药理学管理慢性疼痛结果测量的系统评价:为医疗保健提供者主导的药物治疗服务提供一个新的结果框架

IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES
Abdulrahman Sharaf, Emma Dunlop, Natalie Weir, Rosemary Newham, Sumaya Alsalah, Marion Bennie
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引用次数: 0

摘要

背景与目的慢性疼痛是一种全球性的负担,在治疗评估中需要精确的结果测量。本系统综述旨在确定在慢性疼痛初级保健药物治疗服务中应用的结果测量和工具。从2013年到2023年7月,系统检索MEDLINE、Embase和CINAHL数据库以及已发表文章的参考文献列表。这项研究包括观察性研究,采用世界卫生组织疼痛阶梯和苏格兰校际指导网络指南推荐的药物干预措施。这些研究的目标是在门诊治疗的慢性疼痛患者,并检查了五个预先确定的结果:与健康相关的生活质量(HRQoL)、成本效益、药物优化、不良事件和患者体验。纳入研究的质量采用纽卡斯尔-渥太华量表(NOS)进行评估。结果在纳入的23项研究中,共有51种结果测量工具被用于评估5种预定义结果,涉及44,472例慢性疼痛患者。15项为队列研究,8项为横断面调查或问卷调查。大多数研究只关注一到两个结果(n = 19;82.6%)。在所有23项研究(100%)中,HRQoL成为主要研究结果,主要通过简短疼痛量表(BPI)工具进行评估(n = 9;39.1%)。相反,研究最少的结果是药物优化和成本效益。干预后的测量时间和随访时间在研究中显示出显著的差异。本综述指出了在对药物治疗服务进行更全面评估方面存在的差距,并强调了在临床实践中通过标准化工具加强一致性的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Systematic Review of Outcome Measures in Pharmacologically Managed Chronic Pain: Informing a New Outcome Framework for Healthcare Provider-Led Pharmacotherapy Services

Systematic Review of Outcome Measures in Pharmacologically Managed Chronic Pain: Informing a New Outcome Framework for Healthcare Provider-Led Pharmacotherapy Services

Background and Objective

Chronic pain represents a global burden, highlighting the necessity for accurate outcome measures in treatment evaluation. This systematic review aims to identify what outcome measures and tools are applied in chronic pain primary care-based pharmacotherapy services.

Databases and Data Treatment

The MEDLINE, Embase, and CINAHL databases, along with the reference lists of published articles, were systematically searched from 2013 to July 2023. This search included observational studies that employed pharmacological interventions recommended by the World Health Organisation pain ladder and the Scottish Intercollegiate Guidelines Network guidelines. The studies targeted chronic pain patients treated in outpatient settings and examined five predefined outcomes: health-related quality of life (HRQoL), cost-effectiveness, medication optimisation, adverse events, and patient experience. The quality of included studies was assessed using the Newcastle-Ottawa Scale (NOS).

Results

Among the 23 studies included a total of 51 outcome measurement tools were employed to assess the five predefined outcomes, involving 44,472 patients with chronic pain. Fifteen were cohort studies, while 8 were cross-sectional surveys or questionnaire-based. Most studies focused on one to two outcomes only (n = 19; 82.6%). HRQoL emerged as the primary outcome studied across all 23 studies (100%), predominantly assessed through the Brief Pain Inventory (BPI) tool (n = 9; 39.1%). Conversely, the least studied outcomes were medication optimisation and cost-effectiveness. The timing of measurement post-intervention and follow-up durations displayed significant variability across the studies.

Conclusions

This review identifies gaps in enabling a more holistic assessment of pharmacotherapy services and underscores the need for enhanced consistency via standardised tools in clinical practice.

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来源期刊
CiteScore
4.80
自引率
4.20%
发文量
143
审稿时长
3-8 weeks
期刊介绍: The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.
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