancerMedicine.2019.EpubaheadofprintValadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL●●●研究方法參與國家:10個亞洲國家,包括中國,香港,印尼,菲律賓,韓國,馬來西亞,新加坡,臺灣,泰國,越南研究時間:4個月,2019年09月-12月≥研究方法:無對照,問卷調(diào)査,問題設(shè)計(jì)由16名亞洲資深癌痛專家,嚴(yán)格遵循ESOMAR標(biāo)準(zhǔn)來制定研究對象:醫(yī)生及患者yong-chulkim,etal.CancerMedicine.2019.EpubaheadofprintValadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL●●●研究方法冫醫(yī)生納入標(biāo)準(zhǔn):由國家機(jī)構(gòu),醫(yī)療機(jī)構(gòu),社會醫(yī)療等機(jī)構(gòu)及其他合法組織隨機(jī)挑選≯醫(yī)生排除標(biāo)準(zhǔn):醫(yī)藥公司聘用或相關(guān)醫(yī)務(wù)人員患者入組標(biāo)準(zhǔn):大于18歲,通過患者自發(fā)組織推薦,醫(yī)生推薦,患者推薦,網(wǎng)絡(luò)組織,現(xiàn)場招募,電話招募等獲得≯患者排除標(biāo)準(zhǔn):醫(yī)療,制藥,市場等疼痛相關(guān)組織有關(guān)患者Valadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL●●●研究方法共納科463名醫(yī)生mTable1.Demographiccharacteristicsofphysicians(n=463)基本資料如下Madian(QR)313(67,6)Country/regionepublicofKoreaethamPhilippines30(6Yearsinclinicalpractice87(18.8)ainmanagementIORinterquartilerangeyong-chulkim,etal.CancerMedicine2019.EpubaheadofprintValadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL結(jié)果●●●共納1190名患者基本資料如下多8523untry/regionsingapore516個43.30429Mild(0-3)Median(IORNe6monthsto1yea325c7.3)7g50Lessthan3month1058)urationofpain.monthsyong-chuTkim,etal.CancerMedicine2019.EpubaheadofprintValadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL結(jié)果●●●疼痛對患者生活質(zhì)量影響Table4.Effectsofcancerpainonpatients'qualityoflife(QoLn=1190)n(%6)ofrespondentsinEffectsofcancerpainonQOLaareementCancerpainaffectspatie影響目常生活67(81ofdailylivingpectsofdailylifeaffePainaffectssleepingp影響睡眠831(859)Painaffectsconcentra影響精神及注意力841(870Paincausestoomuch依賴他人642(66.4)otherpeopleOverallQoLisgood生活質(zhì)量不受影響328(33.9)yong-chulkim,etal.CancerMedicine.2019.EpubaheadofprintValadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL●●●結(jié)果Table3.Physicians'perceivedbarrierstooptimizingcancerpainmanagement(n=463)n(%)(NRSscore>Median(IOR)Patient'sreluctancetotakeopioidsduetofear患者害怕成癮311(67.2)7030)Patientsreluctancetotakeopioidsduetofear301(6507.0(30)Patient'sreluctancetoreportpainnadequateassessmentofpainbyphysiciansal230(4975.050)LackofavailablepainmanagementorpalliativeExcessiveregulationofopioiddrugs疼痛藥物監(jiān)管過222(480)5.0(5.0)ysiciansreluctancetoprescribeopioids醫(yī)生不愿意使用阿片類藥物198(4285.0(40)Patient'sinabilitytopayforinterventionalanalge患者無法支付物費(fèi)用173(374050)AnNRSconingsystemfrom0to10wasusedtoevaluatephysicansresponses.NRS,numericratingscale:IQR,interquartilerangeadequateassessmentofpainwasrecognizedasabarriertotherapyoptimizationby49.7%ofphysiciansValadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL●●●結(jié)論冫證實(shí)癌痛嚴(yán)重影響患者生活質(zhì)量疼痛評估不充分加強(qiáng)宣教≯正確,足量使用阿片類藥物yong-c