Cost Burden of Chronic Pain Patients in a Large Integrated Delivery System in the United States

Pain Practice ◽  
2015 ◽  
Vol 16 (8) ◽  
pp. 1001-1011 ◽  
Author(s):  
Peter W. Park ◽  
Richard D. Dryer ◽  
Rozelle Hegeman-Dingle ◽  
Jack Mardekian ◽  
Gergana Zlateva ◽  
...  
Keyword(s):  
United States ◽  
Chronic Pain ◽  
Delivery System ◽  
The United States ◽  
Cost Burden ◽  
Integrated Delivery System ◽  
Chronic Pain Patients ◽  
Integrated Delivery ◽  
Pain Patients

scholarly journals cost burden of chronic pain in a large integrated delivery system in the united states

2014 ◽  
Vol 17 (3) ◽  
pp. A131-A132
Author(s):  
L Lamerato ◽  
R Dryer ◽  
J Mardekian ◽  
R Hegeman-Dingle ◽  
PW Park ◽  
...  
Keyword(s):  
United States ◽  
Chronic Pain ◽  
Delivery System ◽  
The United States ◽  
Cost Burden ◽  
Integrated Delivery System ◽  
Integrated Delivery

scholarly journals Impact of the COVID-19 pandemic on chronic pain management

2021 ◽  
Vol 2 (3) ◽  
pp. 197-212
Author(s):  
Andrew Auyeung ◽  
Hank Wang ◽  
Iulia Pirvulescu ◽  
Nebojša Knežević
Keyword(s):  
United States ◽  
Chronic Pain ◽  
Pain Management ◽  
The United States ◽  
Chronic Pain Management ◽  
Steroid Use ◽  
Chronic Pain Patients ◽  
Interventional Pain Management ◽  
Tools And Techniques ◽  
Pain Patients

Introduction: The COVID-19 pandemic has generated considerable turmoil in the interventional pain management (IPM) community. Due to IPM being classified as 'elective', numerous pain practices across the United States were forced to close during the pandemic, leaving chronic pain patients untreated for indefinite periods, and IPM physicians with increased stress and burnout. Results: In response to these detrimental effects, various re-opening tools and techniques have been created to facilitate a cautious resumption of in-person interventional pain practice. Due to their ability to minimize person-to-person contact, telehealth and pharmacotherapy played a more significant role in IPM during the pandemic, but their increased utilization has also led to the exacerbation of substance abuse and the opioid epidemic. The interplay between steroid use and its immunosuppressive effects, in relation to the COVID-19 infection and the COVID-19 vaccine, has also arisen as an issue of concern. Conclusion: As practices begin to safely re-open throughout the United States, the effects felt by chronic pain patients during the pandemic must be emphasized and not ignored. This review emphasizes the struggles pain patients have had to face during the pandemic and the need to update and redefine regulations regarding interventional and chronic pain management.

scholarly journals Survey of Spinal Cord Stimulation Hardware Currently Available for the Treatment of Chronic Pain in the United States

2020 ◽  
Vol 1 ◽  
Author(s):  
Josephine A. Clingan ◽  
Ashish Patel ◽  
Dermot P. Maher
Keyword(s):  
United States ◽  
Spinal Cord ◽  
Chronic Pain ◽  
The United States ◽  
Analysis Techniques ◽  
Chronic Pain Patients ◽  
The Us ◽  
Optimal Patient Care ◽  
Pain Patients ◽  
Selection Of

Background: The number of spinal cord stimulator (SCS) units sold in the United States (US) for the treatment of chronic pain has increased with a corresponding expansion in the number of different SCS platforms available. Each marketed stimulator has several unique features, indications, and limitations, which distinguish one from the other and makes the selection of appropriate hardware possible for optimal patient care. There are an even greater number of similar and overlapping features between SCS.Measures: We used market analysis techniques to survey the currently available SCS technology. We then reviewed published device specifications and manuals for comparison of features.Outcomes: As of 2020, there are nine commonly used SCS platforms made by four manufacturers including four SCS units from Abbott, three from Boston Scientific, and one each from Medtronic and Nevro.Conclusions: A working understanding of each SCS product's nuances is needed for selecting the most appropriate device with which to manage chronic pain patients. Here we present a brief survey of currently available SCS hardware in the US and the features that make each product unique.

Monitoring outcomes during long-term opioid therapy for noncancer pain: Results with the Pain Assessment and Documentation Tool

2005 ◽  
Vol 1 (5) ◽  
pp. 257 ◽  
Author(s):  
Steven D. Passik, PhD ◽  
Kenneth L. Kirsh, PhD ◽  
Laurie Whitcomb, MA ◽  
Jeffrey R. Schein, PhD, MPH ◽  
Mitchell A. Kaplan, PhD ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Side Effects ◽  
Pain Assessment ◽  
The United States ◽  
Opioid Therapy ◽  
Chronic Pain Patients ◽  
Noncancer Pain ◽  
Documentation Tool ◽  
Pain Patients

The increasingly common practice of long-term opioid therapy for chronic noncancer pain must be guided by ongoing assessment of four types of outcomes: pain relief, function, side effects, and drug-related behaviors. Our objective was to gather initial pilot data on the clinical application of a specialized chart note, the Pain Assessment and Documentation Tool (PADT), which was developed and tested with 27 physicians. This pilot test provided the means to collect cross-sectional outcome data on a large sample of opioid-treated chronic pain patients. Each of the physician volunteers (located in a variety of settings across the United States) completed the PADT for a convenience sample of personally treated chronic pain patients who had received at least three months of opioid therapy. Completion of the PADT required a clinical interview, review of the medical chart, and direct clinical observation. Data from the PADTs were collated and analyzed. The results suggested that the majority of patients with chronic pain achieve relatively positive outcomes in the eyes of their prescribing physicians in all four relevant domains with opioid therapy. Analgesia was modest but meaningful, functionality was generally stabilized or improved, and side effects were tolerable. Potentially aberrant behaviors were common but viewed as an indicator of a problem (i.e., addiction or diversion) in only approximately 10 percent of cases. Using the PADT, physician ratings can be developed in four domains. In this sample, outcomes suggested that opioid therapy provided meaningful analgesia.

scholarly journals Examination of Symptom Clusters in Acute and Chronic Pain Patients

2014 ◽  
Vol 3;17 (3;5) ◽  
pp. E349-E357
Author(s):  
David Fishbain
Keyword(s):  
Chronic Pain ◽  
Acute Pain ◽  
Severe Pain ◽  
Somatic Symptoms ◽  
The United States ◽  
Symptom Clusters ◽  
Pain Level ◽  
Cluster Number ◽  
Chronic Pain Patients ◽  
Pain Patients

Background: Symptom clusters have not been previously explored in acute pain patients (APPs) and chronic pain patients (CPPs) with non-cancer pain. Objectives: The objectives of this study were to determine in CPPs and APPs which somatic and non-somatic symptoms cluster with each other, the number of clusters, and if cluster number and cluster symptom makeup differ by pain level. Study Design: Study sample was 326 APPs and 341 CPPs who had completed a pool of questions that had included current symptom questions other than pain. Symptom cluster analyses were performed on 15 somatic and non-somatic symptoms for APPs and CPPs and for 2 CPP subgroups with moderate and severe pain. Setting: APPs and CPPs were from rehabilitation facilities located in 30 states in all geographical regions of the United States. Results: APPs had 4 symptom clusters and CPPs had 5. For CPPs, the clusters represented memory, neurological, behavioral, somatic, and autonomic problems. CPPs with moderate and severe pain had 3 and 4 symptom clusters, respectively, and differed in cluster symptom constitution. Limitations: Patients selected themselves for study inclusion and were paid for their participation. This could have affected random selection. Lastly, we used the current time definitions of acute pain versus chronic pain (90 days) to separate our patients into these groups. Currently, no consensus exists regarding the optimal time duration to divide acute from chronic. Conclusions: APPs and CPPs are characterized by symptom comorbidities that form clusters. In CPPs, cluster number and cluster symptom makeup are affected by pain level. This has implications for clinical practice and future research. Key words: Comorbidity, somatic symptoms, comorbid symptoms, chronic pain patients, acute pain patients, community patients without pain, clusters, symptom clusters

Unusual Drugs of Abuse in Chronic Pain Patients

2017 ◽  
Author(s):  
Alan D. Kaye ◽  
Elyse Cornett ◽  
Charles Fox ◽  
Shilpadevi Patil ◽  
Harish Siddaiah ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Drug Abuse ◽  
Health Care Providers ◽  
Drugs Of Abuse ◽  
Pain Treatment ◽  
The United States ◽  
Care Providers ◽  
Chronic Pain Patients ◽  
Pain Patients

Chronic pain occurs in one third of the American population. Management of chronic pain is a growing area in health care; however, there is a dilemma for health care providers to treat the chronic pain of individuals who have known current or suspected drug abuse or addiction. Even if the individual is not addicted to opiates or prescription pain medications, it is possible to become addicted to a new substance. The National Institutes of Health considers drug addiction a neurophysiologic disease, and as of 2014, 24.6 million people in the United States abuse drugs. As more patients are seeking treatment for chronic pain, health care providers are seeing an increase in patients who have a history of drug abuse or addiction, and it is imperative that health care providers are aware of how best to care for these patients. This review discusses chronic pain and the drugs that are typically used to treat chronic pain, as well as drugs that have been reported to be abused in chronic pain patients. There are limited or no data available on the more recent designer drugs, such as bath salts, K2 (spice), and even common drugs of abuse, such as methylenedioxymethamphetamine (MDMA). More research should be conducted on what drugs are abused in chronic pain patients, especially nonopioid drugs such as stimulants. This information would help educate health care providers and create better pain treatment regimens for patients who abuse drugs. Key words: chronic pain, drug abuse, marijuana, methamphetamine, opioids

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