Academic literature on the topic 'Pain management medication interventions'
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Journal articles on the topic "Pain management medication interventions"
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Shade, Marcia, Kyle Rector, and Kevin Kupzyk. "VERIFICATION OF PAIN MEDICATION ADHERENCE IN OLDER ADULTS USING INTERACTIVE VOICE REMINDERS." Innovation in Aging 3, Supplement_1 (November 2019): S926. http://dx.doi.org/10.1093/geroni/igz038.3371.
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Abstract Adherence to analgesics needs to be monitored to ensure optimal pain management and avert adverse events among older adults. mHealth reminders may encourage adherence behavior, but it is unclear if medication use ensues following the reminder. The purpose of this study was to trial the use of medication event monitoring to verify the initiation of scheduled pain medication after an mHealth reminder. Methods: N=15 adults 55 and older created Google Assistant reminders to take their scheduled pain medication and write in a pain diary. A sub sample of n= 5 participants used a Medication Event Monitoring System Cap with their scheduled pain medications over 4 weeks. Data were collected on demographics, pain severity, and medication adherence. Descriptive statistics were performed. Results: Five women with ages ranging from 56-80 years, reported pain in multiple body locations. Pain severity on average was rated at 4 and at its worst 7; with pain relief ranging from 50-90%. Adherence percentages ranged from 82% to 100%. The overall latency was M = 55 min, SD = 100 min. The average latencies varied among the 5 participants; the shortest average time was 17 minutes and the longest average time was 4.5 hours. Only 15% of pain medications were taken within 5 minutes and 64% within 30 minutes of the interactive voice assistant reminder. Conclusions: It is important to ensure a behavioral intervention promotes the desired outcome. Medication event monitoring systems may help to identify non adherent behaviors when using mHealth interventions to promote pain medication adherence.
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Taylor, Robert, Salma Lemtouni, Karen Weiss, and Joseph V. Pergolizzi. "Pain Management in the Elderly: An FDA Safe Use Initiative Expert Panel’s View on Preventable Harm Associated with NSAID Therapy." Current Gerontology and Geriatrics Research 2012 (2012): 1–9. http://dx.doi.org/10.1155/2012/196159.
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Optimization of current pain management strategies is necessary in order to reduce medication risks. Promoting patient and healthcare provider education on pain and pain medications is an essential step in reducing inadequate prescribing behaviors and adverse events. In an effort to raise awareness on medication safety, the FDA has launched the Safe Use Initiative program. The program seeks to identify areas with the greatest amount of preventable harm and help promote new methods and practices to reduce medication risks. Since the establishment of the program, FDA’s Safe Use initiative staff convened a panel of key opinion leaders throughout the medical community to address pain management in older adults (≥65 years of age). The aim of the expert panel was to focus on areas where significant risk occurs and where potential interventions will be feasible, implementable, and lead to substantial impact. The panel suggested one focus could be the use of NSAIDs for pain management in the elderly.
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Chunduri, Aparna, and Amit Kumar Aggarwal. "Multimodal Pain Management in Orthopedic Surgery." Journal of Clinical Medicine 11, no. 21 (October 28, 2022): 6386. http://dx.doi.org/10.3390/jcm11216386.
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Background: Orthopedic surgery typically results in moderate to severe pain in a majority of patients. Opioids were traditionally the primary medication to target mechanisms of pain transmission. Multimodal analgesia has become a preferred method of pain management in orthopedic practice. Utilizing more than one mode to address post-surgical pain by recruiting multiple receptors through different medications accelerates the recovery process and decreases the need for opioids. By implementing effective analgesic techniques and interventions, this practice, in turn, decreases the usage of perioperative opioids, and in the long term, prevents addiction to pain medications and risk of opioid overdose. In orthopedic surgeries, previous studies have found that multimodal analgesia has reduced early opioid usage in the postoperative course. Pain is the result of direct injury to the nervous system, with a wide variety of chemicals directly stimulating or sensitizing the peripheral nociceptors. The pathophysiology behind the mechanism of post-surgical pain, along with the importance of preoperative, perioperative, and postoperative pain regimens are emphasized. A brief overview of pain medications and their properties is provided. These medications are further categorized, with information on special considerations and typical dosage requirements. Pain management should address both neuropathic and subjective types of pain. Effective pain control requires constant reassessment with individualized strategies. Conclusion: By focusing on multimodal analgesia, anesthesiologists can now utilize newer techniques for postoperative pain relief from orthopedic surgery, with better short-term and long-term outcomes for the patient.
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Knopp-Sihota, Jennifer, Megan Nuspl, Tara MacGregor, Jennifer Reeves, and Ahsan Saleem. "HEALTHCARE AIDE-FOCUSED INTERVENTIONS TO IMPROVE PAIN MANAGEMENT IN LONG-TERM CARE." Innovation in Aging 6, Supplement_1 (November 1, 2022): 535. http://dx.doi.org/10.1093/geroni/igac059.2035.
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Abstract Pain is endemic for residents of long-term care homes, with many residents experiencing pain daily. Given that healthcare aides provide most daily care for residents, they are ideally situated to deliver timely assessment and non-drug interventions for managing resident pain. In this Cochrane-style systematic review, we searched 7 databases to identify intervention studies that included long-term care residents aged ≥60 years who received interventions to reduce chronic pain. Interventions were either delivered by healthcare aides at the resident level or were directed at healthcare aides to improve their pain management practices. We screened 400 titles/abstracts and 152 full-text articles. Nine studies met inclusion criteria and were included in a narrative review. Due to the limited number of studies and variety of study designs, data were insufficient to perform meta-analyses or thematic analysis. Three studies described pain interventions delivered by healthcare aides at the resident level reporting significant improvement of pain. Six studies described pain interventions delivered to healthcare aides. Results of these interventions were inconsistent; 2 reported significant improvements in pain-related outcomes (e.g., resident pain, monitoring of pain), 3 reported insignificant changes, and 1 reported a positive correlation between measured pain and pain medication use. We concluded that despite the paucity of research in this area, this systematic review provides preliminary support for pain interventions by healthcare aides for long-term care residents. Future research exploring interventions for healthcare aides to take greater roles in pain management could unlock further improvements in resident care.
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Ros-Cucurull, E., M. Perea, D. Romero, R. F. Palma-Álvarez, P. Pozo-Rosich, M. Torres-Ferrús, L. Grau-López, et al. "Psychological approach in headache patients with pain medication misuse in an outpatient center for drug treatment in Barcelona." European Psychiatry 41, S1 (April 2017): s876. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1766.
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IntroductionPain medication misuse is commonly found in patients under headache treatment and may produce co-morbid anxiety and depressive symptomatology. Management of this issue requires a comprehensive and integrative treatment including psychotherapy. Group interventions have been scarcely studied in addictive disorders, those interventions aims to decrease drug misuse and improve related psychiatric symptoms.AimTo study the efficacy of group interventions base on cognitive-behavior approach in patients with pain medication misuse.MethodPatients with pain medication misuse were included and were evaluated with BDI, STAI, SF36 and HIT scales (basal and at the end of treatment sessions). Patients were recruited from headache outpatient unit. Twelve sessions of one hour were performed with a cognitive-behavior approach (weekly).ResultsWe present preliminary results about the efficacy of group interventions in patients with pain medication misuse. Descriptive results pre- and post- treatment were analyzed in depressive symptoms (M = 20.14, SD = 12.25; M = 14.67, SD = 19.50) and in areas of quality of life: physical functioning (M = 48.75, SD = 31.13; M = 60.50, SD = 41.68), bodily pain (M = 12, SD = 9.25; M = 42.75, SD = 34.09), general health perceptions (M = 25.75, SD = 16.96; M = 44.25, SD = 22.33), vitality (M = 33.75, SD = 13.82; M = 48, SD = 34.82).ConclusionsPain medication misuse is commonly found in chronic headache patients, consequently worst outcomes for both pathologies. Group interventions may be useful in management of pain, anxiety and other comorbidities. Furthermore, it may favor drug use decrease and even abstinence.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Freedman, Mitchell K., Michael F. Saulino, E. Anthony Overton, Michele Y. Holding, and Ira D. Kornbluth. "Interventions in Chronic Pain Management. 5. Approaches to Medication and Lifestyle in Chronic Pain Syndromes." Archives of Physical Medicine and Rehabilitation 89, no. 3 (March 2008): S56—S60. http://dx.doi.org/10.1016/j.apmr.2007.12.002.
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Mezey, Gyöngyi Anna, Zsuzsanna Máté, and Edit Paulik. "Factors Influencing Pain Management of Patients with Osteoarthritis: A Cross-Sectional Study." Journal of Clinical Medicine 11, no. 5 (March 1, 2022): 1352. http://dx.doi.org/10.3390/jcm11051352.
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Background: Osteoarthritis (OA) is a complex disease associated with chronic pain. Many patients treat their joint pain at a symptomatic level with over-the-counter (OTC) pain medications, often without the knowledge of their physicians. The aim of this study was to provide physicians with data about osteoarthritic patients’ habits of pain management and to examine the explanatory factors of various ways of self-treatment. Methods: A cross-sectional study involving 189 patients with hip or knee OA and scheduled for joint replacement surgery was carried out. Participants filled out a self-administered questionnaire consisting of the Western Ontario and McMaster Universities Osteoarthritis Index and questions about their methods of alleviating pain. Results: 2.6% of patients did not use anything to alleviate their pain, while 63% practiced a non-pharmacological method. Diclofenac was the most frequently used drug, followed by ibuprofen. Profession had the greatest impact on medication habits; patients doing manual work were significantly more likely to take OTC non-steroidal anti-inflammatory drugs and use topical analgesics. Conclusions: Patients utilized a wide variety of pain management techniques. They seemed to use well-known painkillers, even if their side effects were less desirable. Such patients require comprehensive pain management, including educational and behavioural interventions, complemented by topical and oral medication.
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Ma, Joseph D., Victor Tran, Carissa Chan, William M. Mitchell, and Rabia S. Atayee. "Retrospective analysis of pharmacist interventions in an ambulatory palliative care practice." Journal of Oncology Pharmacy Practice 22, no. 6 (July 9, 2016): 757–65. http://dx.doi.org/10.1177/1078155215607089.
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Background We have previously reported the development of an outpatient palliative care practice under pharmacist–physician collaboration. The Doris A. Howell Service at the University of California, San Diego Moores Cancer Center includes two pharmacists who participate in a transdisciplinary clinic and provide follow-up care to patients. Objective This study evaluated pharmacist interventions and patient outcomes of a pharmacist-led outpatient palliative care practice. Methods This was a retrospective data analysis conducted at a single, academic, comprehensive cancer center. New (first visit) patient consultations were referred by an oncologist or hematologist to an outpatient palliative care practice. A pharmacist evaluated the patient at the first visit and at follow-up (second, third, and fourth visits). Medication problems identified, medication changes made, and changes in pain scores were assessed. Results Eighty-four new and 135 follow-up patient visits with the pharmacist occurred from March 2011 to March 2012. All new patients ( n = 80) were mostly women ( n = 44), had localized disease ( n = 42), a gastrointestinal cancer type ( n = 21), and were on a long-acting ( n = 61) and short-acting ( n = 70) opioid. A lack of medication efficacy was the most common problem for symptoms of pain, constipation, and nausea/vomiting that was identified by the pharmacist at all visits. A change in pain medication dose and initiation of a new medication for constipation and nausea/vomiting were the most common interventions by the pharmacist. A statistically significant change in pain score was observed for the third visit, but not for the second and fourth visits. Conclusions A pharmacist-led outpatient palliative care practice identified medication problems for management of pain, constipation, and nausea/vomiting. Medication changes involved a change in dose and/or initiating a new medication. Trends were observed in improvement and stabilization of pain over subsequent clinic visits.
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Barseghyan, A. B., L. G. Nazaryan, and Simonyan. "Evaluation of pharmacist interventions as part of a multidisciplinary pain management team." NEW ARMENIAN MEDICAL JOURNAL, no. 3 (2022): 100–106. http://dx.doi.org/10.56936/18290825-2022.16.3-100.
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Pharmacists have an important role within the healthcare system. They can offer some services to the patients including consultation, patient education and therapeutic management. Community pharmacists can assess the type and severity of pain, monitor treatment and guide medication regulation to improve the treatment of the pain. The involvement of pharmacists in nonprescription medication counseling about pain will increase the public’s ability to understand the risks and benefits of over-the-counter drugs. Aim and objects was to study and analyze professional abilities and role of pharmacy employees during the pain management. The survey was conducted among 285 employees of licensed pharmacies in Armenia with the help of questionnaires, the number of which was determined according to “The Survey System Version 11.0”. Survey data were entered and analyzed using SPSS software package. The study was quantitative investigation and the questionnaire was developed based on the World Health Organization standard questionnaire. As a result of our research, it became clear that pharmacists have pure, indistinct knowledge about adverse reactions of over-the-counter analgesics and pharmacy employees in the Republic of Armenia have incomplete knowledge and ideas about pain management. According to the study pharmacists’ information sources was not reliable and the use of these sources in professional pharmaceutical practice were not inappropriate. Involvement of pharmacists in primary care pain management is very important and pain management training of pharmacy staffs should be encouraged. Pharmacist should be a part of a multidisciplinary pain management team and for this reason comprehensive information on pain management as well as development of practical skills should be included in continuing education programs for pharmacists.
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Lichtman, S. M., and M. K. Boparai. "Geriatric medication management: Evaluation of pharmacist interventions and potentially inappropriate medication (PIM) use in older (≥65 years) cancer patients." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): 9507. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.9507.
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9507 Background: Polypharmacy and inappropriate drug use are risk factors for adverse drug reactions (ADR) and poor compliance in older cancer patients. Drug evaluations in the past have not focused on this group. An evaluation of the prevalence of PIMs, pharmacist interventions, and the number and type of medications was performed. An educational component helped patients with drug management to increase adherence, avoid drug-drug and drug-disease interactions. Methods: A geriatric clinical pharmacist reviewed patient's medications, assessed understanding of their drugs, evaluated adherence, reviewed for PIMs (Beer's criteria), identified possible ADR and side effects, and provided detailed instructions. The pharmacist collaborated with the oncologist to determine appropriate therapy for the patient. Only patients over the age of 65 were eligible for this clinic. Consults were performed from March 2008 to June 2008, this includes new and follow up visits. An additional retrospective chart review was performed on 100 patients ≥ 65 years of age seen from July 2007 to November 2007. Results: There were 154 patients who underwent a prospective consultations; 74 yrs (65–91; 58% female). The interventions were: an alternative agent was recommended (31pts/20%), drug - drug interactions identified (15/10%), problems with adherence (58/37%), drugs discontinued (54/35%), additional medication (64/42%), dose change (17/11%), pain management (28/18%) and cost issues (19/12%). More then one issue was addressed during visits. In the retrospective study, median age 72 (65 - 90), 48% were females; medications: median 8 (range 0–23). Most common classes of medications were anti-hypertensives (52%), vitamins/herbals (46%), proton pump inhibitors (32%) and lipid lowering agents (29%). The prevalence of PIMs was 11%. The most common were propoxyphene, high doses of long-acting benzodiazepines and diphenhydramine. Conclusions: A geriatric medication management evaluation resulted in 50% of patients requiring specific interventions and identification of PIMs in 11% of patients. This type of intervention can optimize care by increasing adherence and avoiding adverse drug events and their serious sequelae. No significant financial relationships to disclose.
Dissertations / Theses on the topic "Pain management medication interventions"
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Reed, Sydney Lain, and Sydney Lain Reed. "Evidence based practice recommendation: non-pharmacological pain management interventions during labor." Thesis, The University of Arizona, 2017. http://hdl.handle.net/10150/626738.
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The purpose of this thesis is to explore best practices for non-pharmacologic pain management during the birthing process in order to create an educational pamphlet that explains to women their options for pain management during labor and birth. The focus of this project is to provide best practice recommendations to pregnant women so that they can make informed decisions on birth plans and specifically decide what pain management techniques they may use during labor and birth. The goal is to inform all expecting women with necessary information to ensure her knowledge about pain control options during the birthing process and promote a healthy birth experience. The author conducted an extensive literature review that explores outcomes of different pain management techniques and focused on non-pharmacologic pain management techniques to provide women with the resources needed to have an improved labor experience. Based on the evidence in the literature review a pamphlet will be created to describe the various pain management options available to women with explained risks and benefits. The hope is that a well-informed decision on pain management to promote a birthing experience in which coping is enhanced and suffering is reduced.
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Braddock, Kaylee. "Nonpharmacological interventions for the management of procedural pain in the neonate." Honors in the Major Thesis, University of Central Florida, 2010. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/1365.
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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.Bachelors
Nursing
Nursing
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O'Connor, Seán Richard. "Walking-based physical activity interventions for the management of chronic musculoskeletal pain." Thesis, Ulster University, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.702475.
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Chronic musculoskeletal pain (CMP) is a major cause of morbidity, and one of the most common reasons for individuals to seek treatment in both the primary and secondary care settings. Physical activity interventions are a central component of the non-pharmacological management of such conditions. However, encouraging patients to exercise or increase their overall physical activity can be problematic. This can be due to a number of potential barriers, including a belief that some activities may cause pain or injury. Walking is a form of exercise or physical activity that may potentially be effective at improving adherence to treatment recommendations; due in part to its relatively low impact, ease of accessibility and general acceptability. However, there is limited evidence which has sought to investigate the effectiveness of such interventions in patients with chronic musculoskeletal complaints. The central aim of this thesis was therefore to examine the role of walking-based physical activity interventions in this population. A number of different methodological approaches were used to address this aim. This included: (1) a systematic review of randomised and quasirandomised studies examining walking-based interventions in participants with osteoarthritis (OA), fibromyalgia (FM) and chronic lower back pain (CLBP) (chapter two and chapter three); (2) a laboratory based pilot study examining the effects of a single bout of moderate intensity treadmill walking on experimentally induced lower-limb muscle pain (chapter four); (3) a randomised controlled trial (RCT) to determine the feasibility of using a structured, pedometer walking programme as an adjunct to a standard education and advice session in participants with CLBP (chapter five and chapter six).
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Stilwell, George Thomas. "Pain evaluation and control after routine interventions in cattle." Doctoral thesis, Universidade Técnica de Lisboa. Faculdade de Medicina Veterinária, 2009. http://hdl.handle.net/10400.5/1326.
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Tese de Doutoramento em Ciências VeterináriaDisbudding and castration are two routine interventions in cattle practice. Both can cause severe pain and cause poor welfare. Through plasma cortisol levels and behaviour evaluation we measured pain caused by different disbudding and castration methods. We also studied the efficacy of several anaesthesia and analgesia protocols. The main conclusions are: - Cortisol together with behaviour assessment is very useful in detecting calves in pain. - Certain behaviours are only shown by very young calves. - Vocalization should not be used as a sign of pain in calves. - Scoop disbudding causes long term pain and local anaesthesia is not efficient. - Hot-iron disbudding causes severe pain during the procedure but does not differ from paste disbudding in the next hours. Local anaesthesia plus analgesia does reduce pain cause by these methods. - Xylazine causes an increase in cortisol even if pain is not induced. - Pain caused by clamp-castration lasts for at least 48 hours and is only controlled by long acting analgesics. - Surgical castration causes intense pain but shorter if two incisions are made instead of just one.
RESUMO - Avaliação e controlo da dor causada por intervenções de rotina em bovinos - A descorna e a castração de bovinos jovens são duas intervenções de rotina nas explorações. Ambas intervenções têm o potencial de causar dor e, portanto, de afectar gravemente o bem-estar animal. Através da medição do cortisol plasmático e avaliação do comportamento medimos a dor causada por diversos métodos de descorna e castração. Testámos ainda diversos protocolos de anestesia e analgesia. Principais conclusões: - O cortisol associado à observação do comportamento é eficaz na detecção de vitelos em dor. - Certos comportamentos de dor apenas são exibidos por animais muito novos. - A vocalização não é um sinal útil na identificação da dor em vitelos. - A descorna por amputação causa dor prolongada e a anestesia local não é eficaz. - O procedimento de descorna por ferro causa dor elevada, mas nas horas seguintes a dor não difere da descorna com pasta. A anestesia local associada a um analgésico controla a dor nestes dois métodos. - A xilazina causa elevação de cortisol mesmo quando não há dor. - Dor causada pela castração por esmagamento dura pelo menos 48 horas e só é controlada por analgésicos com acção prolongada. - Castração cirúrgica causa dor intensa mas menos prolongada quando feita através de duas incisões do que através de uma incisão.
Centro de Investigação Interdisciplinar em Sanidade Animal - Projecto de Investigação: CIISA/73.Dor Bovinos
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Sindhu, Fahera. "Are non-pharmacological nursing interventions for the management of pain effective? : a meta-analysis." Thesis, University of Oxford, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.240403.
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Costello, Verona. "An examination of the efficacy of specific nursing interventions to the management of pain in cancer patients." Thesis, Queensland University of Technology, 2003. https://eprints.qut.edu.au/15792/1/Verona_Costello_Thesis.pdf.
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Aim of the Study: The aim of this study was to determine if the nursing interventions of patient education and multidisciplinary coordination of care were able to improve pain control in the cancer patient in an acute hospital setting. Background of the Study: The role of the nurse in cancer pain management has been defined as being that of an educator, coordinator of care and advocate. A nurse with adequate knowledge of pain and its application to the cancer population and functioning in the role as defined is believed to be able to overcome many of the barriers that exist in implementing adequate analgesia and improve pain management in cancer patients. Design of the Study: A randomized experimental control group design was utilized. The study comprised 3 experimental groups and one control group incorporating pre and post testing. The Intervention of the Study: Experimental group one: subjects received education regarding their pain management which was tailored to meet their specific needs. Experimental group two: subjects underwent a pain assessment and construction of a care plan which was communicated verbally to the treating medical and nursing team and followed up with a written report which was documented in the history and sent to the treating medical physician. Experimental group three: subjects received the combined interventions administered to groups one and two. Control group four: subjects were assessed and all information was record in the same manner as for the experimental groups. The control group received their usual care during the study and their pain scores were measured at the same time intervals as the three experimental groups. Instrumentation: The Wisconsin Brief Pain Questionnaire was used for the assessment of all subjects. The McGill Pain Questionnaire was used as the outcome measure following intervention. Data Analysis: A one-way analysis of variance was used to detect the differences between the intervention groups and the control group. T-Tests were used to detect the differences between the groups incorporating a Bonferroni adjustment for frequent T tests. Results: The main effect demonstrated a significant difference between the treatment groups and control at a significance level of 0.002. T-Tests showed no significant difference between control and communication groups and no significant difference between education and combined groups. A significant difference was detected between education and control and between combined and control. Conclusions: Nursing interventions of patient education, coordination of care and advocacy can significantly improve cancer pain management. Intervention was tailored to meet the specific patient needs based on findings from the assessment and was dependent upon an adequate knowledge base. The nursing intervention of education was the most powerful of the three intervention types and its success was in tailoring to each individual. However, it is believed that with further recognition of the role of the nurse as coordinator of care will lead to greater improvements in cancer pain management.
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Costello, Verona. "An Examination of the Efficacy of Specific Nursing Interventions to the Management of Pain in Cancer Patients." Queensland University of Technology, 2003. http://eprints.qut.edu.au/15792/.
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Aim of the Study The aim of this study was to determine if the nursing interventions of patient education and multidisciplinary coordination of care were able to improve pain control in the cancer patient in an acute hospital setting. Background of the Study The role of the nurse in cancer pain management has been defined as being that of an educator, coordinator of care and advocate. A nurse with adequate knowledge of pain and its application to the cancer population and functioning in the role as defined is believed to be able to overcome many of the barriers that exist in implementing adequate analgesia and improve pain management in cancer patients. Design of the Study A randomized experimental control group design was utilized. The study comprised 3 experimental groups and one control group incorporating pre and post testing. The Intervention of the Study Experimental group one: subjects received education regarding their pain management which was tailored to meet their specific needs. Experimental group two: subjects underwent a pain assessment and construction of a care plan which was communicated verbally to the treating medical and nursing team and followed up with a written report which was documented in the history and sent to the treating medical physician. Experimental group three: subjects received the combined interventions administered to groups one and two. Control group four: subjects were assessed and all information was record in the same manner as for the experimental groups. The control group received their usual care during the study and their pain scores were measured at the same time intervals as the three experimental groups. Instrumentation The Wisconsin Brief Pain Questionnaire was used for the assessment of all subjects. The McGill Pain Questionnaire was used as the outcome measure following intervention. Data Analysis A one-way analysis of variance was used to detect the differences between the intervention groups and the control group. T-Tests were used to detect the differences between the groups incorporating a Bonferroni adjustment for frequent T tests. Results The main effect demonstrated a significant difference between the treatment groups and control at a significance level of 0.002. T-Tests showed no significant difference between control and communication groups and no significant difference between education and combined groups. A significant difference was detected between education and control and between combined and control. Conclusions Nursing interventions of patient education, coordination of care and advocacy can significantly improve cancer pain management. Intervention was tailored to meet the specific patient needs based on findings from the assessment and was dependent upon an adequate knowledge base. The nursing intervention of education was the most powerful of the three intervention types and its success was in tailoring to each individual. However, it is believed that with further recognition of the role of the nurse as coordinator of care will lead to greater improvements in cancer pain management.
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Robb, Karen Anne. "Non-pharmacological interventions in the management of chronic pain associated with breast cancer treatment." Thesis, King's College London (University of London), 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.404611.
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Goodwin, Amy Lee. "Health Literacy Associated with Parental Management of Dental Pain in the Child." The Ohio State University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=osu1274767956.
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Kutumbuka, Benjamin Kukatula. "A systematic review of the effectiveness of lifestyle and medication: interventions in the management of hypertension in pregnancy." University of the Western Cape, 2017. http://hdl.handle.net/11394/6314.
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Magister Curationis - MCurPregnancy induced hypertension is one of the causes of maternal, fetus and neonatal morbidity and mortality. It is the condition in which a pregnant woman develops hypertension because of physiological changes that result during pregnancy and both mother and fetus can be affected. According to the World Health Organization (WHO), the first target of the third United Nations Sustainable Development Goals (SDG-3) is to reduce the maternal mortality rate (MMR) to less than 10 per 100.000 live births by 2030 (WHO, 2017). This is because globally, about 350 000 women die every year from pregnancy related causes (Hogan, Foreman, & Naghavi, 2010). According to the WHO (2015), these conditions namely post-partum hemorrhage, hypertension in pregnancy, infections, unsafe abortion and other delivery-related complications cause three quarters of all maternal deaths in the World. Hence the needs to prevent or successfully treat conditions that contribute to this scourge (WHO, 2011). The two main interventions that are used to prevent or treat hypertension in pregnancy are medication and lifestyle adjustment. However, it is important to understand the intervention that is most suited to a context and its patient and compare the effects of these interventions on management of hypertension in pregnant women as a patient outcome.
Books on the topic "Pain management medication interventions"
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Souza, Dmitri, and Lynn R. Kohan, eds. Bedside Pain Management Interventions. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-11188-4.
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Grinstead, Stephen F. Addiction-free pain management: Recovery guide : managing pain and medication in recovery. 2nd ed. Independence, MO: Herald House/Independence Press, 2008.
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Addiction-free pain management: Recovery guide : managing pain and medication in recovery. Independence, MO: Herald House/Independence Press, 2002.
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Foundation, Arthritis, ed. Arthritis: Your comprehensive guide to pain management, medication, diet, exercise, surgery, and physical therapies. London: DK, 2009.
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T, Gorski Terence, ed. Addiction-free pain management: The relapse prevention counseling workbook. Independence, Mo: Herald House/Independence Press, 1997.
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Maani, Christopher V., and LT Col Edward M. Lopez. Pain Management Procedures. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190495756.003.0030.
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Patients referred to pain clinics are often those with the most severe pain, who have failed more conservative approaches or strictly medical modalities. In other instances, the patients are referred for concerns of comorbidities or lack of pain management resources such as a clinic and procedure room with fluoroscopic capabilities. While the goal for these percutaneous interventions is improved pain control, they should be considered adjuncts and not replacements for a comprehensive pain management strategy. Most patients benefit from multimodal pain medication strategies, physical therapy, stress management and relaxation training, occupational therapy, acupuncture, or other treatment therapies. This chapter provides an overview and discussion of several of the most common pain procedures encountered in clinical pain management practices today. Each procedure is discussed with an initial description of the strategy, including technical aspects, medical indications, and relevant complications important for the pain management physician to understand. This will be followed by a section on considerations for anesthetic management.
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Trestman, Robert L. Psychiatric aspects of pain management. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0039.
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Chronic pain differs from acute pain in many ways. First, by definition, it has become enduring and goes beyond the expected period of healing, whether post-trauma, post-surgery, or as part of a degenerative or progressive disease. The typical time frame used for defining chronic pain is defined as pain that persists beyond a six month window. Another characteristic that distinguishes chronic from acute pain is the emotional element of perceived suffering. This component of chronic pain becomes important in the assessment and subsequent treatment of chronic pain. Chronic pain management in a correctional setting is very challenging due to a host of factors. First, the majority of people being treated have a history of substance abuse disorders. Further, as a whole, the population of incarcerated adults has a disproportionate prevalence of significant chronic medical and psychiatric conditions. Finally, access to illicit drugs is limited, if not completely eliminated in correctional settings, shifting the environmental demand characteristics to prescription medication misuse. This chapter addresses issues of the psychiatric assessment and management of chronic pain in correctional settings. Information is provided regarding the factors to be elicited in a chronic pain interview, the methods used to assess chronic pain, and the assessment factors appropriate to integrate into a management plan. The methods used to manage chronic pain, including close coordination with a treatment team, cognitive behavioral interventions, and pharmacological management are presented. Tracking treatment outcomes from a psychiatric perspective in the correctional setting are then discussed.
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Trestman, Robert L. Psychiatric aspects of pain management. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199360574.003.0039_update_001.
Full textAbstract:
Chronic pain differs from acute pain in many ways. First, by definition, it has become enduring and goes beyond the expected period of healing, whether post-trauma, post-surgery, or as part of a degenerative or progressive disease. The typical time frame used for defining chronic pain is defined as pain that persists beyond a six month window. Another characteristic that distinguishes chronic from acute pain is the emotional element of perceived suffering. This component of chronic pain becomes important in the assessment and subsequent treatment of chronic pain. Chronic pain management in a correctional setting is very challenging due to a host of factors. First, the majority of people being treated have a history of substance abuse disorders. Further, as a whole, the population of incarcerated adults has a disproportionate prevalence of significant chronic medical and psychiatric conditions. Finally, access to illicit drugs is limited, if not completely eliminated in correctional settings, shifting the environmental demand characteristics to prescription medication misuse. This chapter addresses issues of the psychiatric assessment and management of chronic pain in correctional settings. Information is provided regarding the factors to be elicited in a chronic pain interview, the methods used to assess chronic pain, and the assessment factors appropriate to integrate into a management plan. The methods used to manage chronic pain, including close coordination with a treatment team, cognitive behavioral interventions, and pharmacological management are presented. Tracking treatment outcomes from a psychiatric perspective in the correctional setting are then discussed.
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Cheatle, Martin, and Perry G. Fine, eds. Facilitating Treatment Adherence in Pain Medicine. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190600075.001.0001.
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One of the most distressing features of a healthcare providers practice is that of patient nonadherence. Adherence refers to an active, voluntary, collaborative involvement of the patient in a mutually acceptable course of behavior to produce a desired preventative or therapeutic result. Most of the research in the area of medical adherence has been focused on medication adherence or increasing the likelihood that a patient will take their medications as prescribed by their physician. Adherence also has a broader application with regards to patient behaviors that can either support or undermine a positive response to prescribed therapies.In the field of pain medicine there are a number of evidence-based interventions that can improve an individual’s pain, mood and functionality, but this depends highly on the patient adhering to the prescribed treatment regimens.This book will provide a practically oriented guide to understanding the conceptual models of adherence and non-adherence and methods to improve adherence, to both pharmacotherapy and psychosocial pain management strategies. Topics include the use of biometrics to measure and promote adherence, employing novel psychosocial techniques to improve adherence to pain management and healthy lifestyle interventions and the ethical considerations of patient and clinician nonadherence.
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McCabe, Candy, Richard Haigh, Helen Cohen, and Sarah Hewlett. Pain and fatigue. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0012.
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Pain and fatigue are the prominent problems for those with a rheumatic disease, and are often underestimated by clinicians. Symptoms may fluctuate in quality and intensity over time and commonly will vary over the course of a day. For pain, clinical signs and symptoms will be dependent on the source of the pain and whether causative underlying pathology is identifiable or not. Fatigue may range from mild effects to total exhaustion and may include cognitive and emotional elements, with a complex, probably multicausal, pathway. Theoretical knowledge of potential mechanistic pathways for pain and fatigue should be used to inform assessment and treatment approaches. Best practice recommends a multidisciplinary and holistic treatment approach with the patient an active participant in the planning of their care, and self-management. Many patients with chronic musculoskeletal conditions will not achieve a pain-free or fatigue-free status. Medication use must therefore balance potential benefit against short- and long-term side effects. Rheumatology centres should offer specific fatigue and pain self-management support as part of routine care. Emphasis should be given to facilitating self-management strategies for both pain and fatigue to help the patient optimize their quality of life over years or a lifetime of symptoms. Interventions should include behaviour change and cognitive restructuring of pain/fatigue beliefs, as well as access to relevant self-help groups and charitable organizations. Referral for specialist advice from regional or national clinics on pain relief and management should be considered if pain interferes significantly with function or quality of life despite local interventions.
Book chapters on the topic "Pain management medication interventions"
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Damiani, S., M. Bendinelli, and Stefano Romagnoli. "Intensive Care and Anesthesiology." In Textbook of Patient Safety and Clinical Risk Management, 161–75. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-59403-9_13.
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AbstractThe wide range of medical disciplines afferent to anesthesiology (anesthesia, perioperative care, intensive care medicine, pain therapy, and emergency medicine), carry a great, cross-specialty opportunity to influence safety and quality of patients’ care. Operating rooms and Intensive Care Units are settings burdened with a high risk of error: surgery is evolving, while the medical staff working in ICU is expected to provide high-quality care in a stressful and complex setting. It is estimated that about 1.5% of surgical interventions are complicated by critical events, but the true incidence is likely underestimated. Across medical specialties, preventable patient harm is more prevalent in the ICU.Recommendations and good practices for the safe provision of anesthesia and critical care exist and must be known and transferred into daily practice, since one of the main duties of anesthesia and critical care providers is to provide patient safety. Strategies to reduce the occurrence of medication errors, appropriate monitoring practices, equipment care and knowledge, planification and mastery of non-technical skills during emergencies, as well as designing and sustaining a healthy work environment and adopting adequate staffing policies could have an impact on patient safety and positively influence patient outcomes in this setting. The development of simulation training and cognitive aids (e.g., checklists, emergency manuals) is also changing the approach to crises and is expected to encourage a deeper cultural change.
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Lake, Elizabeth. "Medication Management." In Trigeminal Nerve Pain, 77–87. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-60687-9_8.
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Chen, Grant H. "Medications in Intrathecal Pumps." In Essentials of Interventional Cancer Pain Management, 287–92. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-99684-4_32.
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Chavali, Siddharth. "Medications for Interventional Pain Management in Trigeminal Neuralgia." In Handbook of Trigeminal Neuralgia, 71–77. Singapore: Springer Singapore, 2019. http://dx.doi.org/10.1007/978-981-13-2333-1_9.
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Hall, Bonnie Huang. "Management of Chronic Pain: Medication." In Evaluation and Management of Chronic Pain for Primary Care, 49–81. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-47117-0_6.
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Mallick-Searle, Theresa. "Background and Medication Overview." In Holistic Pain Management in Pregnancy, 9–26. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-06322-0_2.
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Tran, Bryant W., Michael R. Buxhoeveden, and Timothy T. Wills. "Periarticular Elbow Interventions." In Bedside Pain Management Interventions, 561–69. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-11188-4_56.
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Krazit, Stephen T. "Opioid Alternative Medication and Clinical Dilemmas." In Pain Management for Clinicians, 679–702. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-39982-5_22.
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Patel, Nirav M., and Harsh Sachdeva. "Interventions for Coccygeal Pain." In Bedside Pain Management Interventions, 379–85. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-11188-4_39.
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Wong, Andrea C., and Salim M. Hayek. "Intrathecal Drug Delivery: Medication Selection." In Advanced Procedures for Pain Management, 367–84. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-68841-1_31.
Full textConference papers on the topic "Pain management medication interventions"
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Arora, Rahul D. "Inpatient pharmacologic management of malignant bowel obstruction." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685360.
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Background: Management of life threatening complications encountered in Advanced Cancer is an important domain of Palliative Oncology. Malignant Bowel Obstruction is usually an indicator of poor prognosis in Advanced cancer. It is usually associated with malignancies in the gastrointestinal tract or those outside the gastrointestinal tract (gynaecological malignancies). MBO can also occur with primary peritoneal as well as secondary peritoneal malignancies. Diagnostic criteria for MBO include Clinical evidence of bowel obstruction, obstruction distal to the Ligament of Treitz, presence of primary intraabdominal or extra abdominal cancer with peritoneal involvement. Materials: Detailed below are two cases of Malignant Bowel obstruction managed with Conservative inpatient nonoperative management with discussion of the proposed pharmacological protocol for the same. Case Details: A 45 year old Postmenopausal female diagnosed as carcinoma ovary stage iiic with left lower limb Deep Venous Thrombosis post multiple lines of chemotherapy including Paclitaxel plus Carboplatin, Etoposide, Tamoxifen and Liposomal Doxorubin, Malignant pleural effusion post thoracentesis was seen in the wards. A 31 year old Female a known case of moderately differentiated carcinoma colon with transmural infiltration and serosal seeding along with omental deposits with hepatic metastasis was seen in the casualty with signs of Multiple episodes of bilious vomiting with colicky abdominal pain and diagnosed to have malignant bowel obstruction on clinic radiological evaluation. Both these patients were provided non operative management of malignant bowel obstruction, were kept nil per oral, nasogastric decompression was performed with ryles tube insertion, antisecretory medication Inj Octreotide 100 ug three times daily, Anti Edema measures Inj Dexamethasone 8 mg intravrenous three times daily, Anti spasmodic and anti secretory medication Inj Hyoscine Butyl bromide 10 mg three times daily, inj Metronidazole 500 mg intravenous three times daily and Pain medication Inj Tramadol hydrochloride 50 mg intravenous in 100 ml of normal saline three times daily. Both these patients developed hyperglycemia which was managed with human regular insulin prescribed as per the sliding scale. Results: Ryles tube aspirate showed a decreasing trend and both the Patients achieved clinical resolution of symptoms underwent deintubation on Day 10 and Day 13 respectively and were taking oral feeds at the time of discharge. They were prescribed pharmacologic management of adhesive bowel obstruction consisting of Tab activated Dimethicone 40 mg three times daily, Tab Lactobacillus one tablet three times daily and Polyethylene glycol one satchet upto three times daily for 15 days at the time of discharge. Results: Resolution of symptoms can be achieved by providing non operative pharmacological management outlined above which consists of adequate hydration, parenteral nutrition when indicated, antibiotics, decongestive anti edema measures, anti spasmodic and anti secretory medication. Conclusion: Management of Hyperglycemia induced by Octreotide and Dexamethasone requires Insulin therapy. Optimum Duration, dosage and route of administration of Octreotide in management of Malignant Bowel Obstruction needs to be evaluated further.
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Gailer, Joy, Paul Muffet, and Paul Molyneux. "88 Opioid therapy patient agreements: a lever in shifting the focus from pharmacological to non-pharmacological interventions in chronic pain management." In Preventing Overdiagnosis Abstracts, December 2019, Sydney, Australia. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/bmjebm-2019-pod.101.
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Medeiros, Lorrana Alves, and Carla Cristina Lopes Barbosa Tiveron. "Clinical treatment of Idiopathic Benign Intracranial Hypertension (IIH): case report." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.020.
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Introduction: Headache is one of the most common complaints in medicine, being divided into primary or secondary. Idiopathic Benign Intracranial Hypertension (IBIH) is one of the causes of secondary headache, where there is an increase in intracranial pressure in the absence of an expansive process. Goals: To present the management of IBIH refractory to conventional treatment. Methodology: Clinical evaluation of the patient, review of her medical record and review of literature related to the topic. Case report: RMC, female, 55 years old, short stature, BMI 48, presented in 2018 repetitive pictures of severe headache, without improvement factors, associated with visual disturbances that evolved to amausore, sporadic loss of balance and slowing pupillary reflexes, mood disorders and easy cry. Magnetic resonance and fundscopy were inconclusive, and CSF puncture found an opening pressure of 20 cm of water. After CSF puncture, the patient showed instantaneous vision improvement, and therapy with Acetazolamide was introduced, which controlled and kept her ophthalmological symptoms stable. Angina conditions were only resolved with the introduction of Lamotrigine. RESULTS: The most commonly prescribed medication for IBIH, Acetazolamide, controlled the reported patient’s ophthalmological condition, but not the pain episodes. When this medication alone cannot control the condition, the association of other medications or surgical conduct is indicated. The association of Acetazolamide with Lamotrigine was extremely important to solve the patient’s pain episodes, making her clinical management positive. Conclusion: The combination of Lamotrigine and Acetazolamide has been shown to be an excellent form of outpatient treatment for IBIH.
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"Knowledge and practice of analgesics use among Albaq’a refugees camp, Jordan. : A cross sectional study." In International Conference on Public Health and Humanitarian Action. International Federation of Medical Students' Associations - Jordan, 2022. http://dx.doi.org/10.56950/ehgb9785.
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Background : Due to the rising healthcare costs around the world, self-medication has become an important option in the management of common conditions. However, the benefits of such selfmedication practices depend upon them being used responsibly. Studies about the prevalence of analgesics use and related factors are limited in Jordan, particularly among refugees which is one of the vulnerable sectors of the population. Objective: The objective of this study was to evaluate the knowledge and practices of Palestinian refugees in the Al-Baqa’a camp in Jordan regarding the use of analgesics to address any common misuse or misknowledge. Method: A cross-sectional study design was conducted from 20 October to 10 November 2021. A researcher-developed questionnaire to assess knowledge and practices were used as a tool for studying both interviewer-administered and self-administered survey among 253 adult Palestine refugees at Al Baqa’a refugee camp. Statistical analysis was performed using SPSS version 26 for descriptive and inferential statistics. Results: A high percentage of the respondents 78.3% reported that they use analgesics as selfmedication. Of these participants, 37.9% reported having a chronic disease, 34.4 % never suffer from pain in the last month, and 33.6% reported that they do not have health insurance. the most commonly used class of drugs was NSAIDs with a frequency of 193 fowled by paracetamol with a frequency of 90. While the most common condition for which the refugees use self-medication is the cost with 168 frequency, In the assessment of participant’s knowledge; analgesics are used to treat minor illnesses by 70%. 94% reported that analgesics can’t be used after their expiry date while 34% reported that analgesics do not have side effects. Final statics will have presented at the conference. Conclusion: Self-medication is widely practiced in Albaq’a refugees camp, although they are familiar with the most important information regarding the risks associated with the use of analgesics. Keywords: over-the-counter , non-steroidal anti-inflammatory drugs
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Hussain, Mozammil, and Rodger Tepe. "Effect of Traction Load on the Biomechanical Behavior of Cervical, Thoracic, and Lumbar Spinal Segments: A Finite Element Analysis." In ASME 2008 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2008. http://dx.doi.org/10.1115/sbc2008-193246.
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Degeneration in the spinal structures can be a major source of pain that increases with aging in a roughly linear progression. Pain has been further correlated with the regions of high stress and strain concentrations. Due to difference in the regional anatomy and physiology of the cervical, thoracic, and lumbar levels, their biomechanical response to physiological loadings is different. The fluid egresses outside in the radial direction from nucleus pulposus (NP) to annulus fibrosus (AF) under compression, which generates a hydrostatic pressure against an external applied load. The increased NP pressure, in many clinical cases, results into various abnormal disc pathologies such as protrusions and herniations. Chiropractic care in the management of these spinal dysfunctions uses manual manipulation therapies such as distraction techniques to relieve the disc from high pressure and radial bulging. Despite manual distraction therapy is a three-dimensional force application; major proportion of the load is exerted in the axial upward direction. Although few biomechanical studies have compared the segmental biomechanics under axial traction loads, to the best of our knowledge, there is no study that distinguishes between the behavior of cervical, thoracic, and lumbar segments to these loads. The objective of the present study, therefore, was to investigate that how the biomechanical stresses, that were developed under upper body weight (BW), changes in the various spinal segments (cervical, thoracic, and lumbar) and in the different spinal structures (top vertebra, superior endplate, and disc) when the traction forces were applied as the therapeutic modalities in the chiropractic interventions.
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Pilav, Aida, and Anes Jogunčić. "DIAGNOSTICS OF PREVENTABLE DISEASES IN CARDIOLOGY." In International Scientific Symposium “Diagnostics in Cardiology and Grown-Up Congenital Heart Disease (GUCH)”. Academy of Sciences and Arts of Bosnia and Herzegovina, 2021. http://dx.doi.org/10.5644/pi2021.199.03.
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Despite many efforts to diagnose and treat preventable cardiovascular diseases (CVD), more specifically to detect known risk factors, these diseases continue to be the leading cause of morbidity and mortality. Bosnia and Herzegovina belongs among the high-risk countries with standardized death rate (SDR) of 385 per 100 000 inhabitants in 2018. Two leading causes of death are acute myocardial infraction, with rate around 90 deaths per 100 000 inhabitants and stroke with the rate around 80 deaths per 100 000 inhabitants in one year. Both incidents are preventable. Digital interventions are necessary for strengthening of the healthcare system. Benefits of eHealth could be seen in transmission of customized health information for different audiences: transmission of health-event alerts to a specified population group; transmission of health information based on health status or demographics; alerts and reminders to clients; transmission of diagnostic results (or of the availability of results) or even notifications and reminders for appointments, medication adherence, or follow-up services. Successful implementation of digital health requires multidisciplinary approaches, from mass dissemination of recommendations through public health education programs directly in the field, to clinical treatments for patients. All this requires the involvement of numerous actors, from the strategic to the operational level of management within the healthcare system in the country.
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JJ Knibbe a, Hanneke, Nico E. Knibbea, and Elly Waaijerb. "The Challenge of Early Mobilization on the Intensive Care Unit: The Ergonomic Opportunities and Barriers." In Applied Human Factors and Ergonomics Conference. AHFE International, 2021. http://dx.doi.org/10.54941/ahfe100484.
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In recent years ICU-care and ICU-management of the critically ill patient is paying more attention to long term effects of the stay on the ICU and of the negative consequences of immobilization, long periods of bed rest, mechanical ventilation and medication aimed at pain reduction and sedation. Immobilization in bed affects practically all body conditions within a very short time frame: ranging from less than an hour to a few days. Some of these effects are reversible, some are not and may result in negative long term effects of the stay on the ICU. Recently new devices and equipment have been developed that enable mobilization of ICU patients at an extremely early stage, even without the patient being aware of being mobilized and being ventilated. This so-called Early Mobilisation (EM) has shown to be safe, feasible and improves outcomes both in the short term and especially also in the long run. There is a gradually building body of knowledge demonstrating the positive effects. In spite of these positive developments mobilizing critically ill and very passive patients in the complicated and often crowded ICU environment is also a first degree ergonomic challenge. Currently occupational musculoskeletal disorders are already prevalent in an ICU environment among nurses and physical therapists across the world. Lifting, assisting and supporting these complicated patients often attached to monitoring and (live) supportive equipment 24 hours a day can be very strenuous. EM requires considerable additional effort from these workers. These ergonomic implications will need to be resolved if an EM policy is to be successfully implemented. Therefore a study was undertaken describing the current situation and the potential of EM for the ICU’s in Dutch hospitals. The results indicate a whole array of different descriptions of EM and a lack of consensus, the lack of sufficient and adequate equipment especially when it comes to ergonomic considerations for the nurses, a lack of knowledge of what is required for EM and a lack of up-to-date protocols indicating safe procedures for both patient and nurse. Nevertheless most nurses are convinced of the need for and relevance of EM and see opportunities there. However: they are mostly focused on the patient side of EM and have not sufficiently analyzed the potential consequences for their own health.
Reports on the topic "Pain management medication interventions"
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Chou, Roger, Jesse Wagner, Azrah Y. Ahmed, Ian Blazina, Erika Brodt, David I. Buckley, Tamara P. Cheney, et al. Treatments for Acute Pain: A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), December 2020. http://dx.doi.org/10.23970/ahrqepccer240.
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Objectives. To evaluate the effectiveness and comparative effectiveness of opioid, nonopioid pharmacologic, and nonpharmacologic therapy in patients with specific types of acute pain, including effects on pain, function, quality of life, adverse events, and long-term use of opioids. Data sources. Electronic databases (Ovid® MEDLINE®, PsycINFO®, Embase®, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews) to August 2020, reference lists, and a Federal Register notice. Review methods. Using predefined criteria and dual review, we selected randomized controlled trials (RCTs) of outpatient therapies for eight acute pain conditions: low back pain, neck pain, other musculoskeletal pain, neuropathic pain, postoperative pain following discharge, dental pain (surgical or nonsurgical), pain due to kidney stones, and pain due to sickle cell disease. Meta-analyses were conducted on pharmacologic therapy for dental pain and kidney stone pain, and likelihood of repeat or rescue medication use and adverse events. The magnitude of effects was classified as small, moderate, or large using previously defined criteria, and strength of evidence was assessed. Results. One hundred eighty-three RCTs on the comparative effectiveness of therapies for acute pain were included. Opioid therapy was probably less effective than nonsteroidal anti-inflammatory drugs (NSAIDs) for surgical dental pain and kidney stones, and might be similarly effective as NSAIDs for low back pain. Opioids and NSAIDs were more effective than acetaminophen for surgical dental pain, but opioids were less effective than acetaminophen for kidney stone pain. For postoperative pain, opioids were associated with increased likelihood of repeat or rescue analgesic use, but effects on pain intensity were inconsistent. Being prescribed an opioid for acute low back pain or postoperative pain was associated with increased likelihood of use of opioids at long-term followup versus not being prescribed, based on observational studies. Heat therapy was probably effective for acute low back pain, spinal manipulation might be effective for acute back pain with radiculopathy, acupressure might be effective for acute musculoskeletal pain, an opioid might be effective for acute neuropathic pain, massage might be effective for some types of postoperative pain, and a cervical collar or exercise might be effective for acute neck pain with radiculopathy. Most studies had methodological limitations. Effect sizes were primarily small to moderate for pain, the most commonly evaluated outcome. Opioids were associated with increased risk of short-term adverse events versus NSAIDs or acetaminophen, including any adverse event, nausea, dizziness, and somnolence. Serious adverse events were uncommon for all interventions, but studies were not designed to assess risk of overdose, opioid use disorder, or long-term harms. Evidence on how benefits or harms varied in subgroups was lacking. Conclusions. Opioid therapy was associated with decreased or similar effectiveness as an NSAID for some acute pain conditions, but with increased risk of short-term adverse events. Evidence on nonpharmacological therapies was limited, but heat therapy, spinal manipulation, massage, acupuncture, acupressure, a cervical collar, and exercise were effective for specific acute pain conditions. Research is needed to determine the comparative effectiveness of therapies for sickle cell pain, acute neuropathic pain, neck pain, and management of postoperative pain following discharge; effects of therapies for acute pain on non-pain outcomes; effects of therapies on long-term outcomes, including long-term opioid use; and how benefits and harms of therapies vary in subgroups.
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Skelly, Andrea C., Roger Chou, Joseph R. Dettori, Erika D. Brodt, Andrea Diulio-Nakamura, Kim Mauer, Rongwei Fu, et al. Integrated and Comprehensive Pain Management Programs: Effectiveness and Harms. Agency for Healthcare Research and Quality (AHRQ), October 2021. http://dx.doi.org/10.23970/ahrqepccer251.
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Objectives. To evaluate the effectiveness and harms of pain management programs that are based on the biopsychosocial model of care, particularly in the Medicare population. Data sources. Electronic databases (Ovid® MEDLINE®, PsycINFO®, CINAHL®, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews) from 1989 to May 24, 2021; reference lists; and a Federal Register notice. Review methods. Given lack of consensus on terminology and program definition for pain management, we defined programs as integrated (based in and integrated with primary care) and comprehensive (referral based and separate from primary care) pain management programs (IPMPs and CPMPs). Using predefined criteria and dual review, we selected randomized controlled trials (RCTs) comparing IPMPs and CPMPs with usual care or waitlist, physical activity, pharmacologic therapy, and psychological therapy in patients with complex acute/subacute pain or chronic nonactive cancer pain. Patients needed to have access to medication support/review, psychological support, and physical function support in programs. Meta-analyses were conducted to improve estimate precision. We classified the magnitude of effects as small, moderate, or large based on predefined criteria. Strength of evidence (SOE) was assessed for the primary outcomes of pain, function, and change in opioid use. Results. We included 57 RCTs; 8 evaluated IPMPs and 49 evaluated CPMPs. Compared with usual care or waitlist, IPMPs were associated with small improvements in pain in the short and intermediate term (SOE: low) and in function in the short term (SOE: moderate), but there were no clear differences at other time points. CPMPs were associated with small improvements in pain immediately postintervention (SOE: moderate) but no differences in the short, intermediate, and long term (SOE: low); for function, improvements were moderate immediately postintervention and in the short term; there were no differences in the intermediate or long term (SOE: low at all time points). CPMPs were associated with small to moderate improvements in function and pain versus pharmacologic treatment alone at multiple time frames (SOE: moderate for function intermediate term; low for pain and function at all other times), and with small improvements in function but no improvements in pain in the short term when compared with physical activity alone (SOE: moderate). There were no differences between CPMPs and psychological therapy alone at any time (SOE: low). Serious harms were not reported, although evidence on harms was insufficient. The mean age was 57 years across IPMP RCTs and 45 years across CPMP RCTs. None of the trials specifically enrolled Medicare beneficiaries. Evidence on factors related to program structure, delivery, coordination, and components that may impact outcomes is sparse and there was substantial variability across studies on these factors. Conclusions. IPMPs and CPMPs may provide small to moderate improvements in function and small improvements in pain in patients with chronic pain compared with usual care. Formal pain management programs have not been widely implemented in the United States for general populations or the Medicare population. To the extent that programs are tailored to patients’ needs, our findings are potentially applicable to the Medicare population. Programs that address a range of biopsychosocial aspects of pain, tailor components to patient need, and coordinate care may be of particular importance in this population.
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Tololiu, Kevin Efrain, Arie Kurnianto, and krisztina Csokasi. Audio Intervention for Acute Pain Management - Protocol of Systematic Review and Meta-Analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, January 2023. http://dx.doi.org/10.37766/inplasy2023.1.0002.
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Review question / Objective: This study aims to investigate, review, and asses existing literature concerning audio intervention to reduce acute pain. Condition being studied: The study will focus on acute pain experienced by adults in any diseases or surgical procedures. Eligibility criteria: This study will exclude papers published older than ten years ago to collect updated data, non RCTs, non-English literature, paper with combined interventions, and papers with an incomplete essential statical value of pain for meta-analysis.
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Totten, Annette, Dana M. Womack, Marian S. McDonagh, Cynthia Davis-O’Reilly, Jessica C. Griffin, Ian Blazina, Sara Grusing, and Nancy Elder. Improving Rural Health Through Telehealth-Guided Provider-to-Provider Communication. Agency for Healthcare Research and Quality, December 2022. http://dx.doi.org/10.23970/ahrqepccer254.
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Objectives. To assess the use, effectiveness, and implementation of telehealth-supported provider-to-provider communication and collaboration for the provision of healthcare services to rural populations and to inform a scientific workshop convened by the National Institutes of Health Office of Disease Prevention on October 12–14, 2021. Data sources. We conducted a comprehensive literature search of Ovid MEDLINE®, CINAHL®, Embase®, and Cochrane CENTRAL. We searched for articles published from January 1, 2015, to October 12, 2021, to identify data on use of rural provider-to-provider telehealth (Key Question 1) and the same databases for articles published January 1, 2010, to October 12, 2021, for studies of effectiveness and implementation (Key Questions 2 and 3) and to identify methodological weaknesses in the research (Key Question 4). Additional sources were identified through reference lists, stakeholder suggestions, and responses to a Federal Register notice. Review methods. Our methods followed the Agency for Healthcare Research and Quality Methods Guide (available at https://effectivehealthcare.ahrq.gov/topics/cer-methods-guide/overview) and the PRISMA reporting guidelines. We used predefined criteria and dual review of abstracts and full-text articles to identify research results on (1) regional or national use, (2) effectiveness, (3) barriers and facilitators to implementation, and (4) methodological weakness in studies of provider-to-provider telehealth for rural populations. We assessed the risk of bias of the effectiveness studies using criteria specific to the different study designs and evaluated strength of evidence (SOE) for studies of similar telehealth interventions with similar outcomes. We categorized barriers and facilitators to implementation using the Consolidated Framework for Implementation Research (CFIR) and summarized methodological weaknesses of studies. Results. We included 166 studies reported in 179 publications. Studies on the degree of uptake of provider-to-provider telehealth were limited to specific clinical uses (pharmacy, psychiatry, emergency care, and stroke management) in seven studies using national or regional surveys and claims data. They reported variability across States and regions, but increasing uptake over time. Ninety-seven studies (20 trials and 77 observational studies) evaluated the effectiveness of provider-to-provider telehealth in rural settings, finding that there may be similar rates of transfers and lengths of stay with telehealth for inpatient consultations; similar mortality rates for remote intensive care unit care; similar clinical outcomes and transfer rates for neonates; improvements in medication adherence and treatment response in outpatient care for depression; improvements in some clinical monitoring measures for diabetes with endocrinology or pharmacy outpatient consultations; similar mortality or time to treatment when used to support emergency assessment and management of stroke, heart attack, or chest pain at rural hospitals; and similar rates of appropriate versus inappropriate transfers of critical care and trauma patients with specialist telehealth consultations for rural emergency departments (SOE: low). Studies of telehealth for education and mentoring of rural healthcare providers may result in intended changes in provider behavior and increases in provider knowledge, confidence, and self-efficacy (SOE: low). Patient outcomes were not frequently reported for telehealth provider education, but two studies reported improvement (SOE: low). Evidence for telehealth interventions for other clinical uses and outcomes was insufficient. We identified 67 program evaluations and qualitative studies that identified barriers and facilitators to rural provider-to-provider telehealth. Success was linked to well-functioning technology; sufficient resources, including time, staff, leadership, and equipment; and adequate payment or reimbursement. Some considerations may be unique to implementation of provider-to-provider telehealth in rural areas. These include the need for consultants to better understand the rural context; regional initiatives that pool resources among rural organizations that may not be able to support telehealth individually; and programs that can support care for infrequent as well as frequent clinical situations in rural practices. An assessment of methodological weaknesses found that studies were limited by less rigorous study designs, small sample sizes, and lack of analyses that address risks for bias. A key weakness was that studies did not assess or attempt to adjust for the risk that temporal changes may impact the results in studies that compared outcomes before and after telehealth implementation. Conclusions. While the evidence base is limited, what is available suggests that telehealth supporting provider-to-provider communications and collaboration may be beneficial. Telehealth studies report better patient outcomes in some clinical scenarios (e.g., outpatient care for depression or diabetes, education/mentoring) where telehealth interventions increase access to expertise and high-quality care. In other applications (e.g., inpatient care, emergency care), telehealth results in patient outcomes that are similar to usual care, which may be interpreted as a benefit when the purpose of telehealth is to make equivalent services available locally to rural residents. Most barriers to implementation are common to practice change efforts. Methodological weaknesses stem from weaker study designs, such as before-after studies, and small numbers of participants. The rapid increase in the use of telehealth in response to the Coronavirus disease 2019 (COVID-19) pandemic is likely to produce more data and offer opportunities for more rigorous studies.
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Tipton, Kelley, Brian F. Leas, Nikhil K. Mull, Shazia M. Siddique, S. Ryan Greysen, Meghan B. Lane-Fall, and Amy Y. Tsou. Interventions To Decrease Hospital Length of Stay. Agency for Healthcare Research and Quality (AHRQ), September 2021. http://dx.doi.org/10.23970/ahrqepctb40.
Full textAbstract:
Background. Timely discharge of hospitalized patients can prevent patient harm, improve patient satisfaction and quality of life, and reduce costs. Numerous strategies have been tested to improve the efficiency and safety of patient recovery and discharge, but hospitals continue to face challenges. Purpose. This Technical Brief aimed to identify and synthesize current knowledge and emerging concepts regarding systematic strategies that hospitals and health systems can implement to reduce length of stay (LOS), with emphasis on medically complex or vulnerable patients at high risk for prolonged LOS due to clinical, social, or economic barriers to timely discharge. Methods. We conducted a structured search for published and unpublished studies and conducted interviews with Key Informants representing vulnerable patients, hospitals, health systems, and clinicians. The interviews provided guidance on our research protocol, search strategy, and analysis. Due to the large and diverse evidence base, we limited our evaluation to systematic reviews of interventions to decrease hospital LOS for patients at potentially higher risk for delayed discharge; primary research studies were not included, and searches were restricted to reviews published since 2010. We cataloged the characteristics of relevant interventions and assessed evidence of their effectiveness. Findings. Our searches yielded 4,364 potential studies. After screening, we included 19 systematic reviews reported in 20 articles. The reviews described eight strategies for reducing LOS: discharge planning; geriatric assessment or consultation; medication management; clinical pathways; inter- or multidisciplinary care; case management; hospitalist services; and telehealth. All reviews included adult patients, and two reviews also included children. Interventions were frequently designed for older (often frail) patients or patients with chronic illness. One review included pregnant women at high risk for premature delivery. No reviews focused on factors linking patient vulnerability with social determinants of health. The reviews reported few details about hospital setting, context, or resources associated with the interventions studied. Evidence for effectiveness of interventions was generally not robust and often inconsistent—for example, we identified six reviews of discharge planning; three found no effect on LOS, two found LOS decreased, and one reported an increase. Many reviews also reported patient readmission rates and mortality but with similarly inconsistent results. Conclusions. A broad range of strategies have been employed to reduce LOS, but rigorous systematic reviews have not consistently demonstrated effectiveness within medically complex, high-risk, and vulnerable populations. Health system leaders, researchers, and policymakers must collaborate to address these needs.
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Keating, Louise, Ailish Malone Name, Maire-Brid Casey, Ciaran Bolger, Dara Meldrum, and Catherine Doody. Conservative Primary Care Management for Recent Onset Cervical Radiculopathy – a Systematic Review & Meta-analysis Protocol. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, February 2022. http://dx.doi.org/10.37766/inplasy2022.2.0047.
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Review question / Objective: To investigate the effectiveness of conservative management available in primary care for adults with recent onset (less than 12 weeks) cervical radiculopathy. Conservative management will be compared to any available comparator i.e. no treatment, placebo or any treatment. Eligibility criteria: Inclusion criteria – trials (as defined in item 15) investigating any conservative management (e.g. exercise, advice, manual therapy, traction, acupuncture, pharmacology etc), involving adults with single level CR (as defined in item 10) of any aetiology, with symptom duration of 12 weeks or less, and including 1 or more of the following outcomes i.e. pain, disability, overall improvement or satisfaction with intervention, quality of life or participation restriction. Exclusion criteria – full text not available, not a randomised controlled trial, trials not involving CR (e.g. cervicobrachial pain, neck pain only), trials involving chronic CR, multilevel or bilateral CR (polyradiculopathy) or radiculomyelopathy, major or systemic pathology, post-surgery interventions, trials of surgery or spinal injection only, or involving a paediatric population or not in English language.
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Chmielewska, Daria, Jitka Malá, Alena Kobesova, Agnieszka Opala-Berdzik, Magdalena Nocuń, Michał Kuszewski, Patrycja Dolibog, Paweł Dolibog, and Magdalena Stania. Dry needling for physical therapy of scar. A protocol for a systematic review. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, January 2023. http://dx.doi.org/10.37766/inplasy2023.1.0058.
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Review question / Objective: The research question was defined according to the PICOS criteria: P - participants of any age with a scar / keloid / hypertrophic scar. I - interventions: local management with needling, dry needling, acupuncture or combination of local needling / dry needling / acupuncture with distal acupuncture. C - comparator: local intervention (physical therapy) aimed at scar, keloid or hypertrophic scar treatment or no treatment. O - objectives: changes in pain associated with scar, keloid or hypertrophic scar. Pigmentation, vascularity, height / thickness, pliability / plasticity, itchiness of the scar area. S - study design: The articles were included based on the following inclusion criteria: full text articles in English, randomized controlled trials, clinical trials, case reports, case-series, case control studies.
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Swinson Evans, Tammeka, Suzanne West, Linda Lux, Michael Halpern, and Kathleen Lohr. Cancer Symptoms and Side Effects: A Research Agenda to Advance Cancer Care Options. RTI Press, July 2017. http://dx.doi.org/10.3768/rtipress.2017.rb.0016.1707.
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Cancer survivors have unique physical, psychological, social, and spiritual health needs. These can include symptoms and side effects associated with cancer and cancer treatment, such as pain, cognitive dysfunction, insomnia, and elevated anxiety and depression. This research brief summarizes a landscape review done for the Patient Centered Outcomes Research Institute (PCORI) to develop a clear, comprehensive understanding of the state of research as of the mid-2000s. We conducted a targeted search strategy to identify projects funded by federal and commercial sources and the American Cancer Society (ACS) in addition to identifying funding opportunities released by the National Institutes of Health (NIH). We conducted additional review to identify studies focused on symptom and side-effect measures and five priority topic areas (selected by PCORI prior to the review) in the following five databases (from January 2005- through September 2015) with an inclusion criteria in an adapted PICOTS framework (populations, interventions, comparators, outcomes, time frames, and settings). We identified 692 unduplicated studies (1/2005 to 9/2015) and retained 189 studies about cancer symptom and side-effect management. Of these studies, NIH funded 40% and the ACS 33%. Academic institutions, health care systems, other government agencies, and private foundations or industry supported the remainder. We identified critical gaps in the knowledge base pertaining to populations, interventions, comparators (when those are relevant for comparative effectiveness reviews), and outcomes. We also discovered gaps in cross-cutting topics, particularly for patient decision-making studies, patient self-management of cancer symptoms and side effects, and coordinated care.
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Acred, Aleksander, Milena Devineni, and Lindsey Blake. Opioid Free Anesthesia to Prevent Post Operative Nausea/Vomiting. University of Tennessee Health Science Center, July 2021. http://dx.doi.org/10.21007/con.dnp.2021.0006.
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Purpose The purpose of this study is to compare the incidence of post-operative nausea and vomiting (PONV) in opioid-utilizing and opioid-free general anesthesia. Background PONV is an extremely common, potentially dangerous side effect of general anesthesia. PONV is caused by a collection of anesthetic and surgical interventions. Current practice to prevent PONV is to use 1-2 antiemetics during surgery, identify high risk patients and utilize tracheal intubation over laryngeal airways when indicated. Current research suggests minimizing the use of volatile anesthetics and opioids can reduce the incidence of PONV, but this does not reflect current practice. Methods In this scoping review, the MeSH search terms used to collect data were “anesthesia”, “postoperative nausea and vomiting”, “morbidity”, “retrospective studies”, “anesthesia, general”, “analgesics, opioid”, “pain postoperative”, “pain management” and “anesthesia, intravenous”. The Discovery Search engine, AccessMedicine and UpToDate were the search engines used to research this data. Filters were applied to these searches to ensure all the literature was peer-reviewed, full-text and preferably from academic journals. Results Opioid free anesthesia was found to decrease PONV by 69%. PONV incidence was overwhelming decreased with opioid free anesthesia in every study that was reviewed. Implications The future direction of opioid-free anesthesia and PONV prevention are broad topics to discuss, due to the nature of anesthesia. Administration of TIVA, esmolol and ketamine, as well as the decision to withhold opioids, are solely up to the anesthesia provider’s discretion. Increasing research and education in the importance of opioid-free anesthesia to decrease the incidence of PONV will be necessary to ensure anesthesia providers choose this protocol in their practice.
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Improving the counseling and medical care of postabortion patients in Egypt. Population Council, 1995. http://dx.doi.org/10.31899/rh1995.1026.
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This pilot study conducted in Cairo and Minya examined the effects of improving the medical care and counseling of post-abortion patients in Egypt. A pre-test/post-test, no control group study design was used to measure the effects of an intervention that upgraded physicians' clinical and interpersonal communication skills for the care of post-abortion patients, including counseling and family planning (FP). The study's surveys utilized direct interviews with staff working in the OB/GYN wards, structured observations of treatment procedures and counseling of post-abortion patients, and interviews with patients prior to discharge. Changes in the clinical management of post-abortion patients were introduced through a five-day training program in each hospital for senior staff, who then trained junior colleagues individually. Training for nurses and other paramedical personnel was also provided. Results demonstrate that the use of vacuum aspiration for treating post-abortion patients offers significant potential benefits for women, service providers, and the health care system. As this report states, the challenge now is to consolidate the experience gained from this study and develop a larger-scale introduction program in Egypt for the use of vacuum aspiration, combined with minimal pain-control medication and improved counseling.