Physicians' perception about predictors of opioid abuse in patients with chronic non-cancer pain: a Delphi study.

IF 2.5 Q2 CLINICAL NEUROLOGY Frontiers in pain research (Lausanne, Switzerland) Pub Date : 2023-10-19 eCollection Date: 2023-01-01 DOI:10.3389/fpain.2023.1269018
Santiago Galán, Rocío de la Vega, Rosa Esteve, Alicia E López-Martínez, Mariano Fernández Baena, Carmen Ramírez-Maestre
{"title":"Physicians' perception about predictors of opioid abuse in patients with chronic non-cancer pain: a Delphi study.","authors":"Santiago Galán,&nbsp;Rocío de la Vega,&nbsp;Rosa Esteve,&nbsp;Alicia E López-Martínez,&nbsp;Mariano Fernández Baena,&nbsp;Carmen Ramírez-Maestre","doi":"10.3389/fpain.2023.1269018","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Opioids are being prescribed widely, and increasingly, for the treatment of chronic non-cancer pain (CNCP). However, several side effects are associated with mid- and long-term opioid use and, for certain patients, with the risk of problematic opioid use. The aim of this study is to know the perception of the physicians about which variables could be associated with increased risk of patients with CNCP developing a problem of abuse or misuse of the prescribed opioid medication.</p><p><strong>Methods: </strong>Twenty-nine physicians with experience in CNCP pain management and opioids prescription participated in a two-round Delphi study focused on the risk factors for opioid misuse and abuse.</p><p><strong>Results: </strong>The variables that reached consensus regarding their relationship with the increased risk of suffering a problem of opioid abuse or misuse were: (1) Experiencing pain on a daily basis, (2) previous use of high-dose opioids, (3) generalized anxiety, (4) hopelessness, (5) benzodiazepine intake, (6) use of opioids for reasons other than pain, (7) family problems, family instability or family breakdown, and (8) having access to several opioid prescribers. The only variable that reached consensus regarding it not being associated to a possible risk of abuse or misuse was having mild pain intensity (0-4 on a NRS-11).</p><p><strong>Conclusions: </strong>This study provides useful information that could help make decisions about the use of opioids for CNCP treatment and prevent future difficulties. Prospective studies testing the relationship of the variables that reached consensus with the risk of opioid misuse and abuse are warranted.</p><p><strong>Significance: </strong>This study shows the variables of CNCP that the professional must take into account in order to avoid possible problems when prescribing opioids.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10621745/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in pain research (Lausanne, Switzerland)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3389/fpain.2023.1269018","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Opioids are being prescribed widely, and increasingly, for the treatment of chronic non-cancer pain (CNCP). However, several side effects are associated with mid- and long-term opioid use and, for certain patients, with the risk of problematic opioid use. The aim of this study is to know the perception of the physicians about which variables could be associated with increased risk of patients with CNCP developing a problem of abuse or misuse of the prescribed opioid medication.

Methods: Twenty-nine physicians with experience in CNCP pain management and opioids prescription participated in a two-round Delphi study focused on the risk factors for opioid misuse and abuse.

Results: The variables that reached consensus regarding their relationship with the increased risk of suffering a problem of opioid abuse or misuse were: (1) Experiencing pain on a daily basis, (2) previous use of high-dose opioids, (3) generalized anxiety, (4) hopelessness, (5) benzodiazepine intake, (6) use of opioids for reasons other than pain, (7) family problems, family instability or family breakdown, and (8) having access to several opioid prescribers. The only variable that reached consensus regarding it not being associated to a possible risk of abuse or misuse was having mild pain intensity (0-4 on a NRS-11).

Conclusions: This study provides useful information that could help make decisions about the use of opioids for CNCP treatment and prevent future difficulties. Prospective studies testing the relationship of the variables that reached consensus with the risk of opioid misuse and abuse are warranted.

Significance: This study shows the variables of CNCP that the professional must take into account in order to avoid possible problems when prescribing opioids.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
医生对慢性非癌性疼痛患者阿片类药物滥用预测因素的认知:德尔菲研究。
背景:阿片类药物被广泛且越来越多地用于治疗慢性非癌性疼痛(CNCP)。然而,一些副作用与中长期阿片类药物使用有关,对某些患者来说,还与阿片类物质使用有问题的风险有关。本研究的目的是了解医生对哪些变量可能与CNCP患者出现滥用或滥用处方阿片类药物问题的风险增加有关的看法。方法:29名在CNCP疼痛管理和阿片类药物处方方面有经验的医生参与了一项两轮德尔菲研究,重点是阿片类物质滥用和滥用的风险因素。结果:就其与阿片类药物滥用或滥用问题风险增加的关系达成共识的变量是:(1)每天经历疼痛,(2)以前使用过高剂量阿片类,(3)普遍焦虑,(4)绝望,(5)苯二氮卓类药物摄入,(6)因疼痛以外的原因使用阿片类,家庭不稳定或家庭破裂,以及(8)接触到几位阿片类药物处方医生。唯一达成共识的与可能的滥用或误用风险无关的变量是轻度疼痛强度(NRS-11为0-4)。结论:这项研究提供了有用的信息,有助于决定使用阿片类药物治疗CNCP,并防止未来的困难。有必要进行前瞻性研究,测试达成共识的变量与阿片类药物滥用风险的关系。意义:本研究显示了专业人员在开具阿片类药物处方时必须考虑的CNCP变量,以避免可能出现的问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
2.10
自引率
0.00%
发文量
0
审稿时长
13 weeks
期刊最新文献
Rescue analgesia with a transversus abdominis plane block alleviates moderate-to-severe pain and improves oxygenation after abdominal surgery: a randomized controlled trial. Evaluating pain in non-verbal critical care patients: a narrative review of the critical care pain observation tool and Its clinical applications. Pediatric pain physician workforce: an assessment of supply and demand. Enhancing analgesia in acute renal colic pain: a randomized controlled trial of gabapentin adjunct to ketorolac-based regimen. Non-opioid psychiatric medications for chronic pain: systematic review and meta-analysis.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1