BACKGROUND Accommodating a patient's treatment preference has been reported to promote greater responsiveness and better clinical outcomes. The effect of administration route preference (ARP) on the individual analgesic response has not been extensively examined to date. This study aimed to investigate whether ARP-matched treatment, i.e., individualized intramuscular (IM) or oral (PO) analgesic administration according to patient choice, would increase the analgesic effect. METHODS In this prospective randomized study, we collected 38 patients with acute low back pain (aLBP) presenting at the emergency room of the Galilee Medical Center (Naharia, Israel) and asked them to report their ARP for analgesics. Regardless of their reported preference, they received either PO or IM diclofenac according to the treating physician's preference. Pain intensity was self-reported using the numeric pain score (NPS) before and during the first hour after drug administration. RESULTS Both groups receiving PO or IM administration reported similar initial pain on admission, (NPS 8.63 ± 1.5 and 8.74 ± 1.6, respectively) and the same magnitude of pain reduction. However, patients who received the drug in their desired route (oral or injection) had a significantly greater reduction in pain levels (4.05 ± 2.8) as compared with patients who received the undesired route (2.08 ± 1.8), p < 0.05. CONCLUSIONS These findings support the hypothesis that individualized ARP-matched treatment in aLBP improves therapeutic outcomes, although further studies with larger cohorts are needed.

中文翻译：

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将实际治疗与患者给药途径偏好相匹配可改善急性下腰痛患者的镇痛反应-一项随机前瞻性试验。

背景技术已经报道了适应患者的治疗偏好以促进更大的反应性和更好的临床结果。迄今为止，尚未广泛研究给药途径偏好（ARP）对个体镇痛反应的影响。这项研究旨在调查ARP匹配治疗（即根据患者选择进行个性化肌内（IM）或口服（PO）镇痛）给药是否会提高镇痛效果。方法在这项前瞻性随机研究中，我们收集了加利利医学中心（以色列纳哈里亚）急诊室中出现的38例急性下背痛（aLBP）患者，并要求他们报告其ARP镇痛药。不管他们报告的偏好如何，他们都根据治疗医师的偏好接受了PO或IM双氯芬酸。在给药后第一小时和给药后第一小时，使用数字疼痛评分（NPS）自我报告疼痛强度。结果两组均接受PO或IM的患者在入院时报告了相似的初始疼痛（分别为NPS 8.63±1.5和8.74±1.6），并且疼痛减轻程度相同。然而，与接受不希望的途径（2.08±1.8）的患者相比，以所需途径（口服或注射）接受药物的患者的疼痛水平明显降低（4.05±2.8），p <0.05。结论这些发现支持aLBP个性化ARP匹配治疗可改善治疗效果的假说，尽管还需要对更大人群进行进一步研究。