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【medical-news】新研究：近半癌症患者未得到充分
"Pain is a major health care problem for patients with cancer: despite the existence of guidelines for cancer pain management, undertreatment is a widespread problem," write Dr. S. Deandrea, from the Mario Negri Institute for Pharmacological Research in Milano, Italy, and colleagues. "Pain Management Indexes (PMIs) evaluate the congruence between the patient's reported level of pain and the intensity/strength of the analgesic therapy. Negative scores indicate inadequate prescriptions."
Using a MEDLINE search for "pain management," "index," or "measure," the reviewers identified studies that measured undertreatment of pain in patients with cancer. Independent predictors of undertreatment were determined with univariate and multivariate logistic regression.
Of 44 studies selected, 26 used the PMI proposed by Cleeland, with a weighted mean value of 43% and a range of negative PMIs from 8% to 82%. Multivariate analyses revealed that publications dated before 2001, studies performed in Europe or Asia and in countries with a gross national income per capita of less than $40,000 per year, and care setting not specific for cancer were associated with negative PMIs. In this review, age was not a significant predictor for undertreatment of pain.
"Nearly one of two patients with cancer pain is undertreated," the reviewers write. "The percentage is high, but consists of a large variability of undertreatment across studies and settings."
Limitations of this review include failure to account for other aspects of cancer pain management, such as compliance, dosage, route of administration, and use of other nonpharmacologic therapies; shortcomings related to the PMI; inability to exclude the existence of additional studies which used PMI that were not published or not retrievable through MEDLINE; low sensitivity of identifying variables predictive of better pain management; and possible confounding variables.
"PMI may be useful in evaluating the quality of the analgesic care in large sample cases," the study authors conclude. "These results are important for implementing policies to reduce inappropriate high pain prevalence and to address barriers to pain control in the neglected context."
Grunenthal-Italy supported this study.
Ann Oncol. Published online July 15, 2008. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 1. July 25, 2008 — Pain is undertreated in nearly half of all patients with cancer, according to the results of a large review reported in the July 15 Advance Access issue of the Annals of Oncology. Important determinants of pain in this study included geographic region, countries with lower economic level, and setting not specific for cancer care and management.
本期的Annals of oncology 中，一项大规模的综述表明，有近一半的癌症患者的疼痛未得
到很好的控制。这项研究认为，造成癌痛处理不尽如人意的原因包括：地域、经济欠发达国家、以及非专业化的肿瘤治疗护理环境。
2. "Pain is a major health care problem for patients with cancer: despite the existence of guidelines for cancer pain management, undertreatment is a widespread problem," write Dr. S. Deandrea, from the Mario Negri Institute for Pharmacological Research in Milano, Italy, and colleagues. "Pain Management Indexes (PMIs) evaluate the congruence between the patient's reported level of pain and the intensity/strength of the analgesic therapy. Negative scores indicate inadequate prescriptions."
意大利米兰的Mario Negri药理学研究所的Dr. S. Deandrea及其同事在这篇综述中指出：“疼痛是肿瘤患者治疗中的一个主要问题，尽管针对止痛治疗已经有了相应的指南，止痛治疗的不充分，依旧是一个广泛存在的问题。” 这篇综述还提到了疼痛治疗因子（PMIs）：“PMIs是用来衡量止痛治疗的强度和病人对疼痛的感受之间是否一致的一个变量。负性评分则提示止痛剂的剂量不够。”
3.Using a MEDLINE search for "pain management," "index," or "measure," the reviewers identified studies that measured undertreatment of pain in patients with cancer. Independent predictors of undertreatment were determined with univariate and multivariate logistic regression.
这篇综述的作者通过在MEDLINE上用"pain management," "index," or "measure,"为关键词搜索，找出研究评价癌性疼痛治疗补充分性的文章。对于治疗非充分性的判断，这些文章采用的是单因素或者多因素分析。
4.Of 44 studies selected, 26 used the PMI proposed by Cleeland, with a weighted mean value of 43% and a range of negative PMIs from 8% to 82%. Multivariate analyses revealed that publications dated before 2001, studies performed in Europe or Asia and in countries with a gross national income per capita of less than $40,000 per year, and care setting not specific for cancer were associated with negative PMIs. In this review, age was not a significant predictor for undertreatment of pain.
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作者:admin@医学,生命科学 2011-06-10 17:14
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