CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022.

IF 33.7 1区 医学 Q1 Medicine Mmwr Recommendations and Reports Pub Date : 2022-11-04 DOI:10.15585/mmwr.rr7103a1
Deborah Dowell, Kathleen R Ragan, Christopher M Jones, Grant T Baldwin, Roger Chou
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Abstract

This guideline provides recommendations for clinicians providing pain care, including those prescribing opioids, for outpatients aged ≥18 years. It updates the CDC Guideline for Prescribing Opioids for Chronic Pain - United States, 2016 (MMWR Recomm Rep 2016;65[No. RR-1]:1-49) and includes recommendations for managing acute (duration of <1 month), subacute (duration of 1-3 months), and chronic (duration of >3 months) pain. The recommendations do not apply to pain related to sickle cell disease or cancer or to patients receiving palliative or end-of-life care. The guideline addresses the following four areas: 1) determining whether or not to initiate opioids for pain, 2) selecting opioids and determining opioid dosages, 3) deciding duration of initial opioid prescription and conducting follow-up, and 4) assessing risk and addressing potential harms of opioid use. CDC developed the guideline using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Recommendations are based on systematic reviews of the scientific evidence and reflect considerations of benefits and harms, patient and clinician values and preferences, and resource allocation. CDC obtained input from the Board of Scientific Counselors of the National Center for Injury Prevention and Control (a federally chartered advisory committee), the public, and peer reviewers. CDC recommends that persons with pain receive appropriate pain treatment, with careful consideration of the benefits and risks of all treatment options in the context of the patient's circumstances. Recommendations should not be applied as inflexible standards of care across patient populations. This clinical practice guideline is intended to improve communication between clinicians and patients about the benefits and risks of pain treatments, including opioid therapy; improve the effectiveness and safety of pain treatment; mitigate pain; improve function and quality of life for patients with pain; and reduce risks associated with opioid pain therapy, including opioid use disorder, overdose, and death.

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美国疾病预防控制中心《2022 年阿片类药物治疗疼痛处方临床实践指南》。
本指南为临床医生提供疼痛护理建议,包括为年龄≥18 岁的门诊患者开具阿片类药物处方。它更新了美国疾病预防控制中心《2016 年美国慢性疼痛阿片类药物处方指南》(MMWR Recomm Rep 2016;65[No.RR-1]:1-49),并包括管理急性(持续时间为 3 个月)疼痛的建议。这些建议不适用于与镰状细胞病或癌症有关的疼痛,也不适用于接受姑息治疗或临终关怀的患者。该指南涉及以下四个方面:1)确定是否开始使用阿片类药物治疗疼痛;2)选择阿片类药物并确定阿片类药物的剂量;3)决定首次阿片类药物处方的持续时间并进行随访;4)评估风险并解决阿片类药物使用的潜在危害。疾病预防控制中心采用建议评估、发展和评价分级(GRADE)框架制定了该指南。建议基于对科学证据的系统回顾,并反映了对益处和危害、患者和临床医生的价值观和偏好以及资源分配的考虑。疾病预防控制中心从国家伤害预防和控制中心科学顾问委员会(联邦特许咨询委员会)、公众和同行评审者那里获得了意见。疾病预防控制中心建议疼痛患者接受适当的疼痛治疗,并根据患者的具体情况仔细考虑所有治疗方案的益处和风险。不应将建议作为一成不变的护理标准适用于不同的患者群体。本临床实践指南旨在改善临床医生与患者之间关于疼痛治疗(包括阿片类药物治疗)的益处和风险的沟通;提高疼痛治疗的有效性和安全性;减轻疼痛;改善疼痛患者的功能和生活质量;降低阿片类药物疼痛治疗的相关风险,包括阿片类药物使用障碍、用药过量和死亡。
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来源期刊
Mmwr Recommendations and Reports
Mmwr Recommendations and Reports PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
36.00
自引率
0.00%
发文量
3
期刊介绍: The MMWR series of publications is published by the Office of Science, Centers for Disease Control and Prevention (CDC), U.S. The MMWR Recommendations and Reports contain in-depth articles that relay policy statements for prevention and treatment in all areas in the CDC’s scope of responsibility (e.g., recommendations from the Advisory Committee on Immunization Practices).
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