Facilitating Treatment Adherence in Pain Medicine

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.

2017 ◽  
Vol 8 (1) ◽  
pp. 79
Author(s):  
Deya Prastika ◽  
Luppana Kitrungrote ◽  
Jintana Damkliang

Although trauma is a common cause of greater pain and interference on daily activities, little is known about pain experience, pain management strategies and pain management outcomes in hospitalized trauma patients in Indonesia. This descriptive study aimed (1) to assess the pain experience, (2) to describe pain management strategies, and (3) to describe satisfaction with pain management conducted by healthcare providers as perceived by trauma patients. A total of 154 hospitalized trauma patients from a teaching hospital in Indonesia were recruited from January to March 2016. Data were analyzed using descriptive and inferential statistics. The study found that most of the hospitalized trauma patients had single extremity fractures (56.49%) and mild head injury (20.13%). They have experienced a mild to moderate level of pain intensity and pain interference during the first three days of admission. These pain intensity and pain interference levels were found to be significantly decreased from the first to the third day. The pain management strategies often used by the healthcare providers were showing interest and asking about pain, assessing the outcomes after receiving analgesic drugs, and giving information about pain. The pain management strategies often used by patients were praying (86.36%), slow and deep breathing (77.27%), and reciting Dzikir (meditation) (68.18%). Patients reported that performing Dzikir and praying were the effective strategies to reduce their pain. The patients rated moderate to high levels of satisfaction with pain management conducted by healthcare providers. Therefore, combinations analgesic drugs with praying and performing Dzikir related to cultural contexts are crucial to alleviate pain among hospitalized trauma patients in Indonesia.


Author(s):  
Jeremy Prout ◽  
Tanya Jones ◽  
Daniel Martin

This chapter summarizes the assessment and management of acute and chronic pain for FRCA. Pain pathways and physiological consequences of pain are considered along with sites of action and the pharmacology of common analgesics. Assessment of pain for different patient groups and settings is explained. Pain management strategies, pharmacological, non-interventional and interventional techniques are described, including multidisciplinary management of chronic pain. Specific management of some common chronic pain conditions, such as trigeminal neuralgia, are discussed in more detail.


Author(s):  
Michael E. Schatman

Even though the efficacy of interdisciplinary pain management programs is supported, their numbers have decreased and the vast majority of Americans with chronic pain do not have access to them. Insurance companies do not want to pay for these services, hospitals believe they are financial losers, and the opioid crisis has placed a pall over the practice of pain medicine. The demise of these programs has left pain medicine in a fragmented state. Few healthcare providers who treat chronic pain patients have the time to coordinate care by multiple professionals The opioid crisis seen in certain areas, such as Appalachia, may be related to the lack of these interdisciplinary programs. There should be concerted efforts to increase access to and funding of these programs. Although they are not a panacea for all types of chronic pain, they can improve patients’ well-being and function and reduce their need for opioid medications.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Hagen ◽  
A Georgescu

Abstract Background Pain is a nearly universal experience, but little is known about how people treat pain. This international survey assessed real-world pain management strategies. Methods From 13-31 January, 2020, an online survey funded by GSK Consumer Healthcare was conducted in local languages in Australia, Brazil, Canada, China, Colombia, France, Germany, India, Italy, Japan, Saudi Arabia, Malaysia, Mexico, Poland, Russia, Spain, Sweden, UK, and USA. Adults were recruited from online panels of people who agreed to participate in surveys. Quotas ensured nationally representative online populations based on age, gender, and region. Results Of 19,000 people (1000/country) who completed the survey, 18,602 (98%) had ever experienced physical pain; 76% said they would like to control their pain better. Presented with 17 pain-management strategies and asked to select the ones they use in the order of use, respondents chose an average of 4 strategies each. The most commonly selected strategies were pain medication (65%), rest/sleep (54%), consult a doctor (31%), physical therapy (31%), and nonpharmacologic action (eg, heat/cold application; 29%). Of those who use pain medication, 56% take some other action first. Only 36% of those who treat pain do so immediately; 56% first wait to see if it will resolve spontaneously. Top reasons for waiting include a desire to avoid medication (37%); willingness to tolerate less severe pain (33%); concerns about side effects (21%) or dependency (21%); and wanting to avoid a doctor's visit unless pain is severe or persistent (21%). Nearly half (42%) of those who take action to control pain have visited ≥1 healthcare professional (doctor 31%; pharmacist 18%; other 17%) about pain. Conclusions This large global survey shows that people employ a range of strategies to manage pain but still wish for better pain control. Although pain medication is the most commonly used strategy, many people postpone or avoid its use. Key messages More than three-quarters (76%) of respondents across countries seek better pain control. Pain medication and rest/sleep consultation are the most common pain management strategies. More than half of respondents (56%) wait to see if pain will resolve spontaneously before taking any action, and 56% of those who use pain medication try some other approach first.


2021 ◽  
pp. 136749352110136
Author(s):  
Logan J Camp-Spivey ◽  
Ayaba Logan ◽  
Michelle Nichols

The primary aim of this integrative review was to critically evaluate and synthesize published, peer-reviewed research to better understand self-management strategies of children and adolescents with chronic diseases. This review was guided by Whittemore and Knafl’s methodological framework. The Pediatric Self-management Model provided the theoretical framework for understanding how self-management behaviors operate within the domains of individual, family, community, and healthcare systems. In June 2019, the electronic databases of EBSCOhost, PubMed, and Scopus, along with reference lists of applicable studies, were searched for appropriate publications. The initial searches yielded 920 citations. Of these, 11 studies met inclusion criteria. A key finding was that involving children and adolescents in the design and delivery phases of interventions was most effective in improving self-management when the interventions did not outweigh cognitive ability or maturity level. In addition, incorporating self-efficacy promotion into self-management interventions may lead to greater sense of responsibility and improved health outcomes. In terms of intervention delivery of self-management strategies, the use of technological platforms and devices was revealed as a promising avenue for youth. A final implication was the importance of family members, peers, and healthcare providers in supporting children and adolescents in adopting self-management behaviors.


Haemophilia ◽  
2015 ◽  
Vol 21 (6) ◽  
pp. e487-e489
Author(s):  
X. Wang ◽  
M. Yang ◽  
S. Jackson

2003 ◽  
Vol 18 (3) ◽  
pp. 170-178 ◽  
Author(s):  
Gregory Luke Larkin ◽  
Jeffrey Arnold

AbstractThroughout the globe, healthcare providers are increasingly challenged with the specter of terrorism and the fallout from weapons of mass destruction. Preparing for and responding to such manmade emergencies, however, threatens the ethical underpinnings of routine, individualized, patient-centered, emergency healthcare. The exigency of a critical incident can instantly transform resource rich environs, to those of austerity. Healthcare workers, who only moments earlier may have been seeing two to three patients per hour, are instantly thrust into a sea of casualties and more basic lifeboat issues of quarantine, system overload and the thornier determinations of who will be given every chance to live and who will be allowed to die. Beyond the tribulations of triage, surge capacity, and the allocation of scarce resources, terrorism creates a parallel need for a host of virtues not commonly required in daily medical practice, including prudence, courage, justice, stewardship, vigilance, resilience, and charity. As a polyvalent counterpoint to the vices of apathy, cowardice, profligacy, recklessness, inflexibility, and narcissism, the virtues empower providers at all levels to vertically integrate principles of safety, public health, utility, and medical ethics at the micro, meso, and macro levels. Over time, virtuous behavior can be modeled, mentored, practiced, and institutionalized to become one of our more useful vaccines against the threat of terrorism in the new millennium.


2018 ◽  
Vol 3 (1) ◽  

As dementia progresses, the elderly with dementia often have difficulties finishing their meals and weight loss is a common feature at this stage of their dementia journey. Eating disorders cause tremendous caregiver stress and burden. In considering provision of best care for this group of elderly, the hospital is probably not the best place and yet, they are frequently brought in to the hospital to seek help for fever, pneumonia, dislodged feeding tube, medical complications arising from poor feeding and dehydration. It is important to understand the aetiology of poor feeding among this group of patients and advise the patients and their family on the appropriate management strategies to improve the intake of food and to maximize their quality of life. At this stage of dementia, focusing on means to ensure nutritional needs are met may end up causing further harm and distress.


2018 ◽  
Vol 87 (1) ◽  
pp. 14-15
Author(s):  
Sandra Botros

Dr Earl Russell (1920-2008) was a Canadian anesthetist and pain specialist who spent the majority of his career as a Western University faculty member and a pain physician in Southwestern Ontario. Dr Russell obtained his medical degree at Western, graduating in the class of 1950, and went on to serve in the Korean War as a medical officer. It was in Korea that he began developing a keen interest in pain medicine, using self-taught anesthesia skills to help soldiers suffering from frostbite. He returned to Canada and focused the rest of his career on the practice and advancement of pain medicine, and endowed the Earl Russell Chair in Pain Management in order to fund future research and education in the field. This article highlights the importance of his contributions to the field, in particular through his creation of the Earl Russell Chair, and how this led to the first Pain Medicine residency program in Canada at Western University.


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