Pain intensity and pain medication prescription patterns in Veterans with heart failure and back pain

In order to evaluate the effectiveness of a rehabilitation programme for patients with chronic back pain, data on the subjective outcomes of perceived pain intensity (as measured by the Visual Analogue Scale Horizontal) and perceived level of disability (as measured by the Oswestry Low Back Pain Disability Questionnaire), and the objective outcome of functional capacity (as measured by the West Standardised Evaluation), were collected on 51 subjects prior to entry into a back pain rehabilitation programme and at discharge. The results at discharge showed a significant reduction in the perceived level of disability and a significant Increase in the functional capacity. The perceived pain intensity did not change significantly. The discussion focuses on the importance of directing therapeutic interventions towards increasing physical function rather than concentrating on the reduction or elimination of pain.

Download Full-text

Cross-sectoral Analysis of 1.4 Million AOK-insured Patients with Back Pain in Baden-Württemberg – What Influence does Outpatient Specialist Care Have?

Zeitschrift für Orthopädie und Unfallchirurgie ◽

10.1055/a-1542-9327 ◽

2021 ◽

Author(s):

Tom R. Jansen ◽

Heinz Endres ◽

Lina Barnewold ◽

Petra Kaufmann-Kolle ◽

Sabine Knapstein ◽

...

Keyword(s):

Primary Care ◽

Back Pain ◽

Surgical Procedures ◽

Regional Differences ◽

Pain Medication ◽

Hospital Treatment ◽

Specialist Care ◽

Billing Data ◽

Primary Care Clinics ◽

The Mean

Abstract Background Back pain is one of the leading causes of disability globally and the most common musculoskeletal pain in Germany. The lifetime prevalence of back pain ranges from 74% to 85%, and the point prevalence ranges from 32% to 49%. One in five individuals with statutory health insurance visits a doctor at least once a year for back pain, and 1 in 20 individuals is on sick leave at least once a year. The question as to what extent can different outpatient care concepts substantially contribute to improving care and avoiding inpatient hospital treatment has repeatedly been the subject of controversial political discussions. This study aimed to present a description of the reality of care in Baden-Württemberg (BW), Germany, based on claims data. Material and Methods Anonymised routine billing data of AOK Baden-Württemberg were analysed in compliance with data protection regulations. The billing data cover the outpatient and inpatient care sectors. All AOK patients in BW who received at least one ICD10 diagnosis from their physician in the first half of 2015 were considered for the analysis. Patients with at least one diagnosis of back pain were evaluated as patients with back pain, whereby the assignment to the diagnosis group of specific or non-specific back pain was made based on the code. Results In the first half of 2015, nearly 988 925 patients with back pain were registered in the 6696 primary care clinics in BW, approximately 302 524 patients in 1172 orthopaedic clinics and 17 043 patients in 89 neurosurgical clinics. Primary care clinics reported back pain diagnosis in 34.6%, orthopaedic clinics in 51.9% and neurosurgical clinics in 78.6% of cases. Primary care clinics diagnosed a specific cause in approximately one-third of patients with back pain, orthopaedic clinics in approximately 40% of their patients and neurosurgery clinics in one in two cases. Overall, approximately 1.2% of 1.3 million patients with back pain (January to December 2015 in BW) were hospitalised. Inpatient therapy consisted of surgical therapy and conservative therapy. Nucleotomy, decompression and spondylodesis were the three most common surgical procedures performed. Pain medication and remedy prescriptions decreased pain after spinal surgery. There are significant regional differences in referral and surgery rates. The mean inpatient referral rate was 535 of 100 000 AOK insurants, and the median was 536 of 100 000 AOK insurants. The mean surgery rate among all admitted patients with back pain was 49.9%, and the median was 49.8%. Conclusion The vast majority of patients with back pain are treated as outpatients. Only approximately 1.2% of all patients with back pain were treated as inpatients in 2015. Of these, approximately half underwent surgery. Spinal surgeries led to a decrease in pain medication and remedy prescription postoperatively. The three most frequent surgical procedures were ‘decompression’, ‘excision of disc tissue’ and ‘spondylodesis’. There were significant regional differences.

Download Full-text

Prevalence of pain and self-medication pattern of Paracetamol and NSAIDs among university students in United Arab Emirates

Research Journal of Pharmacy and Technology ◽

10.52711/0974-360x.2021.00590 ◽

2021 ◽

pp. 3393-3398

Author(s):

Nageeb AGM Hassan ◽

Sabrina Ait Gacem ◽

Afnan Abdul-Hameed Al-Qaysi ◽

Maryam Jaafar AlAani

Keyword(s):

Back Pain ◽

University Students ◽

Negative Correlation ◽

Mefenamic Acid ◽

Pain Medication ◽

The Body ◽

Menstrual Pain ◽

Self Medication ◽

Pain Medications ◽

Study Results

Background: Most of individuals do not prefer consulting a physician when they suffer from mild to moderate pain or fever and they tend to get over the counter drugs (OTC) from the pharmacy. Non-steroidal anti-inflammatory (NSAIDs) consumption pattern and self-medication behavior is a common practice especially during adolescence. Many self-medication behaviors were observed from individuals especially students which use NSAIDs frequently and that might lead to some unwanted effects due to improper knowledge and awareness. Although NSAIDs are considered as safe medications in general, but serious side effects are still present and can affect different parts of the body. Objectives: Our study aims to assess the correlation between several types of pain and self-medication pattern of Paracetamol and NSAIDs among university students in UAE. Methods: This was a cross-sectional study that was conducted among individuals aged 17 years and above from different nationalities and specialties from June till July 2018. The data were obtained through a validated self-administrated questionnaire that was distributed as a hardcopy as well as online. Data collection took place in UAE universities targeting 345 university students. The data were analyzed using SPSS version 20 and the results were considered significant at the 0.05 level with a 95% Confidence interval. Results: The current study results show that (67%) of individuals use pain medications to relief pain associated with headache. The majority of individuals reported that they suffer from pain at least one day weekly (26.4%). The pain that mostly led individuals to take pain medications is headache and it is accounts for (67%). The most frequently used pain medication is Paracetamol (80.9%) followed by Ibuprofen, Mefenamic acid and Diclofenac (35.4%, 17.1% and 13.6%) respectively. It was observed that (28.4%) of individuals use more than one pain medication at the same time. The results show that there was a significant correlation between the intake of Mefenamic acid for pain and individuals that reported the use of pain medications for menstrual pain [p=0.000, OR: 5.223, 95% CI: 2.73 - 9.96]. The significant intake of Aspirin for back pain [p=0.020, OR: 3.239, 95% CI: 1.159 - 9.05] and Diclofenac for both muscles pain and back pain back pain [p=0.000, OR: 3.061, 95% CI: 1.792 - 5.228), p=0.000, OR: 3.037, 95% CI: 1.789 - 5.15 respectively] and Paracetamol for both toothache and fever [p=0.002, OR: 1.220, 95% CI: 1.120 - 1.32 and p=0.044, OR: 1.137, 95% CI: 1.027 - 1.259 respectively]. The following NSAIDs showed a significant correlation with the intake of pain medications for toothache: Aspirin [p=0.018, OR: 3.167, 95% CI: 1.171 - 8.56], Ibuprofen [p=0.004, OR: 1.618, 95% CI: 1.201 - 2.17] and Diclofenac [p=0.000, OR: 2.692, 95% CI: 1.591 - 4.55]. Only Paracetamol was found to have a significant correlation for the use during fever [p=0.044, OR: 1.137, 95% CI: 1.027 - 1.259] while other pain medications were found to have a negative correlation. Conclusion: The majority of respondents use the pain medications to relief headache and the most frequently used pain medication was Paracetamol. A significant correlation was observed between the intake of Mefenamic acid for pain and individuals that reported the use of pain medications for menstrual pain as well as Aspirin intake for back pain, Diclofenac for muscles pain and back pain. Only Paracetamol was found to have a significant correlation for the use during fever while other pain medications were found to have a negative correlation.

Download Full-text

A Dyadic Investigation of Depressed Affect and Interspousal Behavior in Couples With Chronic Back Pain

Annals of Behavioral Medicine ◽

10.1093/abm/kaab100 ◽

2021 ◽

Author(s):

Kristina M Post ◽

David A Smith ◽

John W Burns ◽

Laura S Porter ◽

Francis J Keefe

Keyword(s):

Back Pain ◽

Pain Intensity ◽

Hierarchical Linear Modeling ◽

Chronic Back Pain ◽

Pain Behavior ◽

Linear Modeling ◽

Electronic Diary ◽

Higher Criticism ◽

Depressed Affect ◽

And Behavior

Abstract Background Depression and marital discord are characteristic not only of individuals with chronic low back pain (ICPs) but also of their spouses. Purpose We examined actor–partner interdependence models to evaluate associations among depressed affect and criticism and support of partners at the same time point (concurrent effects) and 3 hr later (lagged effects). Fully dyadic models were used to account for both within-person and cross-spouse associations among depressed affect, criticism, and support for ICPs and spouses. We also examined the direction of the relationships (depressed affect predicting behavior and behavior predicting depressed affect) all while controlling for pain intensity, pain behavior, and the prior dependent variable. Methods ICPs (n = 105) and their spouses completed electronic diary measures of depressed affect and behavior (criticism and support) five times a day for 2 weeks. Hierarchical linear modeling with person-mean centering was used for data analysis. Results Within the same 3 hr epoch, more depressed affect was related to higher criticism and generally less support. Lagged analyses suggested bidirectional relationships between spouse’s own depressed affect and spouse’s own criticism of ICPs. Spouse depressed affect was also associated with decreased support received from ICPs. Pain behavior and pain intensity were also related to depressed affect, criticism, and support especially concurrently. Conclusions Theories and interventions need to address not only ICP depressed affect but also spouse depressed affect, as spouse depressed affect may be a stress generating precursor to criticism and support.

Download Full-text

Prescription Patterns of Sodium-Glucose Cotransporter 2 Inhibitors and Cardiovascular Outcomes in Patients with Diabetes Mellitus and Heart Failure

Cardiovascular Drugs and Therapy ◽

10.1007/s10557-021-07234-7 ◽

2021 ◽

Author(s):

Felix Hofer ◽

Niema Kazem ◽

Bernhard Richter ◽

Patrick Sulzgruber ◽

Ronny Schweitzer ◽

...

Keyword(s):

Diabetes Mellitus ◽

Heart Failure ◽

Cardiovascular Outcomes ◽

Prescription Patterns ◽

Sodium Glucose Cotransporter ◽

Patients With Diabetes

Download Full-text

Rasterstereographic Analysis of Lateral Shift in Patients with Lumbar Disc Herniation: A Case Control Study

Advances in Orthopedics ◽

10.1155/2018/6567139 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8

Author(s):

Britta K. Krautwurst ◽

Jürgen R. Paletta ◽

Sylvia Mendoza ◽

Adrian Skwara ◽

Melvin Mohokum

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Intensity ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Pelvic Tilt ◽

Lumbar Disc ◽

Lateral Shift ◽

Healthy Controls ◽

Low Back

Objective. Detection of a lateral shift (LS) in patients with diagnosed disc herniation compared to healthy controls. Summary of Background Data. A specific lateral shift (LS) pattern is observed in patients with disc herniation and low back pain, as shown in earlier studies. Methods. Rasterstereography (RS) was used to investigate the LS. Thirty-nine patients with lumbar disc herniation diagnosed by radiological assessment and low back pain and/or leg pain (mean age 48.2 years, mean BMI 28.5, 28 males and 11 females) and 36 healthy controls (mean age 47.4 years, mean BMI 25.7, 25 males and 11 females) were analysed. LS, pelvic tilt, pelvic inclination, lordotic angle, and trunk torsion were assessed. Results. The patient group showed a nonsignificant increase in LS, that is, 5.6 mm compared to the healthy controls with 5.0 mm (p = 0.693). However, significant differences were found between groups regarding pelvic tilt in degrees (patients 5.9°, healthy controls 2.0°; p = 0.016), trunk torsion (patients 7.5°, controls 4.5°; p = 0.017), and lordotic angle (patients 27.5°, healthy controls 32.7°; p = 0.022). The correlation between pain intensity and the FFbH-R amounted 0.804 (p = < 0.01), and that between pain intensity and the pain disability index was 0.785 (p < 0.01). Discussion. Although some studies have illustrated LS with disc herniation and low back pain, the present findings demonstrate no significant increase in LS in the patient group compared to healthy controls. Conclusion. The patients with lumbar disc herniation did not demonstrate an increased LS compared to healthy controls. Other parameters like pelvic tilt and inclination seemed to be more suitable to identify changes in posture measured by RS in patients with low back pain or disc herniation.

Download Full-text