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.
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Mikhail, Christine. "Physiotherapists' use of interventions with high evidence of effectiveness in the management of low back pain." Thesis, McGill University, 2004. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=80333.
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Background. Evidence-based practice aims to improve patient care and service delivery, particularly in the management of individuals with low back pain, the largest client group seen by out-patient physiotherapists. Objective: This study determined the prevalence of use of interventions with evidence of effectiveness in the management of acute non-specific low back pain by physiotherapists. Methods. A multi-centered cross-sectional study was conducted on 100 physiotherapists working with low back pain patients. Using a telephone-administered interview, therapists described their current and desired treatment practices for a typical case of low back pain. Each intervention reported was coded according to its evidence of effectiveness (strong, moderate, limited or none) as per Van Tulder's rating system. Information on clinician, workplace and client characteristics was also obtained. Results. The prevalence of use of interventions with strong or moderate evidence of effectiveness was 68%. Almost all therapists use interventions with limited or no evidence of effectiveness or moderate evidence of ineffectiveness. Users of interventions with high evidence of effectiveness, as compared to non-users, had graduated more recently (p = 0.0098) and had taken a higher number of post-graduate clinical courses (p = 0.0091). Conclusion. Although most therapists use interventions with high evidence of effectiveness, much of their treatment programs consist of interventions that are not well studied in the literature.
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Reynolds-Wilcox, Wendy Lee. "The impact of child life non-pharmacologic pain interventions on pediatric patient's pain perception in the emergency department." CSUSB ScholarWorks, 2004. https://scholarworks.lib.csusb.edu/etd-project/2645.
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The purpose of this current study is to examine the impact of non-pharmacologic pain interventions administered by trained Child Life professionals in an emergency department on pain perception in children. Results showed no significant decrease in children's pain report during the medical procedure compared to before the medical procedure. However, pain after the medical procedure is significantly less than pain during the medical procedure.
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Mathis, Taylor. "Beating Diabetes: The Use of a Novel Nutrition and Medication Adherence Measure to Improve the Outcomes of Patients with Diabetes." University of Cincinnati / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin153570253467365.
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Armstrong, Dometrives. "Educational Module Toolkit to Assist Adult Patients with Type II Diabetes Mellitus." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4498.
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Diabetes is a challenging chronic disease for adult patients to manage effectively. Poor adherence to prescribed medications treatment is one of the main reasons for poor blood sugar control. Despite healthcare providers' efforts to emphasize the importance of taking medications, adult patients with Type II diabetes frequently present with complications related to persistent failure to adhere to prescribed medication regimen. These patients should thoroughly understand why adhering to a strict medication regimen to maintain control of their blood sugar is so important. The purpose of this project, guided by Orem's self-care deficit nursing theory, was to develop an educational module toolkit that identifies best practices for nurses to address issues of medication adherence with adult patients with Type II diabetes. Future implementation of these toolkit resources may enhance nurses' ability to teach adult patients how to adhere to their medication regimen. Five participants, all considered professional diabetes content experts, were invited to evaluate the educational module toolkit subject matter. The completion response rate was 100% (n = 5). The content experts rated survey items using a 5-point Likert scale where 1= strongly disagree, 2= disagree, 3= not applicable, 4 = agree and 5= strongly agree and responded to 2 questions that allowed for narrative feedback. The experts were satisfied with the content of the educational module toolkit; suggesting that the toolkit may serve as a functional guide for nurses assisting adult patients with diabetes. Improved medication regimen compliance may produce cascading effects; helping these patients achieve a better quality of life while producing positive social change within their families and communities.
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Chizick, Jarett. "Ankylosing Spondylitis & Chronic Pain Syndrome: Bridging the Gap Between Perpetuated Medicine & Holistic Therapies." ScholarWorks @ UVM, 2015. http://scholarworks.uvm.edu/graddis/329.
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Ankylosing Spondylitis (AS) and Chronic Pain Syndrome (CPS) can be treated in many different ways. I found a problem in the balance of healing modalities surrounding diagnosis and care of illness and disease. This struggle is not singular to AS and CPS, but universal to physical and mental concerns. Some effective treatments and therapies are not recognized as such or are just beginning to become so. The scope of my work reflects on the course of my life. It was heavily influenced by the way my medical care was managed from an early age and how it evolved over the years. Through my educational program, I examined the necessity to bridge the gap between treatment paradigms and to expand on a broader, more inclusive, healing rubric. This rubric includes a broader emphasis on skill-based and complementary and alternative medicines. The viability to incorporate holistic health therapies earlier in life is explored through my use of the Scholarly Personal Narrative (SPN) qualitative research method. I chose this methodology because scientific fact could be argued either way for one therapeutic approach over another. By incorporating lived experience through SPN the union and cohesion necessary in all healing modalities, and their positive aspects, can be seen. The truth becomes self-evident.
The results of this examination showed awareness earlier in life toward alternative and holistic treatments being paramount. Parents and educators lack information concerning modern therapeutic approaches. It also showed each situation will vary, but choice in treatment for ailments and illness of all kinds is not only viable, but highly recommended and researched. Access issues such as health insurance remain obstacles with some treatments and therapies, while others are a matter of cost prohibition, such as nutrition therapies. The implications of my work indicate a need for earlier incorporation of holistic healing programs and skill based therapies alongside perpetuated medical models in early childhood development and education.
In conclusion, awareness towards medical concerns and how we as a society treat them can be improved upon by systemically incorporating less harmful therapies earlier in life. Fostering relations between medical providers, care providers and educators for students' wellbeing should be the foreground of any educational policy. Educators and parents alike should be made aware of and take advantage of effective skill-based treatments before a physical or mental condition surfaces or medication only approaches are authoritatively recommended. Integrating programs that build strong mental resilience and focus on youth development and education can reduce the necessity for more invasive treatments or medications should an ailment or illness develop.
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Hughes, James A. "Person, environment, and health and illness factors influencing time to first analgesia and patient experience of pain management in the adult emergency department." Thesis, Queensland University of Technology, 2018. https://eprints.qut.edu.au/123311/3/James_Hughes_Thesis.pdf.
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This thesis explored patient, clinician, environmental and illness factors that influence how doctors and nurses treat patients who present to the emergency department in pain. The findings confirm that patients are more likely to receive analgesic medication in a shorter time and have a more positive experience with pain care when the emergency department is less busy, they have less pre-existing illness, and have a higher socioeconomic status. The identification of these factors has important implications for making changes to the way emergency departments and emergency clinicians treat pain in a timely and patient-centered manner.
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Granat, Nicklas, and Sofie Malmström. "Internetbaserade interventioners effekter vid långvarig smärta : En begränsad systematisk litteraturöversikt." Thesis, Röda Korsets Högskola, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-2827.
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Bakgrund: Långvarig smärta är en av de främsta orsakerna till varaktigt lidande och funktionsnedsättning både i Sverige och globalt. Dagens behandlingsmetoder anses i många fall bristfälliga. I ett allt mer högteknologiskt samhälle utvecklas elektroniska hjälpmedel som stöd till personer med olika sjukdomstillstånd. Tidigare studier visar att internetbaserade interventioner främjar hälsa, lindrar lidande och ökar egenmakten, dock är området fortfarande under snabb utvecklig. Syfte: Att beskriva effekterna av internetbaserade interventioner riktade mot långvarig smärta. Metod: Begränsad systematisk litteraturöversikt med elva kvantitativa artiklar. Resultat: Fem av artiklarna använde KBT, tre artiklar använde ACT och tre artiklar använde självhanteringsmetoder. Fyra effekter av interventionerna framkom; smärtreducering, smärthantering, livskvalitet och psykisk hälsa. Smärthantering förbättrades signifikant, resterande förbättrades, dock ej signifikant. Effekterna är förbättrade till signifikant förbättrade vid uppföljningar efter avslutad behandling. Slutsats: Att införa internetbaserade interventioner som tillägg till klinisk omvårdnad kan innebära hälsovinster för enskild person samt för samhället. Dock ses svårigheter att implementera den här typen av intervention på en större befolkning då faktorer som tillgänglighet och könsfördelning påverkar negativt. Fortsatt forskning: Jämnare könsfördelning i studier, större geografisk utbredning samt långtidsuppföljningar bör ligga i fokus för framtida forskning.Background: Chronic pain is one of the primary causes to abiding suffering and disabilities in Sweden and globally. Today’s treatment methods are somewhat considered lacking. In a high technology society, as the one we are living in today, the developing of electronic aids for persons with different disease states increases. Internet-based interventions is considered a part of the future in health care. Aim: The aim of this study was to describe the effects of Internet-based interventions designed for people with chronic pain. Method: A rapid systematic review with eleven quantitative studies. Result: Five studies used CBT, three studies used ACT and three is denominated as self-management. Four effects became clear; mental health, pain management, pain reducing, and quality of life. Pain management showed significant improvement, the other three effects showed improvement, although no significant improvement. At follow-up after post intervention the effects improved, some with significance. Conclusion: To implement internet-based interventions as an addition to clinical care could mean health benefits for the community as well as the individual person. However, this intervention type is not accessible on a larger population. Further Research: There should be focus on gender equality, broader geographic areas and longer follow-ups in future research.
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Hasson, Dan. "Stress Management Interventions and Predictors of Long-term Health : Prospectively Controlled Studies on Long-term Pain Patients and a Healthy Sample from IT- and Media Companies." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-5944.
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Erasmus, Estelle Annette. "The effect of soft tissue mobilization techniques on the symptoms of chronic posterior compartment syndrome in runners a multiple case study approach /." Thesis, Pretoria : [s.n.], 2008. http://upetd.up.ac.za/thesis/available/etd-09252008-113736.
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Mann, Elizabeth Gayle. "Self-Management of Chronic Pain: Interventions, Strategies, Barriers, and Facilitators." Thesis, 2013. http://hdl.handle.net/1974/8321.
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Background & Purpose:
Chronic pain is a prevalent chronic condition for which the best management options rarely provide complete relief. Individuals with chronic pain with neuropathic characteristics (NC) report more severe pain and experience less relief from interventions. Little is known about current self-management practices. The purpose of this dissertation was to inform self-management of chronic pain with and without NC at the individual, health system, and policy levels using the Innovative Care for Chronic Conditions Framework.
Methods:
The study included a systematic search and review and cross-sectional survey. The review evaluated the evidence for chronic pain self-management interventions and explored the role of health care providers in supporting self-management. The survey was mailed to 8,000 randomly selected Canadians in November 2011, and non-respondents were followed-up in May 2012. Screening questions were included for both chronic pain and NC. The questionnaire captured pain descriptions, self-management strategies, and self-management barriers, and facilitators.
Results:
Findings of the review suggested that self-management interventions are effective in improving pain and health outcomes. Health care professionals provided self-management advice and referred individuals to self-management interventions. The questionnaire was completed by 1,520 Canadians. Those with chronic pain (n=710) identified primary care physicians as the most helpful pain management professional. Overall, use of non-pharmaceutical medical self-management strategies was low. While use positive emotional self-management strategies was high, individuals with NC were more likely to use negative emotional self-management strategies compared to those without NC. Multiple self-management barriers and facilitators were identified, however those with NC were more likely than those without NC to experience low self-efficacy, depression and severe pain which may impair the ability to self-management.
Conclusions:
Health care professionals have the opportunity to improve chronic pain outcomes by providing self-management advice, referring to self-management interventions, and addressing self-management barriers and facilitators. Individuals with NC may require additional health services to address their greater self-management challenges, and further research is needed to identify non-pharmaceutical interventions effective in relieving chronic pain with NC. Public policy is needed to facilitate health systems in providing long-term self-management support for individuals with chronic pain.Thesis (Ph.D, Nursing) -- Queen's University, 2013-09-25 12:57:58.59
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Hadi, M. A., David P. Alldred, M. Briggs, and T. Munyombwe. "Effectiveness of pharmacist-led medication review in pain management: systematic review and meta-analysis." 2014. http://hdl.handle.net/10454/9841.
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NoThe objective of this article was to evaluate the effectiveness of pharmacist-led medication review in chronic pain management. Six electronic databases (Medline, Embase, PsycInfo, CINHAL, CENTRAL, International Pharmaceutical Abstracts) reference lists of retrieved articles and relevant websites were searched for randomized controlled trials published in the English language involving adults with chronic pain. Studies were included if one of the intervention arms had received pharmacist-led medication review independently or as part of a multidisciplinary intervention. Risk of bias was assessed for all the included studies. The search strategy yielded 583 unique articles including 5 randomized controlled trials. Compared with control, meta-analysis showed that participants in the intervention group had: a 0.8-point reduction in pain intensity on a 0 to 10 numerical rating scale at 3 months [95% confidence interval (CI), -1.28 to -0.36] and a 0.7-point reduction (95% CI, -1.19 to -0.20) at 6 months; a 4.84 point (95% CI, -7.38 to -2.29) and -3.82 point (95% CI, -6.49 to -1.14) improvement in physical functioning on a 0- to 68-point function subscale of Western Ontario and McMaster Universities Osteoarthritis Index at 3 and 6 months, respectively; and a significant improvement in patient satisfaction equivalent to a "small to moderate effect." Pharmacist-led medication review reduces pain intensity and improves physical functioning and patient satisfaction. However, the clinical significance of these findings remain uncertain due to small effect size and nature of reported data within clinical trials that limits recommendation of wider clinical role of pharmacist in chronic pain management.
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Maddison, Christopher Royce. "A CBT inpatient chronic pain management model: factors impacting treatment outcomes." Thesis, 2015. http://hdl.handle.net/1959.13/1059200.
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Masters Research - Master of Philosophy (MPhil)Biopsychosocial factors are increasingly recognised as important factors in the treatment of chronic pain. This pilot study seeks to identify those psychosocial factors that impact successful treatment outcomes of chronic pain in patients attending a 2 week intensive pain management program. Treatment targeted beliefs, psychological distress (trauma, anxiety and depression), and disability associated with chronic pain. The DASS-21 and Chronic Pain Acceptance questionnaires administered prior to, at completion of, and at 12 weeks post treatment revealed a significant decrease in depression and a significant increase in pain acceptance respectively and maintained over the 12 weeks. The Pain Beliefs Questionnaire results showed significant change in pain beliefs post treatment, however, this was not maintained at 12 weeks post treatment. Outcomes related to biopsychosocial factors, with age positively correlating with gains in acceptance, and number of interventions attempted correlating with poorer reductions in depression. Changes in pain beliefs and maintenance of those changes had a relationship with the distress from previous interventions and surgery. However, of interest in this study were client factors influencing treatment outcomes for example hope, prior beliefs, and acceptance. Both qualitative and quantitative future studies would broaden our understanding of common factors impacting the management of chronic pain.
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Edwards, Zoe, L. Ziegler, C. Craigs, Alison Blenkinsopp, and M. I. Bennett. "Pharmacist educational interventions for cancer pain management: a systematic review and meta-analysis." 2018. http://hdl.handle.net/10454/16804.
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YesEducational interventions by pharmacists for patients with cancer pain aim to improve pain management, but little is known about the different components of interventions and their effectiveness. Our aim was to assess the benefit of pharmacist delivered educational interventions for patients with cancer pain. A systematic review and meta‐analysis of experimental trials testing pharmacist delivered educational interventions for cancer pain was carried out to identify the components of interventions and effectiveness at improving pain‐related outcomes for patients with cancer. A literature review was conducted in EMBASE, MEDLINE, CINAHL, PsycINFO, ASSIA, Web of Science and CENTRAL from inception until January 2018 searching for educational interventions involving a pharmacist for patients with cancer pain. Four studies were included involving 944 patients. Meta‐analysis was carried out where possible. Meta‐analysis of three of the four studies found that mean pain intensity in the intervention group was reduced by 0.76 on a 0–10 scale (95% confidence interval), although only two of the studies used validated measures of pain. Improvements in knowledge, side effects and patient satisfaction were seen although with less reliable measures. Pharmacist educational interventions for patients with cancer pain have been found to show promise in reducing pain intensity. Studies were few and of varying quality. Further, good quality studies should be carried out in this area and these should be comprehensively reported. Trials measuring patient self‐efficacy and patient satisfaction are needed before the impact of the pharmacist delivered interventions on these outcomes can be established.
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Anderson, Colleen McDavid. "Parents' attitudes toward pain medication, parents' perception of children's pain and parents' management of children's pain at home following day surgery or short-stay surgery /." 2002.
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Tomlinson, Justine, V.-L. Cheong, Beth Fylan, Jonathan Silcock, H. Smith, Kate Karban, and Alison Blenkinsopp. "Successful care transitions for older people: a systematic review and meta-analysis of the effects of interventions that support medication continuity." 2019. http://hdl.handle.net/10454/17703.
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YesBackground: medication-related problems occur frequently when older patients are discharged from hospital. Interventions to support medication use have been developed; however, their effectiveness in older populations are unknown. This review evaluates interventions that support successful transitions of care through enhanced medication continuity. Methods: a database search for randomised controlled trials was conducted. Selection criteria included mean participant age of 65 years and older, intervention delivered during hospital stay or following recent discharge and including activities that support medication continuity. Primary outcome of interest was hospital readmission. Secondary outcomes related to the safe use of medication and quality of life. Outcomes were pooled by random-effects meta-analysis where possible. Results: twenty-four studies (total participants=17,664) describing activities delivered at multiple time points were included. Interventions that bridged the transition for up to 90 days were more likely to support successful transitions. The meta-analysis, stratified by intervention component, demonstrated that self-management activities (RR 0.81 [0.74, 0.89]), telephone followup (RR 0.84 [0.73, 0.97]) and medication reconciliation (RR 0.88 [0.81, 0.96]) were statistically associated with reduced hospital readmissions. Conclusion: our results suggest that interventions that best support older patients’ medication continuity are those that bridge transitions; these also have the greatest impact on reducing hospital readmission. Interventions that included self management, telephone follow-up and medication reconciliation activities were most likely to be effective; however, further research needs to identify how to meaningfully engage with patients and caregivers to best support post-discharge medication continuity. Limitations included high subjectivity of intervention coding, study heterogeneity and resource restrictions.
National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant PB-PG-0317-20010).
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Modesto, Gonçalo Miguel Xavier. "Integration of Mobile Health Apps and Web-Based Interventions in the Self-Management of Low Back Pain: A Systematic Review." Master's thesis, 2018. http://hdl.handle.net/10316/81892.
Full textAbstract:
Trabalho Final do Mestrado Integrado em Medicina apresentado à Faculdade de MedicinaConhecimento prévio: A dor lombar (LBP) é um problema de saúde pública com um impacto substancial na capacidade funcional do indivíduo e nas suas atividades de vida diária. O tratamento da LBP é desafiador e complexo e, por isso, requer novas abordagens que promovam uma reabilitação de qualidade, segura e de baixo custo.Objetivo: O objetivo deste estudo é fornecer uma visão geral da evidência disponível e avaliar se os estudos incluídos seguem uma estrutura comum e homogénea que permita avaliar o impacto da utilização de apps e intervenções baseadas na web na auto gestão da dor lombar.Materiais e Métodos: As bases de dados eletrónicas PubMed/Medline, PubMed Central (PMC), PubMed Health, Cochrane CENTRAL e PEDro foram pesquisadas de 2007 até dezembro de 2017. A estratégia de pesquisa incluiu o uso de termos MESH e termos de texto livre, combinando 3 conceitos: LBP, aplicações móveis e autocuidado/autogestão. Foram incluídos ensaios de controlo randomizado (RCTs) e protocolos de RCTs, que usam apps ou intervenções baseadas na web como parte do tratamento para doentes com LBP. Resultados: Um total de 17 artigos relativos a 14 estudos diferentes - 9 ensaios de controlo randomizado e 8 protocolos de RCTs - cumpriram os critérios de inclusão. Os nove RCTs incluíram um total de 1659 participantes, variando de 51 a 398 participantes por estudo. A maioria dos participantes eram mulheres com níveis educacionais elevados (faculdade parcial ou superior). Nenhum estudo analisou a utilização dos cuidados de saúde. Três estudos utilizaram uma app, acessível a partir de vários dispositivos. Elementos interativos foram relatados em todos os estudos.Conclusões: Foi fornecida uma visão geral da evidencia disponível relativamente à integração de apps e intervenções baseadas na web na auto gestão da dor lombar. Os estudos incluídos não seguiram uma estrutura homogénea e apresentaram inúmeros resultados e dados heterogéneos. Desta forma, não foi possível estabelecer uma ideia clara do seu verdadeiro impacto. Os protocolos de RCTs parecem avaliar resultados mais homogéneos e provavelmente fornecerão dados úteis no futuro. A utilização dos cuidados de saúde e períodos de seguimento mais longos devem ser avaliados em ensaios futuros. Os aplicativos e as intervenções baseadas na web podem ser a solução para superar barreiras atuais e aumentar o acesso a uma reabilitação de qualidade, segura e de baixo custo.
Background: Low back pain (LBP) is a highly prevalent public health related problem with a substantial impact on the individual's disability and daily functioning. The challenging and complex treatment of LBP requires new motivational, time and cost-effective approaches. Objective: The aim of this study is to provide an overview of the available evidence and to determine if the included studies follow a well-structured and homogenous design that allow an effective assessment of the impact of mobile health apps and web-based interventions in the self-management of LBP.Methods: Electronic databases such as PubMed/Medline, PubMed Central (PMC), PubMed Health, Cochrane CENTRAL and PEDro were searched from 2007 until December 2017. The search strategy included the use of MESH terms and free-text terms, combining 3 concepts: low back pain, mobile applications and self-care. Randomized control trials (RCTs) and RCT protocols using mobile health apps or web-based interventions as part of the treatment for patients with LBP were included.Results: A total of 17 articles concerning 14 different studies - 9 randomized control trials and 8 RCT protocols - met the inclusion criteria. The nine completed RCTs included a total of 1659 participants, ranging from 51 to 398 participants per study. The majority of the participants were females and reported educational levels as partial college or higher. A wide range of outcome measures were used, although none of the studies reported on health care utilization. There was a significant variation in the reported results, even though some studies indicated improvement in certain outcomes favouring the intervention group. Three studies delivered the content through an app, accessible from multiple devices. Interactive elements were reported in every study.Conclusions: An overview of the available evidence, concerning the integration of mobile health apps and web-based interventions in the self-management of LBP was provided. The included studies did not follow a homogenous design, reporting numerous outcomes and heterogenous data. Therefore, it was not possible to establish a clear idea of its true impact. The protocols for future trials seem to evaluate more homogenous outcomes and are likely to provide future useful data. Health care utilization and longer follow-up periods should be assessed in future trials. Apps and web-based interventions may be the solution to overcome current barriers and increase access to a quality, safe and cost-effective rehabilitation for LBP.
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Knisely, Mitchell R. "Understanding exposure to pharmacogenetically actionable opioids in primary care." Diss., 2016. http://hdl.handle.net/1805/10479.
Full textAbstract:
Indiana University-Purdue University Indianapolis (IUPUI)Pharmacogenetic testing has the potential to improve pain management through addressing wide interindividual variations in responses to pharmacogenetically actionable opioids, ultimately decreasing costly adverse drug effects and improving responses to these medications. A recent review of pharmacogenomics in the nursing literature highlighted the need for nurses to more fully embrace the burgeoning field of pharmacogenomics in nursing research, clinical practice, and education. Despite the promise of pharmacogenetic testing, significant challenges exist for evaluating outcomes related to its implementation, including oversimplification of medication exposure, the complexity of patients' clinical profiles, and the characteristics of healthcare contexts in which medications are prescribed. A better understanding of these challenges could enhance the assessment and documentation of the benefits of pharmacogenetic testing in guiding opioid therapies. This dissertation is intended to address the challenges of evaluating outcomes of pharmacogenetic testing implementation and the need for nurses to lead pharmacogenomic-related research. The dissertation purpose was to advance the sciences of nursing, pain management, and pharmacogenomics through the development of a typology of common patterns of medication exposure to known pharmacogenetically actionable opioids (codeine & tramadol). A qualitative, person-oriented approach was used to retrospectively analyze six months of electronic health record and pharmacogenotype data in 30 underserved adult patients. An overarching typology with eight groups of patients that had one of five opioid prescription patterns (singular, episodic, switching, sustained, or multiplex) and one of three types of medical emphasis of care (pain, comorbidities, or both) were identified. This typology consisted of a description of multiple common patterns that compare and contrast salient factors of exposure and the emphasis of why individuals were seeking care. Furthermore, in an aggregate descriptive analysis evaluating key clinical profile factors, these patients had complex medical histories, extensive healthcare utilization, and experienced significant polypharmacy. These findings can aid in addressing challenges related to the implementation of pharmacogenetic testing in clinical practice and point to ways in which nurses can take the lead in pharmacogenomics research. Findings also provide a foundation for future studies aimed at developing medication exposure measures to capture its dynamic nature and identifying and tailoring interventions in this population.