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介绍慢性非癌症疼痛(chronic non-cancer pain,CNCP)病人常见,呈高发病率。既往研究表明,临床医生对CNCP管理不利,存在着差异。本研究中,我们收集了临床医生关于影响CNCP管理因素的观点。方法我们对多民族网络初级保健,低收入、医疗资源不足、社区和私人初级保健诊所的开业医生研究网络进行了调查。结果 792名中有497名临床医生(63%)参加了研究。针对5个题目做出反应并做了详细的解释:(1)理想管理的障碍和不确定性;(2)CNCP复杂的生物-心理-社会特性;(3)处方阿片类药物滥用严重;(4)影响及负担需要恰当的CNCP管理;(5)临床医生承诺为CNCP提供医疗服务,扩展CNCP服务模式益处。曾用处方阿片类药物的CNCP病人,有1/3报告了严重结果(死亡或威胁生命的事件)。约1/3未开过阿片类药物处方。结论仅用指南和加强继续医学教育不太可能解决CNCP存在的管理问题。就加强综合保健管理而言,为建议及资源的需求增添了证据。
Introduction Chronic non-cancer pain (CNCP) is common in patients with high morbidity. Previous studies have shown that clinicians are not good at CNCP management and there are differences. In this study, we collected the views of clinicians on the factors that influence CNCP management. Methods We conducted an investigation into the network of medical practitioners in multi-ethnic networks for primary health care, low-income, under-resourced and community and private primary health clinics. Results A total of 497 clinicians out of 792 (63%) participated in the study. Responding to five questions and explaining in detail: (1) obstacles and uncertainties in ideal management; (2) complex CNCP biological-psychosocial characteristics; (3) serious abuse of prescribed opiates; (( 4) The impact and burden need proper CNCP management; (5) The clinician promises to provide medical services to CNCP to extend the benefits of the CNCP service model. One third of CNCP patients who used prescription opioids reported serious outcomes (death or life-threatening events). About one-third have not prescribed opioids. Conclusions It is unlikely that guidance alone and enhanced CME will solve the management problems of CNCP. In terms of strengthening integrated health management, evidence is added to the need for advice and resources.