scholarly journals What is the content of virtually delivered pain management programmes for people with persistent musculoskeletal pain? A systematic review

2021 ◽  
pp. 204946372110230
Author(s):  
Gregory Booth ◽  
Deborah Williams ◽  
Hasina Patel ◽  
Anthony W Gilbert
Keyword(s):  
Systematic Review ◽  
Pain Management ◽  
Musculoskeletal Pain ◽  
Clinical Guidelines ◽  
Reporting Quality ◽  
Skills Training ◽  
Evidence Based ◽  
Core Element ◽  
Multidisciplinary Pain Management ◽  
Pain Services

Introduction: Virtual consultations (VC) have been embraced by healthcare organisations during the COVID-19 pandemic. VC allows continuation of patient care while adhering to government advised restrictions and social distancing measures. Multidisciplinary pain management programmes (PMPs) are a core element of many pain services and utilising virtual methods to deliver PMPs has allowed them to continue to provide care. This systematic review aimed to explore the content of existing virtually delivered PMPs and discuss if and how these findings can be used to guide clinical delivery. Methods: Eligible studies included adults (aged ⩾18 years) with persistent musculoskeletal pain and any virtually delivered intervention that was described as a PMP or that had components of PMPs. Databases were searched from inception until July 2020. We performed a content analysis comparing existing interventions with established evidence-based clinical guidelines published by the British Pain Society (BPS). Intervention reporting quality was assessed using the Template for Intervention Description and Replication (TIDieR) checklist: an established checklist developed to improve the completeness of the reporting of interventions. Results: Eight studies were included. One intervention included six of the seven components recommended by the BPS; none included all seven. ‘Skills training and activity management’ was present in all eight interventions; ‘education’ and ‘cognitive therapy methods’ were present in six interventions; ‘graded activation’ and ‘methods to enhance acceptance, mindfulness and psychological flexibility’ were present in four interventions; ‘physical exercise’ was present in two interventions and ‘graded exposure’ was present in one intervention. None of the studies described all 12 items of the TIDieR checklist adequately enough for replication. Conclusion: Published virtual PMPs partially meet established clinical guidelines. Future virtual PMPs should be based on evidence-based clinical guidelines, and more research is needed to explore the effectiveness of virtually delivered PMPs and each recommended component.

scholarly journals An Update of Comprehensive Evidence-Based Guidelines for Interventional Techniques in Chronic Spinal Pain. Part I: Introduction and General Considerations

2013 ◽  
Vol 2s;16 (2s;4) ◽  
pp. S1-S48
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Pain Management ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Methodological Quality ◽  
Expert Advice ◽  
Evidence Based ◽  
Consensus Statements ◽  
Interventional Pain Management

In 2011, the Institute of Medicine (IOM) re-engineered its definition of clinical guidelines as follows: “clinical practice guidelines are statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefit and harms of alternative care options.” This new definition departs from a 2-decade old definition from a 1990 IOM report that defined guidelines as “systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances.” The revised definition clearly distinguishes between the term “clinical practice guideline” and other forms of clinical guidance derived from widely disparate development processes, such as consensus statements, expert advice, and appropriate use criteria. The IOM committee acknowledged that for many clinical domains, high quality evidence was lacking or even nonexistent. Even though the guidelines are important decisionmaking tools, along with expert clinical judgment and patient preference, their value and impact remains variable due to numerous factors. Some of the many factors that impede the development of clinical practice guidelines include bias due to a variety of conflicts of interest, inappropriate and poor methodological quality, poor writing and ambiguous presentation, projecting a view that these are not applicable to individual patients or too restrictive with elimination of clinician autonomy, and overzealous and inappropriate recommendations, either positive, negative, or non-committal. Consequently, a knowledgeable, multidisciplinary panel of experts must develop guidelines based on a systematic review of the existing evidence, as recently recommended by the IOM. Chronic pain is a complex and multifactorial phenomenon associated with significant economic, social, and health outcomes. Interventional pain management is an emerging specialty facing a disproportionate number of challenges compared to established medical specialties, including the inappropriate utilization of ineffective and unsafe techniques. In 2000, the American Society of Interventional Pain Physicians (ASIPP) created treatment guidelines to help practitioners. There have been 5 subsequent updates. These guidelines address the issues of systematic evaluation and ongoing care of chronic or persistent pain, and provide information about the scientific basis of recommended procedures. These guidelines are expected to increase patient compliance; dispel misconceptions among providers and patients, manage patient expectations reasonably; and form the basis of a therapeutic partnership between the patient, the provider, and payers. Key words: Evidence-based medicine (EBM), comparative effectiveness research (CER), clinical practice guidelines, systematic reviews, meta-analysis, interventional pain management, evidence synthesis, methodological quality assessment, clinical relevance, recommendations.

One-Session Treatment of Specific Phobias in Children: Recent Developments and a Systematic Review

2019 ◽  
Vol 15 (1) ◽  
pp. 233-256 ◽  
Author(s):  
Thompson E. Davis ◽  
Thomas H. Ollendick ◽  
Lars-Göran Öst
Keyword(s):  
Systematic Review ◽  
Children And Adolescents ◽  
Skills Training ◽  
Evidence Based ◽  
Future Directions ◽  
Research And Practice ◽  
Evidence Based Treatment ◽  
Specific Phobias ◽  
Recent Developments ◽  
Graduated Exposure

One-Session Treatment is a well-established evidence-based treatment for specific phobias in youths that incorporates reinforcement, cognitive challenges, participant modeling, psychoeducation, and skills training into a single, massed session of graduated exposure. This review begins by briefly examining the phenomenology, etiology, epidemiology, and assessment of specific phobias and then pivots to a description of One-Session Treatment. We examine the use of One-Session Treatment with children and adolescents, briefly discussing its components and application, and subsequently review almost two decades of research supporting its efficacy. Finally, we propose future directions for research and practice.

Systematic review of nonpharmacological analgesic interventions for common needle-related procedure in newborn infants and development of evidence-based clinical guidelines

2017 ◽  
Vol 106 (6) ◽  
pp. 864-870 ◽  
Author(s):  
Paola Lago ◽  
Elisabetta Garetti ◽  
Carlo Valerio Bellieni ◽  
Daniele Merazzi ◽  
Patrizia Savant Levet ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Guidelines ◽  
Newborn Infants ◽  
Evidence Based

scholarly journals Pain management in the emergency department: a clinical review

2021 ◽  
Vol 8 (4) ◽  
pp. 268-278
Author(s):  
Sergey M. Motov ◽  
Katherine Vlasica ◽  
Igor Middlebrook ◽  
Alexis LaPietra
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Clinical Review ◽  
Musculoskeletal Pain ◽  
Pharmacological Treatment ◽  
Treatment Modalities ◽  
Evidence Based ◽  
Opioid Prescribing ◽  
Analgesic Regimen ◽  
Current Practices

Pain is one of the most common reasons for patients to visit the emergency department. The ever-growing research on emergency department analgesia has challenged the current practices with respect to the optimal analgesic regimen for acute musculoskeletal pain, safe and judicious opioid prescribing, appropriate utilization of non-opioid therapeutics, and non-pharmacological treatment modalities. This clinical review is set to provide evidence-based answers to these challenging questions.

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