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目的:测量慢性疼痛病人卷在初级护理实践;来确定药物医师选择治疗中度到重度的慢性疼痛;识别障碍使用阿片类药物治疗慢性疼痛;并评估医生的态度在加拿大当前管理的慢性疼痛。设计:计算机辅助电话调查的100区域代表加拿大医生定义兴趣姑息治疗(PC, n = 30)或疼痛(GP, n = 70)。背景:2001年6月益普索调查机构的调查。只有医生遇到的合格标准写20或更多处方中度到重度的疼痛前4周或姑息治疗,只要投入20%的都有资格参加。结果:在一个月里,平均数量的中度至重度慢性疼痛患者被电脑是94.2;平均被GPs是44.7。痛苦的经历,83.3%的医生病人癌相关。慢性癌症疼痛的阿片类镇痛药是治疗的选择79%的医生(48%首选吗啡,可待因21%,10%)。中度到重度的慢性疼痛,阿片类药物的一线治疗,只有32%的医生(16%首选可待因,16%主要阿片类药物),因为大量首选nonsteriodal消炎药(29%)或对乙酰氨基酚(16%)。 Thirty-five per cent of GPs and 23% of PCs would never use opioids for noncancer pain, even when described as severe. Chronic pain was deemed by 68% of physicians to be inadequately managed. Almost 60% thought that pain management could be enhanced by improved physician education. Identified barriers to opioid use included addiction potential (37%) and side effects (25%). Seventeen per cent of GPs and 10% of PCs thought that regulatory sanctions limited opioid prescribing.CONCLUSIONS: Even among physicians experienced in chronic pain treatment, there is a reluctance to use opioids for severe nonmalignant pain. One-half of the survey participants believed that there was a need for improved physician education in pain management, including the use of opioids.