An Audit of Self Acupuncture for Chronic Musculoskeletal Pain

2006 ◽  
Vol 24 (2) ◽  
pp. 80-86 ◽  
Author(s):  
Silje Teig ◽  
Sue Peacock ◽  
Lorraine Stevens ◽  
Kimberley Tordoff ◽  
Edwina Maguire ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pain Relief ◽  
Cost Effective ◽  
Postal Questionnaire ◽  
Pain Clinic ◽  
Acupuncture Points ◽  
Retrospective Audit ◽  
The Cost

Background Acupuncture is increasingly offered as a treatment for chronic pain, but continued treatment is expensive. Self acupuncture might offer a cost effective alternative. The aim of this project was to investigate the effectiveness and safety of self acupuncture in a pain clinic. Methods A retrospective audit was conducted by postal questionnaire of all patients with chronic pain who were taught self acupuncture as a home pain management strategy in the previous three years. The study was conducted by a researcher not involved in the patient's treatment. The patients selected for self acupuncture were those who had responded to acupuncture previously, met certain criteria, and had been taught self acupuncture successfully. Patients were taught self acupuncture using three acupuncture points (LI4, ST44, LR3). Results Of 52 eligible patients (70% female) who were approached, 38 valid questionnaires were returned, giving a response rate of 73.1%. Of these, 76.3% were female; 86.8% (33) still used self acupuncture and 13.3% (5) had stopped; 86.8% of the patients continued to experience pain reduction with self acupuncture. The reported pain relief gained was 5.7 (SD 2.6) measured on a visual analogue scale, improvement in quality of life was reported by 73.7% and no serious adverse effects were reported. Conclusion This audit suggests that self acupuncture is effective for pain relief and improves quality of life in this selected group of patients. Safety can be maintained provided that pre-selection is done with care, and appropriate training is carried out. Self acupuncture has considerable potential to reduce clinic waiting lists and appointment times for patients. Further research is required to determine the cost effectiveness of this approach.

Spinal Cord Stimulation in Treatment of Chronic Benign Pain: Challenges in Treatment Planning and Present Status, a 22-Year Experience

Neurosurgery ◽  
2006 ◽  
Vol 58 (3) ◽  
pp. 481-496 ◽  
Author(s):  
Krishna Kumar ◽  
Gary Hunter ◽  
Denny Demeria
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Pain Relief ◽  
Success Rate ◽  
Spinal Cord Stimulation ◽  
Pain Clinic ◽  
Axial Component

Abstract OBJECTIVE: To present an in-depth analysis of clinical predictors of outcome including age, sex, etiology of pain, type of electrodes used, duration of pain, duration of treatment, development of tolerance, employment status, activities of daily living, psychological status, and quality of life. Suggestions for treatment of low back pain with a predominant axial component are addressed. We analyzed the complications and proposed remedial measures to improve the effectiveness of this modality. METHODS: Study group consists of 410 patients (252 men, 58 women) with a mean age of 54 years and a mean follow-up period of 97.6 months. All patients were gated through a multidisciplinary pain clinic. The study was conducted over 22 years. RESULTS: The early success rate was 80% (328 patients), whereas the long-term success rate of internalized patients was 74.1% (243 patients) after the mean follow-up period of 97.6 months. Hardware-related complications included displaced or fractured electrodes, infection, and hardware malfunction. Etiologies demonstrating efficacy included failed back syndrome, peripheral vascular disease, angina pain, complex regional pain syndrome I and II, peripheral neuropathy, lower limb pain caused by multiple sclerosis. Age, sex, laterality of pain or number of surgeries before implant did not play a role in predicting outcome. The percentage of pain relief was inversely related to the time interval between pain onset and time of implantation. Radicular pain with axial component responded better to dual Pisces electrode or Specify-Lead implantation. CONCLUSION: Spinal cord stimulation can provide significant long-term pain relief with improved quality of life and employment. Results of this study will be effective in better defining prognostic factors and reducing complications leading to higher success rates with spinal cord stimulation.

scholarly journals Impact of Empathy in the Patient-Doctor Relationship on Chronic Pain Relief and Quality of Life: A Prospective Study in Spanish Pain Clinics

Pain Medicine ◽  
2017 ◽  
Vol 19 (7) ◽  
pp. 1304-1314 ◽  
Author(s):  
Luz Cánovas ◽  
Antonio-José Carrascosa ◽  
Modesto García ◽  
Mariano Fernández ◽  
Almudena Calvo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pain Relief ◽  
Prospective Study ◽  
Pain Clinics ◽  
A Prospective Study

scholarly journals Understanding the Cost-Effectiveness of Hearing Aids and Surgery for the Treatment of Otosclerosis

2022 ◽  
Author(s):  
Danielle M. Gillard ◽  
Jeffrey D. Sharon
Keyword(s):  
Quality Of Life ◽  
Cost Effectiveness ◽  
Hearing Aids ◽  
Cost Effective ◽  
Stapes Surgery ◽  
Cost Effective Method ◽  
Patient Reported ◽  
Complications Of Surgery ◽  
The Cost

Abstract Purpose of Review To summarize and critically review recent literature on the relative cost-effectiveness of hearing augmentation versus stapes surgery for the treatment of otosclerosis. Recent Findings Otosclerosis leads to reduced patient quality of life, which can be ameliorated by either stapes surgery, or hearing aid usage. The success of stapes surgery is high, and the risks of serious postoperative complications are low. Hearing aids don’t have the complications of surgery but are associated with long-term costs. Cost-effectiveness models have shown that stapes surgery is a cost-effective method for treating otosclerosis. Summary Both stapes surgery and hearing aids can improve patient-reported quality of life in otosclerosis. Stapes surgery has larger upfront costs and surgical risks, but hearing aids are associated with longer lifetime costs. Stapes surgery is cost-effective for the treatment of otosclerosis.

Influence of Breastfeeding on The Early Aged Children’s Health and Ql Indicators

2021 ◽  
Author(s):  
Marina Ararat Mardiyan ◽  
Siranush Ashot Mkrtchyan ◽  
Razmik Ashot Dunamalyan ◽  
Karine Hrant Simonyan ◽  
Hayk Vachagan Harutyunyan
Keyword(s):  
Quality Of Life ◽  
Cost Effective ◽  
Health Condition ◽  
Significant Difference ◽  
One Year ◽  
Duration Of Breastfeeding ◽  
The Cost ◽  
Effective Public Health ◽  
The Given

Abstract Background: Promotion and coverage of breastfeeding are considered to be the cost-effective public health measures in terms of Healthcare System. The aim of the research is to assess an influence of breastfeeding on infants’ health and quality of life (QL) parameters.Methods: This observational prospective study included 1790 newborns selected from Yerevan State Medical University’s Polyclinics (“Mouratsan” (sample=746) and “Heratsi” ” (sample=1044)). Data collection took a period between January 2016 and December 2017. Evaluation of children’s quality of life was performed with the help of the validated and adapted QUALIN questionnaire. The data related to child’s health condition were collected from the “Child Development History” cards available at the polyclinics of the investigated area.Results: Among 1770 one year old children 1681 were ever breastfed, 1224 (69.1%) were exclusively breastfed up to 3 months, the median duration of breastfeeding was 6 -7 months, 45% ≥ 6 months, 15% ≥ 1 year. There is a significant difference between the QL scores of the ever breastfed and the never breastfed subgroups. Duration of the breastfeeding also have an influence on QL scores.Conclusions: The given study’s results confirm that breastfeeding among the early aged Armenian children is of great importance in their health, influencing on quality of life and morbidity rates.

Assessment and treatment at a pain clinic: A one-year follow-up of patients with chronic pain

2017 ◽  
Vol 17 (1) ◽  
pp. 233-242 ◽  
Author(s):  
Andrea Hållstam ◽  
Monika Löfgren ◽  
Lina Benson ◽  
Christer Svensén ◽  
Britt-Marie Stålnacke
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pain Clinic ◽  
Health Related Quality ◽  
Pain Clinics ◽  
Related Quality ◽  
Health Related ◽  
One Year

AbstractBackground and aimsPain is one of the most common reasons for patients to seek primary health care. Pain relief is likely to be achieved for patients suffering from acute pain, but for individuals with chronic pain it is more likely that the condition will persist. These patients have the option of being referred to specialised pain clinics. However, the complexity surrounding chronic pain patients is not well studied in these settings. This study aimed to describe patients with chronic pain referred to a pain clinic by using the information submitted during their first visit and one year later and also to identify associations between baseline characteristics and improvements in health-related quality of life in the follow-up.MethodsThis was a longitudinal observational study of a sample consisting of 318 patients referred to a pain clinic. One group of patients containing 271 individuals (median age 48, 64% females) was assessed and received conventional pain treatment (CPT group) and a second group of 47 patients (median age 53, 64% females) was assessed by a pain specialist and referred back to their physician with a treatment recommendation (assessment only, AO group). Patient-reported outcome measures in health-related quality of life (EQ-5D), pain intensity (VAS), mental health (HADS), insomnia (ISI), pain-related disability (PDI), kinesiophobia (TSK) and sense of coherence (SOC) were collected at the first visit and one year later.ResultsAt baseline, the CPT group reported a low EQ-5D Index (median (md) 0.157) and EQVAS (md 40) as well as considerable high, current pain intensity VAS (md 58), HADS anxiety (md 8), ISI (md 17), PDI (md 36) and TSK (md 39). The AO group showed similar problems (no significant differences compared to the CPT group), except for ISI, where the AO group reported less severe problems. At the one-year follow-up, the CPT group had a statistically significant improvement in EQ-5D, VAS, ISI, PDI and TSK. In the AO group no significant changes were observed. In the CPT group there was an association between a high ISI level at baseline and an improved EQ-5D Index in the follow-up.ConclusionsThe study describes rarely explored groups of patients with chronic pain at a pain clinic. Severe pain problems were present in both groups at their first visit. A statistically significant improvement could be seen in the group that was conventionally treated while this was not the case among those subjects who were assessed and referred. The results imply, that relatively limited treatment strategies were helpful for the patients’ health-related quality of life. Despite these improvements, the patients were not fully recovered, pointing to the chronicity of pain conditions and the need of support for many patients.ImplicationsIncreased knowledge about assessment, selection and treatment at pain clinics is important to improve the quality of the work performed at these clinics. Despite limited resources, further efforts should be made to collect comparable, valid data on a regular base from pain clinics in order to develop recommendation models.

Patient characteristics and quality of life among a sample of Australian chronic pain clinic attendees

2004 ◽  
Vol 34 (7) ◽  
pp. 403-409 ◽  
Author(s):  
S. Kerr ◽  
G. Fairbrother ◽  
M. Crawford ◽  
M. Hogg ◽  
D. Fairbrother ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Patient Characteristics ◽  
Pain Clinic ◽  
Chronic Pain Clinic

scholarly journals The Pain Frequency-Severity-Duration Scale as a Measure of Pain: Preliminary Validation in a Pediatric Chronic Pain Sample

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Katherine S. Salamon ◽  
W. Hobart Davies ◽  
Melissa R. Fuentes ◽  
Steven J. Weisman ◽  
Keri R. Hainsworth
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pain Intensity ◽  
Functional Limitations ◽  
Pain Clinic ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Pain Frequency

Typically, pain is measured by intensity and sensory characteristics. Although intensity is one of the most common dimensions of pain assessment, it has been suggested that measuring pain intensity in isolation is only capturing part of the pain experience and may not lead to an accurate measurement of how pain impacts a child’s daily functioning. The current study aimed to develop a measure that would capture pain intensity along with frequency and duration in a clinical sample of youth diagnosed with chronic pain. The pain-frequency-severity-duration (PFSD) scale was developed and data were collected from a multidisciplinary pain clinic at a large, midwestern children’s hospital. Validated measures of functional limitations and health related quality of life were also collected. Significant correlations were found between the PFSD composite score, functional limitations, and health related quality of life. Future research should continue to evaluate this questionnaire utilizing other validated pain measures and other areas potentially impacted by chronic pain and with more diverse samples. This initial finding suggests that the PFSD is a convenient self-reported measure and is strongly related to health related quality of life and functional disability.

Patients with chronic pain: One-year follow-up of a multimodal rehabilitation programme at a pain clinic

2016 ◽  
Vol 10 (1) ◽  
pp. 36-42 ◽  
Author(s):  
Andrea Hållstam ◽  
Monika Löfgren ◽  
Christer Svensén ◽  
Britt-Marie Stålnacke
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pain Clinic ◽  
Pain Clinics ◽  
Related Quality ◽  
Health Related ◽  
One Year ◽  
Eq Vas

AbstractBackground and aimsMultimodal rehabilitation (MMR) programmes, including, physical training, educational and psychological interventions by an interdisciplinary team are found to be more successful for patients with disabling chronic pain compared with less comprehensive treatments. MMR programmes are based on the biopsychosocial model and the goal is usually to improve function, quality of life and facilitate and enable return to work. As pain clinics traditionally offer conventional medical pain treatment, there is limited knowledge about MMR given in this context. The aim of our study was to describe characteristics of patients with chronic pain, treated with a MMR programme at a conventional pain clinic, to evaluate patient-reported outcome measures (PROM) from start to one year after, and to study possibly associated factors for the improvement of health-related quality of life after one year.MethodsA prospective, observational study with a one-year follow-up was performed.SubjectsA total of 42 individuals (38 females, age 44.0 ± 12.3 years and 4 men age 40 ± 8.5 years) with different pain diagnoses were included. After a team assessment, the patients began a programme that lasted about three months. The MMR programme contained coordinated, individually adapted treatments administered individually or in groups, and was based on cognitive behavioural principles. Questionnaires regarding health-related quality of life (HRQoL) (EQ-5D), insomnia (ISI), mental health (HADS), painrelated disability (PDI), kinesiophobia (TSK), current pain intensity (VAS) and sense of coherence (SOC) were used at the start of the MMR and at follow-up. Demographic data were collected from the patient records.ResultsThe PROM at baseline showed substantial pain problems with low HRQoL (EQ-5D index of 0.1 ± 0.282, and EQ VAS of 32.67 ± 20.1), moderate insomnia (ISI 18.95 ± 6.7), doubtful cases of depression and anxiety (HADS-depression 9.35 ± 4.1 and HADS-anxiety 9.78 ± 3.95), presence of pain-related disability (PDI 39.48 ±12.64), kinesiophobia (TSK 40.8 ± 9.8), as well as moderate current pain (VAS 61.31 ± 20.4). The sense of coherence was weak (SOC of 51.37 ± 14). At one-year follow-up, significant (p ≥ 0.05) improvement occurred on the EQ-5D index, EQ VAS, ISI, PDI and TSK. In the logistic regression analysis, no significant associations could be identified.ConclusionsMMR for patients with complex pain problems can be a successful treatment alternative at conventional pain clinics.ImplicationsSince access to rehabilitation clinics in Sweden may be limited, the availability of MMR can increase by providing this type of intervention in pain clinics. Increased knowledge of MMR in different settings can also contribute to increased understanding and collaboration between pain clinics and rehabilitation units.

scholarly journals Effect of a Fixed-Dose Opioid Agonist/ Antagonist on Constipation in Patients on Long-term Opioids for Non-Malignant Pain Unable to Tolerate Laxatives

2014 ◽  
Vol 5;17 (5;9) ◽  
pp. 415-424 ◽  
Author(s):  
Dr Vivek Mehta
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Study Design ◽  
Bowel Function ◽  
Pain Clinic ◽  
Fixed Dose ◽  
Life Questionnaire ◽  
Chronic Pain Patients ◽  
Pain Patients

Background: Chronic pain affects a large number of patients throughout the world and impacts greatly on their quality of life, including the ability of a patient to sleep, go to work, and socialize. Guidance on the use of opioids in chronic pain patients is available from the British Pain Society; however, patients receiving opioid treatment for their pain often suffer from symptoms associated with opioid-induced bowel dysfunction (OIBD), including constipation. The usual treatment of constipation in these patients is laxatives; however, one study has shown that 54% of patients do not receive the desired results from this approach. Oxycodone/naloxone tablets have been shown to provide analgesia to chronic pain patients, while improving the symptoms of OIBD, as the naloxone component blocks the effects of oxycodone at opioid receptors in the gut. Objectives: The objective of the present study was to assess improvements in quality of life and bowel function in patients receiving oxycodone/naloxone tablets for their chronic non-malignant pain. Study Design: This was a 12-week observational follow-up study that included 28 outpatients with chronic non-malignant pain attending the Pain Clinic at St. Bartholomew’s Hospital in London. All patients had recently been prescribed oxycodone/naloxone tablets as treatment for their pain. Methods: Patients were assessed at baseline, week 1, week 4, and week 12 for functioning and well-being using the Patient Assessment of Constipation Quality of Life questionnaire (PAC-QOL), and for bowel function using the Bowel Function Index (BFI). Results: Mean PAC-QOL scores, as well as scores for each of the subscales (worries and concerns, physical discomfort, psychosocial discomfort, and satisfaction) significantly improved from baseline to week 12. Mean BFI scores significantly decreased from baseline to all time-points during the study. Subscale analysis of the BFI scores showed that mean scores for ease of defecation and judgment regarding constipation had significantly decreased at week 12; however, mean scores for feeling of incomplete bowel evacuation had not. Limitations: The results of the current study should be interpreted in relation to the study design. However, the results are consistent with previous studies that included a comparator group, had a longer duration of treatment, and included larger patient numbers. Conclusions: The results of this study indicate that patients receiving oxycodone/naloxone tablets achieved statistically and clinically significant improvements in bowel function as well as quality of life after 12 weeks of treatment. Key words: Non-malignant pain, opioid, opioid-induced constipation, laxatives, oxycodone, naloxone, audit

scholarly journals Commitment to activities and quality of life and associated factors in patients with chronic pain

2020 ◽  
Vol 10 (5) ◽  
pp. 171-175
Author(s):  
Sandro Max Castro S ◽  
Carla Hilário da Cunha Daltro ◽  
Martha Moreira Cavalcante Castro ◽  
Camila Cavalcante Castro ◽  
Raphael de Souza Borges ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Depressive Symptoms ◽  
Cross Sectional Study ◽  
Daily Activities ◽  
Pain Clinic ◽  
Cross Sectional ◽  
Emotional Aspects ◽  
Statistical Program

ackground Chronic pain leads to functional and social disability, emotionally impacting individuals. Objective: To describe the main impairments of activities of daily living, anxious and depressive symptoms and quality of life in patients with chronic pain. Methods: Cross-sectional study with patients at the Chronic Pain Clinic attended between June / 2016 and March / 2019. Clinical and socio-demographic variables were collected, using the Hospital scale for Anxiety and Depression, Visual Numerical Scale for Pain, SF-36 scale for Quality of Life, and data analysis using the SPSS statistical program. Results: The mean age was 50.0±10 years, being (89.6%) female. There was a predominance of people with a partner, with religion, complete high school education and unemployed. Degenerative disease was the most frequent diagnosis (68.9%); pain intensity ranged from moderate to severe, score 6-8 (7). Most used drugs were analgesics (93.3%) followed by antidepressants (70.7%). Physical activity as an adjuvant treatment (41.5%), and anesthetic blocks (39.6%). When investigating daily activities, the work showed total limitation followed by movement; and, partially, leisure and home activity. The quality of life was well below the median, with the physical and emotional aspects being worse. Related to the subjects' activities, sleep is the most compromised; followed by partial difficulties with appetite and sexual activity. Most show self-esteem moderately satisfied with the treatment, even with anxious and depressive symptoms. Conclusion: Pain has a very significant impact on quality of life; compromises and limits daily activities and reveals more presence of anxious and depressive symptoms in people suffering from chronic pain.

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