Physicians Experience with and Expectations of the Safety and Tolerability of WHO-Step III Opioids for Chronic (Low) Back Pain: Post Hoc Analysis of Data from a German Cross-Sectional Physician Survey

Q2 Medicine
M. Ueberall, Alice Eberhardt, G. Mueller-Schwefe
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引用次数: 2

Abstract

Objective. To describe physicians' daily life experience with WHO-step III opioids in the treatment of chronic (low) back pain (CLBP). Methods. Post hoc analysis of data from a cross-sectional online survey with 4.283 Germany physicians. Results. With a reported median use in 17% of affected patients, WHO-step III opioids play a minor role in treatment of CLBP in daily practice associated with a broad spectrum of positive and negative effects. If prescribed, potent opioids were reported to show clinically relevant effects (such as ≥50% pain relief) in approximately 3 of 4 patients (median 72%). Analgesic effects reported are frequently related with adverse events (AEs). Only 20% of patients were reported to remain free of any AE. Most frequently reported AE was constipation (50%), also graded highest for AE-related daily life restrictions (median 46%). Specific AE countermeasures were reported to be necessary in approximately half of patients (median 45%); nevertheless AE-related premature discontinuation rates reported were high (median 22%). Fentanyl/morphine were the most/least prevalently prescribed potent opioids mentioned (median 20 versus 8%). Conclusion. Overall, use of WHO-step III opioids for CLBP is low. AEs, especially constipation, are commonly reported and interfere significantly with analgesic effects in daily practice. Nevertheless, beneficial effects outweigh related AEs in most patients with CLBP.
医生对慢性(下)背痛使用世卫组织第三步阿片类药物的经验和安全性和耐受性的期望:德国横断面医生调查数据的事后分析
目标。描述医生使用世卫组织三级阿片类药物治疗慢性(下)背痛(CLBP)的日常生活经验。方法。对4283名德国医生的横断面在线调查数据进行事后分析。结果。据报道,17%的受影响患者中位数使用世卫组织三级阿片类药物,在日常实践中,与广泛的积极和消极影响相关的CLBP治疗中起次要作用。据报道,如果处方,强效阿片类药物在大约3 / 4的患者(中位72%)中显示出临床相关效果(例如≥50%的疼痛缓解)。报道的镇痛作用通常与不良事件(ae)有关。据报道,只有20%的患者没有任何AE。最常见的AE是便秘(50%),AE相关的日常生活限制也评分最高(中位数为46%)。据报道,大约一半的患者有必要采取特定的AE对策(中位数为45%);然而,报告的ae相关过早停药率很高(中位数为22%)。芬太尼/吗啡是提到的最常用/最不常用的强效阿片类药物(中位数为20%对8%)。结论。总体而言,世卫组织第三步阿片类药物治疗CLBP的使用率较低。不良反应,特别是便秘,经常被报道,并在日常实践中显著干扰止痛效果。然而,在大多数CLBP患者中,有益影响大于相关不良反应。
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来源期刊
Pain Research and Treatment
Pain Research and Treatment Medicine-Anesthesiology and Pain Medicine
CiteScore
3.60
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0.00%
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