Interdisciplinary Teams in Endometriosis Care

AbstractEndometriosis-associated chronic pelvic pain can at times be a complex problem that is resistant to standard medical and surgical therapies. Multiple comorbidities and central sensitization may be at play and must be recognized with the help of a thorough history and physical examination. If a complex pain problem is identified, most endometriosis expert reviews and guidelines recommend multidisciplinary care. However, there are no specific recommendations about what should be the components of this approach and how that type of team care should be delivered. There is evidence showing the effectiveness of specific interventions such as pain education, physical therapy, psychological therapies, and pharmacotherapies for the treatment of chronic pain. Interdisciplinary team models have been well studied and validated in other chronic pain conditions such as low back pain. The published evidence in support of interdisciplinary teams for endometriosis-associated chronic pain is more limited but appears promising. Based on the available evidence, a model for an interdisciplinary team approach for endometriosis care is outlined.

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The Effects of Functional Restoration on Disability and Impairment

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2015.novdec02 ◽

2015 ◽

Vol 20 (6) ◽

pp. 6-12

Author(s):

Steven Feinberg

Keyword(s):

Chronic Pain ◽

Body Part ◽

Functional Restoration ◽

Functional Improvement ◽

Team Approach ◽

Patient Centered ◽

Affective Distress ◽

Rehabilitation Programs ◽

Difficult Time ◽

Chronic Pain Conditions

Abstract The treatment of chronic pain conditions is difficult, time consuming, expensive, and, all too often, unsuccessful. An effective alternative is chronic pain rehabilitation or functional restoration (FR). An FR team works together to help patients achieve better outcomes with reduced disability. The basic treatment goals of early and chronic FR rehabilitation programs are functional improvement; improved abilities in performance of activities of daily living (ADL); a return to leisure, sport, and vocational activities; and improved pharmacologic management of pain and related affective distress. Individuals at risk of developing chronic pain conditions may benefit from an FR program because physical and psychological interventions can be used before the disability becomes chronic. FR programs emphasize a multidisciplinary, biopsychosocial approach in which physicians, psychologists, and occupational, physical, and relaxation therapists work in concert. FR treatment includes quantification of physical deficits, psychosocial and socioeconomic assessment, and an emphasis on reconditioning the injured area or body part. The team-centered approach includes simulation of work or activity; disability management using cognitive–behavioral approaches; psychopharmacologic management that focuses on improving analgesia, sleep, and affective distress; and, in appropriate cases, detoxification. FR is a patient-centered, whole-person, team approach that focuses on helping patients achieve individual goals that enable them to improve physical and psychosocial function, decrease pain, lessen disability, and improve quality of life, including return to work.

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A primary care-based interdisciplinary team approach to the treatment of chronic pain utilizing a pragmatic clinical trials framework

Translational Behavioral Medicine ◽

10.1007/s13142-012-0163-2 ◽

2012 ◽

Vol 2 (4) ◽

pp. 523-530 ◽

Cited By ~ 27

Author(s):

Lynn L DeBar ◽

Lindsay Kindler ◽

Francis J Keefe ◽

Carla A Green ◽

David H Smith ◽

...

Keyword(s):

Primary Care ◽

Chronic Pain ◽

Clinical Trials ◽

Interdisciplinary Team ◽

Team Approach ◽

Pragmatic Clinical Trials

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Perspectives on Care: The Interdisciplinary Team Approach

Otolaryngologic Clinics of North America ◽

10.1016/s0030-6665(20)32214-3 ◽

1981 ◽

Vol 14 (4) ◽

pp. 769-775 ◽

Cited By ~ 5

Author(s):

Donald W. Day

Keyword(s):

Interdisciplinary Team ◽

Team Approach

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Developing an interface between engineering and the social sciences: An interdisciplinary team approach to solving societal problems.

American Psychologist ◽

10.1037/0003-066x.30.11.1067 ◽

1975 ◽

Vol 30 (11) ◽

pp. 1067-1071 ◽

Cited By ~ 4

Author(s):

W. Bruce Walsh ◽

George L. Smith ◽

Manuel London

Keyword(s):

Social Sciences ◽

Interdisciplinary Team ◽

Team Approach ◽

The Social ◽

Societal Problems

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INTRAVENOUS LIDOCIANE INFUSION FOR PATIENTS WITH CHRONIC PAIN CONDITIONS. HOW ARE WE DOING?

10.26226/morressier.5ab3c87fa874c60026558c66 ◽

2018 ◽

Author(s):

Husham Al-shather

Keyword(s):

Chronic Pain ◽

Chronic Pain Conditions

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Retrospective analysis on the effect of spinal cord stimulation on opioid consumption

Pain Management ◽

10.2217/pmt-2020-0016 ◽

2020 ◽

Author(s):

Awinita Barpujari ◽

Michael A Erdek

Keyword(s):

Spinal Cord ◽

Chronic Pain ◽

Retrospective Analysis ◽

Spinal Cord Stimulation ◽

Alternative Therapy ◽

Opioid Consumption ◽

Opioid Use ◽

Number Of Patients ◽

Chronic Pain Conditions ◽

Post Trial

Aim: Spinal cord stimulation (SCS) is used to clinically manage and/or treat several chronic pain etiologies. A limited amount is known about the influence on patients' use of opioid pain medication. This retrospective analysis evaluated SCS effect on opioid consumption in patients presenting with chronic pain conditions. Materials & methods: Sixty-seven patients underwent a temporary trial device, permanent implant or both. Patients were divided for assessment based on the nature of their procedure(s). Primary outcome was change in morphine equivalent dose (MED), ascertained from preoperative and postoperative medication reports. Results: Postoperative MED was significantly lower in patients who received some form of neuromodulation therapy. Pretrial patients reported an average MED of 41.01 ± 10.23 mg per day while post-trial patients reported an average of 13.30 ± 5.34 mg per day (p < 0.001). Pre-implant patients reported an average MED of 39.14 ± 13.52 mg per day while post-implant patients reported an average MED of 20.23 ± 9.01 mg per day (p < 0.001). There were no significant differences between pre-trial and pre-implant MED, nor between post-trial and post-implant MED. Of the 42 study subjects who reported some amount of pre-intervention opioid use, 78.57% indicated a lower MED (n = 33; p < 0.001), 16.67% indicated no change (n = 7) and 4.76% (n = 2) indicated a higher MED, following intervention. Moreover, SCS therapy resulted in a 26.83% reduction (p < 0.001) in the number of patients with MED >50 mg per day. Conclusion: Spinal cord stimulation may reduce opioid use when implemented appropriately. Neuromodulation may represent alternative therapy for alleviating chronic pain which may avoid a number of deleterious side effects commonly associated with opioid consumption.

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