Estudio del nivel de acuerdo de los socios de SEMDOR sobre las recomendaciones de uso de fármacos opioides para el tratamiento del dolor crónico no oncológico

  1. Esperanza Regueras 1
  2. Luis Miguel Torres 2
  3. Ignacio Velázquez 3
  1. 1 Universidad de Navarra
    info

    Universidad de Navarra

    Pamplona, España

    ROR https://ror.org/02rxc7m23

  2. 2 Hospital Universitario Puerta de Mar, Cádiz
  3. 3 Hospital de Guadix
Show affiliations +
Journal:
MPJ Multidisciplinary Pain Journal

ISSN: 2697-2263

Year of publication: 2023

Issue: 1

Type: Article

DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: MPJ Multidisciplinary Pain Journal

Abstract

Introduction: Opioid analgesics are essential and irreplaceable drugs in the treatment and control of moderate to severe pain. As a result of the epidemic situation experienced in the United States, it is essential to offer health professionals and partners the recommendation guidelines, recently published by SEMDOR, on how to make good medical use of opioid drugs to treat chronic non-oncological pain (persistent or recurrent). Objectives: To know the level of agreement of SEMDOR members with these recommendations. Methodology: We designed a survey based on 12 closed and open questions in which the following aspects were assessed: relevance of opioid drugs in clinical practice, level in accordance with the recommendations and positions of the SEMDOR guidelines, identification of barriers to the prescription of these drugs in Spain, topics that must be reinforced or updated in the training on these drugs, number of patients treated and percentage with tolerance, dependence or addiction and activities that should be developed in SEMDOR during the next 2 years in relation to opioids. The questionnaire was distributed by digital means to all 601 SEMDOR partners and the answers were collected on an online platform. Results: The sample used in the data analysis was 90 valid participants, representing 14.9 % of the universe equivalent to a 9.5 % margin of error to 95 % confidence. This study shows that opioids are very relevant drugs in the management of moderate-severe pain, with an average relevance score of 8.4 out of 10. 74 % of the professionals considered that the relevance was equal to or greater than 7 out of 10 and a greater relevance was observed in the primary care group (GP) with a relevance of 9.4 out of 10, this score being significantly higher than that of the anesthesiologists (8.2). Regarding the general statements and recommendations, the highest level of agreement (100 %) was reached regarding the duty to use opioid drugs as part of a multimodal strategy. A high level of total or partial agreement was also reached that opioids are highly effective and safe drugs (99 %), that health professionals must be well trained in their management (97 %), that these drugs must be accessible to all patients who require it when the doctor deems it necessary (94 %) and that they are indispensable in the treatment of intense pain (93 %). Conclusions: This study shows that opioids are very relevant drugs in the management of moderate-severe pain, with an average relevance score of 8.4 out of 10. A large majority of participants believe that opioids should be used as part of a multimodal strategy, that they are effective and safe drugs, that the doctors who use them must be trained, that this medicines must be accessible to patients in whom the doctor considers them necessary and that they are indispensable for the treatment of severe pain.

Bibliographic References

  • Regueras E, Torres LM, Velazquez I. Spanish Multidisciplinary Society of Pain (SEMDOR) clinical practice recommendations for the good medical use of prescription opioids in the treatment of chronic non-oncology pain. MPJ. 2022;2:27-51. DOI: 10.20986/mpj.2022.1024/2022.
  • O’Brien T, Christrup LL, Drewes AM, Fallon MT, Kress HG, McQuay HJ, et al. Position paper on appropriate opioid use in chronic pain management. Eur J Pain. 2017;21(1):3-19. DOI: 10.1002/ejp.970.
  • Regueras E, López-Guzmán J. Prescripciones de opioides en España entre 2019 y 2020: qué especialidades médicas lo están prescribiendo y en qué indicaciones. MPJ. 2021;1:5-12.
  • Definitions Related to the Use of Opioids for the Treatment of Pain: Consensus Statement of The American Academy of Pain Medicine, the American Pain Society, and the American Society of Addiction Medicine. 2001 American Academy of Pain Medicine, American Pain Society and American Society of Addiction Medicine.
  • Regueras E, López-Guzmán J. ¿Qué podemos aprender de los errores en el abordaje de la crisis opioides en Estados Unidos?. Rev OFIL·ILAPHAR. 2022;32(2):197-202. DOI: 10.4321/S1699-714X20220002000013.
  • Briggs EV, Battelli D, Gordon D, Kopf A, Ribeiro S, Puig MM, et al. Current pain education within undergraduate medical studies across Europe: Advancing the Provision of Pain Education and Learning (APPEAL) study. BMJ Open. 2015 Aug 10;5(8):e006984. DOI: 10.1136/bmjopen-2014-006984.
  • Jara C, Del Barco S, Grávalos C, Hoyos S, Hernández B, Muñoz M, et al. SEOM clinical guideline for treatment of cancer pain (2017). Clin Transl Oncol. 2018;20(1):97-107.
  • Grupo de trabajo de Opioides. Sociedad Española de Dolor. Decálogo en el manejo de opioides [Internet]. Sociedad Española del Dolor; 12 de marzo de 2018 [Accedido el 10 de abril 2021]. Disponible en https://www.sedolor.es/download/decalogo-correcto-manejo-opioides/
  • Grupo de trabajo de Opioides. Sociedad Española de Dolor. Conclusiones de la jornada del Grupo de Opioides [Internet]. Sociedad Española del Dolor; 10 de marzo de 2018 [Accedido de 10 abril de 2021]. Disponible en: https://www.sedolor.es/download/conclusiones-la-jornada-del-grupo-opioides-madrid-10-marzo-2018/
  • Álvarez Mazariegos JA, Calvete Waldomar S, Fernández-Marcote Sánchez-Mayoral RM, Guardia Serecigni J, Henche Ruiz AI, et al. Guía consenso sobre el buen uso de analgésicos opioides. Gestión de riesgos y beneficios. Valencia: SEMFyC, FAECAP, SECPAL; junio de 2017 Disponible en: https://pnsd.sanidad.gob.es/profesionales/publicaciones/catalogo/bibliotecaDigital/publicaciones/pdf/2017_GUIA_Buen_uso_opioides_Socidrigalcohol.pdf
  • Prácticas seguras para el uso de opioides en pacientes con dolor crónico. Informe 2015. Documento de consenso sobre prácticas para el manejo seguro de opioides en pacientes con dolor crónico. Madrid: Ministerio de Sanidad, Servicios Sociales e Igualdad; 2015. Disponible en: https://www.mscbs.gob.es/gl/biblioPublic/publicaciones.do?metodo=detallePublicacion&publicacion=16593
  • Guidelines for the Use of Controlled Substances in the Treatment of Pain [Internet]. New Hampshire Medical Society; 1998. Disponible en: https://www.nhms.org/sites/default/files/Pdfs/NH%20Pain%20Management%20Guidelines.pdf
  • The Joint Commission. Facts About Joint Commission Accreditation Stan- dards for Healthcare Organizations: Pain Assessment and Management [Internet]. 2018; Disponible en: https://www.jointcommission.org/facts_about_joint_commis- sion_accreditation_standards_for_health_care_organizations_pain_assess- ment_and_management/
  • Jones MR, Viswanath O, Peck J, AD Kaye, Gill JS, Simopoulos TT. A brief his- tory of the opioid epidemic and strategies for pain medicine. Pain Ther. 2018;7(1):13-21. DOI: 10.1007/s40122-018-0097-6.
  • Phillips DM. Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Pain Management Standards Are Unveiled. JAMA. 2000;284(4):428-9. DOI: 10.1001/jama.284.4.423b.
  • Abuse-Deterrent Opioid Analgesics [Internet]. Food and Drug Administration; 2019. Disponible en: https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/abuse-deterrent-opioid-analgesics
  • National Drug Control Strategy [Internet]. 2011; Disponible en: https://obamawhitehouse.archives.gov/sites/default/files/ondcp/ndcs2011.pdf
  • Comprehensive addiction and recovery act of 2016 [Internet]. America CUSo. con- gress.gov. 2019; Disponible en: https://www.congress.gov/bill/114th-congress/senate-bill/524
Data source: Dialnet