INTEGRATIVE PAIN MANAGEMENT APPROACHES WITH PARTICULAR REFERENCE TO PHARMACOLOGICAL TREATMENT MODALITIES

Smjernice za liječenje boli sve učestalije predlažu uporabu nefarmakoloških i integrativnih terapija u liječenju boli, uz standardne farmakološke modalitete liječenja. Suvremeno liječenje boli temelji se na individualiziranom, sveobuhvatnom pristupu, temeljenom na terapijama temeljenim na dokazima. Tipovi i intenzitet terapija moraju se odrediti na temelju pacijentove kliničke slike, komorbiditeta, preferencija i socioekonomskih čimbenika. Svi terapijski pristupi koji se uključuju u sveobuhvatni plan skrbi o pacijentima, nužno je da uključuju primjerenu interprofesionalnu komunikaciju i koordinaciju, kao i redovnu procjenu napretka te kontinuirano dijeljeno donošenje odluka kako bi se optimizirali ishodi za pacijente. Cilj ovoga rada jest pružiti pregled najčešće korištenih farmakoloških i integrativnih pristupa u liječenju boli, s opisom patofizioloških podloga različitih tipova boli i pristupa pacijentu koji osjeća bol.Guidelines for the treatment of pain more frequently recommend the use of non-pharmacological and integrative pain management approaches alongside standard pharmacological modalities of treatment. Contemporary pain treatment is based on an individualized, all-encompassing approach, based on evidence-based medicine. The therapy needs to be based on the patient’s clinical presentation, comorbidities, preferences, and socioeconomic factors. All therapeutic approaches which are included into the comprehensive treatment plan of patients need to include appropriate interprofessional communication and coordination, as well as frequent assessment of progress and continuous shared decision making, in order to optimize the outcomes for the patient. The aim of this paper is to provide insight into the most used pharmacological and integrative pain management approaches, with an overview of the pathophysiological basis of different types of pain and of the approach to the patient who is feeling pain