Quality of Life Associated with Daily Opioid Therapy in a Primary Care Chronic Pain Sample

2009 ◽  
Vol 2009 ◽  
pp. 290-291
Author(s):  
S. Abram
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Chronic Pain ◽  
Opioid Therapy

scholarly journals Quality of Life Associated with Daily Opioid Therapy in a Primary Care Chronic Pain Sample

2008 ◽  
Vol 21 (2) ◽  
pp. 108-117 ◽  
Author(s):  
K. S. Dillie ◽  
M. F. Fleming ◽  
M. P. Mundt ◽  
M. T. French
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Chronic Pain ◽  
Opioid Therapy

scholarly journals The Impact of a Primary Care, Pharmacist-Driven Intervention in Patients with Chronic Non-Cancer Pain—A Pilot Study

Pharmacy ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 113
Author(s):  
Mo Chen ◽  
Tejal Patel ◽  
Feng Chang
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Chronic Pain ◽  
Cancer Pain ◽  
Family Health ◽  
Primary Care Settings ◽  
Pain Intervention ◽  
Family Health Team ◽  
The Impact

Background: Chronic pain is a prevalent condition, experienced by 15.3% to 55% of Canadians, that is difficult to manage. With their broad accessibility and expertise on drugs, primary care pharmacists can help patients optimize their pain management. Methods: The objective of this study is to examine the effectiveness of a primary care, pharmacist-driven chronic pain intervention on pain and quality of life in patients with chronic non-cancer pain. A three-month naturalistic prospective study was conducted in primary care settings (five community pharmacies and one Family Health Team) across Ontario, Canada with a total of six pharmacists and 19 study participants. The primary care, pharmacist-driven chronic pain intervention consisted of patient assessments, medication reviews, care plan recommendations, and patient education. In order to evaluate the effectiveness of the intervention, pain intensity, pain interference, and quality of life were evaluated at baseline and at follow up (week 2 and month 3). Results: Trends towards improvement in pain and quality of life were found, however, these improvements were not statistically significant at follow up (month 3). Conclusions: This study provides the foundational research required to better understand the impact of Ontario pharmacists’ extended role in pain management in non-cancer patients within multiple primary care settings (e.g., Family Health Team, etc.) and has illustrated the importance of modifying and customizing care plans in patients with chronic pain. A larger sample size with tailored outcome measures may be necessary to better highlight significant improvements in pain and quality of life in patients with chronic non-cancer pain using a primary care, pharmacist-driven intervention.

scholarly journals Pain neuroscience education and physical exercise for patients with chronic spinal pain in primary healthcare: a randomised trial protocol

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Miguel A. Galán-Martín ◽  
Federico Montero-Cuadrado ◽  
Enrique Lluch-Girbes ◽  
M. Carmen Coca-López ◽  
Agustín Mayo-Iscar ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Primary Care ◽  
Chronic Pain ◽  
Clinical Practice ◽  
Physical Exercise ◽  
Public Health System ◽  
The Public ◽  
Neuroscience Education

Abstract Background Chronic musculoskeletal pain affects more than 20% of the population, and the prevalence is increasing, causing suffering, loss of quality of life, disability, and an enormous expenditure on healthcare resources. The most common location for chronic pain is the spine. Many of the treatments used are mainly passive (pharmacological and invasive) and poor outcomes. The treatments currently applied in the public health system do not comply with the recommendations of the main clinical practice guidelines, which suggest the use of educational measures and physical exercise as the first-line treatment. A protocol based on active coping strategies is described, which will be evaluated through a clinical trial and which could facilitate the transfer of the recommendations of the clinical practice guidelines to a primary care setting. Methods Randomised and multicentre clinical trials, which will be carried out in 10 Primary Care centres. The trial will compare the effect of a Pain Neuroscience Education program (six sessions, 10 h) and group physical exercise (18 sessions program carried out in six weeks, 18 h), with usual care physiotherapy treatment. Group physical exercise incorporates dual tasks, gaming, and reinforcement of contents of the educational program. The aim is to assess the effect of the intervention on quality of life, as well as on pain, disability, catastrophism, kinesiophobia, central sensitisation, and drug use. The outcome variables will be measured at the beginning of the intervention, after the intervention (week 11), at six months, and a year. Discussion Therapeutic interventions based on active coping strategies are essential for the treatment of chronic pain and the sustainability of the Public Health System. Demonstrating whether group interventions have an effect size is essential for optimising resources in such a prevalent problem. Trial registration NCT03654235 “Retrospectively registered” 31 August 2018.

scholarly journals Group Interprofessional Chronic Pain Management in the Primary Care Setting: A Pilot Study of Feasibility and Effectiveness in a Family Health Team in Ontario

2013 ◽  
Vol 18 (5) ◽  
pp. 237-242 ◽  
Author(s):  
Ricardo N Angeles ◽  
Dale Guenter ◽  
Lisa McCarthy ◽  
Martha Bauer ◽  
Miriam Wolfson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Resource Utilization ◽  
Health Resource ◽  
Health Resource Utilization ◽  
Significant Difference ◽  
The Mean

BACKGROUND: Approximately 18.9% of Canadians live with chronic pain. Primary care reform in Ontario presents unique opportunities to assess approaches to help these patients.OBJECTIVE: To assess the feasibility of an interprofessional primary care-based program for patients living with chronic pain, and to examine the potential impact of such a program on quality of life and health resource utilization.METHODS: >An embedded mixed-methods evaluation (randomized controlled trial with waiting list control and semistructured interviews) of an eight-week series of small group sessions exploring multifactoral aspects of pain management was performed. Participants were randomly assigned to early intervention (EI) or delayed intervention (DI) groups. All participants received the intervention; the DI group served as a control group for comparison with the EI group. Outcomes included the Short Form-36 Health Survey version 2 (SF-36v2), medication use and health care utilization. Qualitative interviews were conducted to identify areas for program improvement.RESULTS: A total of 240 patients were recruited and 63 agreed to participate. The mean (± SD) age of the participants was 55±14.1 years and 62.3% were female. There was no significant difference in the mean change in SF-36v2 summary scores between the EI and DI groups. However, the SF-36v2 subscale score for bodily pain was significantly improved in the EI group compared with the DI group after six months of observation (mean difference = 13.1 points; P<0.05). There was also significant improvement in this score when both groups were pooled and aggregate preintervention and postintervention scores were compared. There was a significant decrease in the mean number of clinic visits in the six-month period following the intervention compared with the six-month period before the intervention (P=0.043).CONCLUSION: An interprofessional program in primary care for patients living with chronic pain may lead to improvements in quality of life and health resource utilization. The challenges to the feasibility of the program and its evaluation are recruitment and retention of patients, leading to the conclusion that the program, as it was conducted in the present study, is not appropriate for this setting.

Opioids May be Appropriate for Chronic Pain

2020 ◽  
Vol 48 (2) ◽  
pp. 241-248 ◽  
Author(s):  
Paul J. Christo
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Cancer Pain ◽  
Treatment Option ◽  
Severe Pain ◽  
Opioid Therapy ◽  
Therapeutic Options ◽  
Opioid Epidemic ◽  
Pain Care

Patients living with chronic pain require appropriate access to opioid therapy along with improved access to pain care and additional therapeutic options. It's both medically reasonable and ethical to consider opioid therapy as a treatment option in the management of chronic, non-cancer pain for a subset of patients with severe pain that is unresponsive to other therapies (e.g., injections, other medications, integrative strategies), negatively impacts function or quality of life, and will likely outweigh the potential harms. This paper will examine opioid therapy in the setting of the opioid epidemic, why critics feel that the CDC guideline has resulted in harsh consequences for patients and their physicians, and the rationale for opioid therapy as a means of providing ethical and compassionate pain care.

scholarly journals Whole Health Options and Pain Education (wHOPE): A Pragmatic Trial Comparing Whole Health Team vs Primary Care Group Education to Promote Nonpharmacological Strategies to Improve Pain, Functioning, and Quality of Life in Veterans—Rationale, Methods, and Implementation

Pain Medicine ◽  
2020 ◽  
Vol 21 (Supplement_2) ◽  
pp. S91-S99
Author(s):  
Karen H Seal ◽  
William C Becker ◽  
Jennifer L Murphy ◽  
Natalie Purcell ◽  
Lauren M Denneson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Pragmatic Trial ◽  
Care Group ◽  
Pain Education ◽  
Primary Care Group ◽  
Health Model

Abstract Background The Whole Health model of the U.S. Department of Veterans Affairs (VA) emphasizes holistic self-care and multimodal approaches to improve pain, functioning, and quality of life. wHOPE (Whole Health Options and Pain Education) seeks to be the first multisite pragmatic trial to establish evidence for the VA Whole Health model for chronic pain care. Design wHOPE is a pragmatic randomized controlled trial comparing a Whole Health Team (WHT) approach to Primary Care Group Education (PC-GE); both will be compared to Usual VA Primary Care (UPC). The WHT consists of a medical provider, a complementary and integrative health (CIH) provider, and a Whole Health coach, who collaborate with VA patients to create a Personalized Health Plan emphasizing CIH approaches to chronic pain management. The active comparator, PC-GE, is adapted group cognitive behavioral therapy for chronic pain. The first aim is to test whether the WHT approach is superior to PC-GE and whether both are superior to UPC in decreasing pain interference in functioning in 750 veterans with moderate to severe chronic pain (primary outcome). Secondary outcomes include changes in pain severity, quality of life, mental health symptoms, and use of nonpharmacological and pharmacological therapies for pain. Outcomes will be collected from the VA electronic health record and patient-reported data over 12 months of follow-up. Aim 2 consists of an implementation-focused process evaluation and budget impact analysis. Summary This trial is part of the Pain Management Collaboratory, which seeks to create national-level infrastructure to support evidence-based nonpharmacological pain management approaches for veterans and military service personnel.

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