识别和评估癌症患者阿片类药物滥用的风险:一项综合综述。

IF 5.1 Q1 SUBSTANCE ABUSE Substance Abuse and Rehabilitation Pub Date : 2016-06-02 eCollection Date: 2016-01-01 DOI:10.2147/SAR.S85409
Ashley-Nicole Carmichael, Laura Morgan, Egidio Del Fabbro
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引用次数: 95

摘要

背景:在许多发达国家,阿片类药物的误用和滥用是一种健康危机,导致卫生系统利用率增加,急诊就诊和过量死亡。人们也越来越关注癌症患者滥用阿片类药物和转移治疗,甚至是在生命的最后阶段。目的:评价目前关于阿片类药物误用和滥用的文献,更具体地说,癌症患者阿片类药物滥用风险的识别和评估。我们的第二个目标是提供最佳临床实践的最新证据,并建议未来的研究方向。材料和方法:我们的综合综述包括使用关键词“癌症中阿片类药物滥用的识别和评估”、“晚期癌症和阿片类药物滥用”、“临终关怀和阿片类药物滥用”和“姑息治疗和阿片类药物滥用”进行文献检索。PubMed, PsycInfo和Embase通过手动搜索进行补充。结果:我们发现了691篇文章,排除了657篇,因为它们主要是非癌症人群或专门排除了癌症患者。共有34篇文章符合我们的标准,包括案例研究、病例系列、回顾性观察研究和叙述性综述。这些研究分为阿片类药物滥用或酒精的筛查问卷,确定阿片类药物滥用或滥用的尿液药物筛查,处方药监测计划以及普遍预防措施的使用。结论:筛查问卷和尿液药物筛查表明,至少五分之一的癌症患者可能存在阿片类药物使用障碍的风险。一些研究表明高危患者与临床结果之间存在关联,如异常行为、长时间使用阿片类药物、较高的吗啡当量日剂量、较高的医疗保健使用率和症状负担。
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Identifying and assessing the risk of opioid abuse in patients with cancer: an integrative review.

Background: The misuse and abuse of opioid medications in many developed nations is a health crisis, leading to increased health-system utilization, emergency department visits, and overdose deaths. There are also increasing concerns about opioid abuse and diversion in patients with cancer, even at the end of life.

Aims: To evaluate the current literature on opioid misuse and abuse, and more specifically the identification and assessment of opioid-abuse risk in patients with cancer. Our secondary aim is to offer the most current evidence of best clinical practice and suggest future directions for research.

Materials and methods: Our integrative review included a literature search using the key terms "identification and assessment of opioid abuse in cancer", "advanced cancer and opioid abuse", "hospice and opioid abuse", and "palliative care and opioid abuse". PubMed, PsycInfo, and Embase were supplemented by a manual search.

Results: We found 691 articles and eliminated 657, because they were predominantly non cancer populations or specifically excluded cancer patients. A total of 34 articles met our criteria, including case studies, case series, retrospective observational studies, and narrative reviews. The studies were categorized into screening questionnaires for opioid abuse or alcohol, urine drug screens to identify opioid misuse or abuse, prescription drug-monitoring programs, and the use of universal precautions.

Conclusion: Screening questionnaires and urine drug screens indicated at least one in five patients with cancer may be at risk of opioid-use disorder. Several studies demonstrated associations between high-risk patients and clinical outcomes, such as aberrant behavior, prolonged opioid use, higher morphine-equivalent daily dose, greater health care utilization, and symptom burden.

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发文量
9
审稿时长
16 weeks
期刊最新文献
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