Adherence in Pain Medicine

2017 ◽  
Author(s):  
Michael E. Schatman ◽  
Oscar J. Benitez
Keyword(s):  
Treatment Adherence ◽  
Treatment Options ◽  
Point Of View ◽  
Clinical Psychologists ◽  
Pain Medicine ◽  
Adherence To Treatment

This chapter reviews adherence to treatment options in pain medicine from the clinician’s point of view. Adherence is discussed in the context of principle-based ethics through the four tenets of autonomy, nonmaleficence, beneficence, and justice. Treatment adherence for pain medicine on the part of the clinician transcends mere compliance with opioid prescriptions and policies. Adherence is addressed as a broad-based approach that can be clinically appropriate when principle-based ethics are followed. The shortage of clinical therapists and the corresponding role of clinical psychologists are discussed. Ways to find a balance between the issues of abuse and underprescribing are also addressed.

scholarly journals New European guidelines for the management of arterial hypertension: the perspective of a clinical psychologist

2019 ◽  
Vol 24 (6) ◽  
pp. 628-630
Author(s):  
A. N. Alekhin ◽  
E. A. Dubinina
Keyword(s):  
Arterial Hypertension ◽  
Psychosocial Factors ◽  
Clinical Guidelines ◽  
Psychosocial Aspects ◽  
Clinical Psychologists ◽  
Clinical Psychologist ◽  
Drug Adherence ◽  
Adherence To Treatment ◽  
European Guidelines

The 2018 ESC/ESH European guidelines for the management of arterial hypertension (HTN) include new statements concerning the role of psychosocial factors in the course and the control of HTN. The importance of adherence to treatment is emphasized and efficient interventions that may improve drug adherence in HTN are presented. However, the Guidelines do not reflect the contemporary knowledge on psychosocial aspects of HTN and their meaning is not presented. It is necessary to integrate psychological concepts into the clinical guidelines, and clinical psychologists should take part in the development of such important documents.

Acute Pain Medicine

2019 ◽  
Keyword(s):  
Acute Pain ◽  
Treatment Options ◽  
Multimodal Analgesia ◽  
Anesthetic Techniques ◽  
Pharmacologic Treatment ◽  
Large Array ◽  
Pain Medicine ◽  
Regional Anesthetic

Acute Pain Medicine tackles a large array of diagnostic and treatment consideration across a variety of surgical and nonsurgical acute pain conditions. It reviews a variety of acute pain–modulating factors followed by interventional and pharmacologic treatment options. For each applicable condition, perineural and neuraxial considerations are given when appropriate along with nociceptive anatomic complements. Pharmacologic modalities are described, stressing the use of multimodal analgesia and a variety of opioid-based options if necessary. The book reviews cases that commonly are associated with significant acute pain but also highlight the role of acute pain medicine physicians in the postdischarge phase. Finally, the book includes a critical update of the Military Advanced Regional Anesthesia and Analgesia handbook. This update serves as an essential bedside tool in the performance of regional anesthetic techniques and their corresponding anatomic considerations.

scholarly journals Heart failure and senile asthenia syndrome

2018 ◽  
pp. 72-79
Author(s):  
Yu. V. Kotovskaya ◽  
A. V. Rozanov ◽  
D. H. Kurashev ◽  
O. N. Tkacheva
Keyword(s):  
Heart Failure ◽  
Treatment Adherence ◽  
Point Of View ◽  
Geriatric Syndromes ◽  
Patients With Heart Failure ◽  
Clinical Point ◽  
Physiological Reserve ◽  
Reduced Mobility ◽  
Emergency Hospitalization

The role of specific approaches to the management of patients with heart failure (HF) increases steeply with increasing age, as the patients of this age need attention to geriatric problems: reduced mobility, multiple diseases and cognitive impairment. Senile asthenia is a syndrome that reflects a decline in physiological reserve and increased vulnerability to various stressors. Senile asthenia is detected in 15–74% of patients with heart failure, the prevalence depends on the method of diagnosis and the studied population. This review discusses the effects of senile asthenia, comorbidity and geriatric syndromes on diagnosis, treatment, and outcomes in elderly patients with heart failure. The detection of senile asthenia in patients with HF is important from a clinical point of view, since this condition has an adverse effect on the course of heart failure and is associated with a higher incidence of emergency hospitalization and mortality. Bodily exercises can improve mobility, and the introduction of nursing observation can enhance treatment adherence among patients.

scholarly journals Adherence to treatment among chronically ill ambulatory patients

2017 ◽  
Vol 48 (3) ◽  
pp. 380-387
Author(s):  
Agnieszka Bojanowska ◽  
Mateusz Zatorski ◽  
Jolanta Gazdowska ◽  
Magdalena Durlik
Keyword(s):  
Treatment Adherence ◽  
Clinical Sample ◽  
Chronically Ill ◽  
Accurate Information ◽  
Adherence To Treatment ◽  
Special Cases ◽  
Ambulatory Patients ◽  
Strong Motivation ◽  
Chronic Disorders

Abstract According to Information-Motivation-Behavioural Skills model (IMB), accurate Information, strong Motivation and adequate Behavioural skills are prerequisites of treatment adherence. This model has been verified among chronically ills patients, usually suffering from one particular disorder. No studies report how the model fits data from a more diverse group. The aim of the study was to analyze adherence and its barriers in a group of three hundred patients suffering from various, common chronic disorders. They filled out IMB and Adherence Questionnaire. Information and Motivation correlated moderately (.35). Behavioural Skills was the strongest predictor of adherence (.24). An additional relationship was found: Information and Motivation interacted and the role of either of these dimensions vanished if the indices of the other were high enough. The relationships between IMB dimensions and adherence were confirmed in a varied clinical sample. Behavioural skills must be considered when working with non-adherent patients, as they are the strongest predictor of adherence. Other interventions may be limited to either Information or Motivation only if there is a chance of raising one of them to extreme levels. This may be useful with special cases, when increasing both is problematic.

scholarly journals Metastatic colorectal cancer. Evolution of treatment strategies: surgeons’ point of view

2021 ◽  
Vol 11 (1) ◽  
pp. 42-59
Author(s):  
V.  A. Aliev ◽  
Z.  Z. Mamedli ◽  
Yu.  A. Barsukov ◽  
Z.   A. Dudaev ◽  
P.  A. Tikhonov ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Combined Modality Therapy ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Distant Metastases ◽  
Point Of View ◽  
Cancer Evolution ◽  
Risks And Benefits ◽  
Clinical Research Data

This article explores evolution of treatment options in colorectal cancer with synchronous metastatic disease, role of surgical approach on different stages of combined‑modality therapy, including “liver first” strategy. Prospects of perioperative and neoadjuvant polychemotherapy in patients with colorectal cancer with synchronous distant metastases to liver, data on possibility of using radiation therapy in treatment of primary tumor and liver metastases, as well as risks and benefits of this approach and available clinical research data are analyzed.

scholarly journals A Clinical Perspective on the Role of Electronic Devices in Monitoring and Promoting Adherence in Airways Disease

2021 ◽  
Vol 3 ◽  
Author(s):  
Vincent Brennan ◽  
Christopher Mulvey ◽  
Garrett Greene ◽  
Elaine Mac Hale ◽  
Richard W. Costello
Keyword(s):  
Treatment Adherence ◽  
Potential Role ◽  
Electronic Devices ◽  
Good Evidence ◽  
Adherence To Treatment ◽  
Technological Advances ◽  
Poor Treatment ◽  
Treatment Use ◽  
Inhaled Medication

Poor adherence to treatment is a common reason why patients with chronic disease have worse outcomes than might be expected. Poor treatment adherence is of particular concern among people with airways disease because, apart from not taking treatment as prescribed, inhaled medication can also be administered incorrectly. Recently, a number of technological advances that accurately document when an inhaled treatment has been used and, in certain instances, how it was used have been developed. There is good evidence from a number of research groups that these devices, either by patient reminders or physician feedback, promote adherence to inhaled treatments. What is less certain is how, in a real-world setting, these devices change outcomes. In this perspective article, the role of electronic devices in quantifying treatment use and addressing poor treatment adherence and their potential role in clinical practice outside of clinical validation trials are described.

scholarly journals The Mediating Role of Resilience and Diabetes Distress in Relationship between Depression and Treatment Adherence in Type 2 Diabetes among Iranian Patients

2020 ◽  
Author(s):  
Masoumeh Rahimi ◽  
Mahsa Jalali ◽  
Rababeh Nouri ◽  
Mojgan Rahimi
Keyword(s):  
Type 2 Diabetes ◽  
Treatment Adherence ◽  
Diabetes Distress ◽  
Diabetic Patients ◽  
Adherence To Treatment ◽  
Mediating Role ◽  
Distress Scale ◽  
Iranian Patients

 Introduction: The coexistence of mental health problems in diabetic patients can lead to poor disease management, lack of adherence to treatment, and poor quality of life. Therefore, this study aimed at investigating the mediating role of resilience and diabetes distress in the relationship between depression and treatment adherence in type 2 diabetes among Iranian patients. Methods: It is a type of analytical study conducted from 2019 to 2020. The statistical population of this study consisted of all-diabetic patients in Tehran. The subjects (200) were selected after purposeful clinical evaluation and qualification of research. In this study, Beck Depression Inventory (BDI), the Persian Version of the Morisky Medication Adherence Scale-8, Diabetes Distress Scale (DDS), Conner & Davison Resilience Scale (CDRS) were used to collect the data. Pearson correlation test by SPSS version 24 and Confirmatory Factor Analysis in AMOS software version 22 were used for analysis (P<0.05). Results: In the present study, most participants (about 36.5%) were in the age group of 56-65 and 58.5% of them were female. According to the results, the variables of depression and diabetes distress has a negative and significant correlation with adherence to treatment (r= -.408, p<0.05). The resiliency has a positive and significant correlation with adherence to treatment (r= 0.414, p<0.05). The result, by multiplying the two non-standard coefficients that constitute the intermediate variable paths by the standard error of the product, showed depression has an indirect effect on adherence to treatment by mediating the role of resiliency and diabetes distress. Conclusion: The findings showed a link between depression, diabetes pain, endurance, and treatment adherence. Resilience and anxiety from diabetes play a mediating role between depression and adherence to care. Therefore, paying attention to patient resilience may lead to improved depression and diabetes distress in patients with diabetes, and it may be a useful way to increase the patient’s involvement in treatment adherence.

Elucidation of block boundaries as the dissolution channels in hydrated cement

1978 ◽  
Vol 36 (1) ◽  
pp. 484-485
Author(s):  
N.V. Belov ◽  
U.I. Papiashwili ◽  
B.E. Yudovich
Keyword(s):  
Liquid Phase ◽  
Grain Boundaries ◽  
Benzoyl Peroxide ◽  
Phase Contrast ◽  
Active Role ◽  
Point Of View ◽  
Hardened Cement ◽  
Hydrated Cement ◽  
Hardened Cement Paste

It has been almost universally adopted that dissolution of solids proceeds with development of uniform, continuous frontiers of reaction.However this point of view is doubtful / 1 /. E.g. we have proved the active role of the block (grain) boundaries in the main phases of cement, these boundaries being the areas of hydrate phases' nucleation / 2 /. It has brought to the supposition that the dissolution frontier of cement particles in water is discrete. It seems also probable that the dissolution proceeds through the channels, which serve both for the liquid phase movement and for the drainage of the incongruant solution products. These channels can be appeared along the block boundaries.In order to demonsrate it, we have offered the method of phase-contrast impregnation of the hardened cement paste with the solution of methyl metacrylahe and benzoyl peroxide. The viscosity of this solution is equal to that of water.

Whatever Happened to the Cambridge Capital Theory Controversies? (With comments by L. Pasinetti, F. Fisher, J. Felipe and J. McCombie, R. Greenfield and reply by the authors)

2009 ◽  
pp. 4-27
Author(s):  
A. Cohen ◽  
G. Harcourt
Keyword(s):  
Economic Theory ◽  
Economic Thought ◽  
Point Of View ◽  
Chronological Order ◽  
Capital Theory

The article written by the well-known theorists and historians of economic thought contains a detailed overview of the Cambridge capital controversy, which had raged from the mid-1950-s through the mid-1970-s. The authors track the origins of the controversy and cover arguments of both sides in chronological order. From their point of view, the discussion hasnt been resolved, and its main underlying aspects were ideological beliefs and fundamental methodological controversies on the nature of equilibrium and on the role of time in economic theory. The article is published with comments written by other leading theoreticians.

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