scholarly journals Pain neuroscience education and physical exercise for patients with chronic spinal pain in primary healthcare: a randomised trial protocol

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Miguel A. Galán-Martín ◽  
Federico Montero-Cuadrado ◽  
Enrique Lluch-Girbes ◽  
M. Carmen Coca-López ◽  
Agustín Mayo-Iscar ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Primary Care ◽  
Chronic Pain ◽  
Clinical Practice ◽  
Physical Exercise ◽  
Public Health System ◽  
The Public ◽  
Neuroscience Education

Abstract Background Chronic musculoskeletal pain affects more than 20% of the population, and the prevalence is increasing, causing suffering, loss of quality of life, disability, and an enormous expenditure on healthcare resources. The most common location for chronic pain is the spine. Many of the treatments used are mainly passive (pharmacological and invasive) and poor outcomes. The treatments currently applied in the public health system do not comply with the recommendations of the main clinical practice guidelines, which suggest the use of educational measures and physical exercise as the first-line treatment. A protocol based on active coping strategies is described, which will be evaluated through a clinical trial and which could facilitate the transfer of the recommendations of the clinical practice guidelines to a primary care setting. Methods Randomised and multicentre clinical trials, which will be carried out in 10 Primary Care centres. The trial will compare the effect of a Pain Neuroscience Education program (six sessions, 10 h) and group physical exercise (18 sessions program carried out in six weeks, 18 h), with usual care physiotherapy treatment. Group physical exercise incorporates dual tasks, gaming, and reinforcement of contents of the educational program. The aim is to assess the effect of the intervention on quality of life, as well as on pain, disability, catastrophism, kinesiophobia, central sensitisation, and drug use. The outcome variables will be measured at the beginning of the intervention, after the intervention (week 11), at six months, and a year. Discussion Therapeutic interventions based on active coping strategies are essential for the treatment of chronic pain and the sustainability of the Public Health System. Demonstrating whether group interventions have an effect size is essential for optimising resources in such a prevalent problem. Trial registration NCT03654235 “Retrospectively registered” 31 August 2018.

Factors modifying the quality of life in patients submitted to cataract surgery in the public health system

2017 ◽  
Vol 27 ◽  
Author(s):  
André Lopes Carvalho Pereira ◽  
Bárbara Machado da Silveira ◽  
Felipe Corrêa Alves Martins ◽  
Júlia Martins Azevedo Eyer Thomaz ◽  
Márcio Heitor Stelmo da Silva ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Health System ◽  
Cataract Surgery ◽  
Public Health System ◽  
The Public

scholarly journals Effectiveness of a Physical Therapeutic Exercise Programme for Caregivers of Dependent Patients: A Pragmatic Randomised Controlled Trial from Spanish Primary Care

2020 ◽  
Vol 17 (20) ◽  
pp. 7359
Author(s):  
Federico Montero-Cuadrado ◽  
Miguel Ángel Galán-Martín ◽  
Javier Sánchez-Sánchez ◽  
Enrique Lluch ◽  
Agustín Mayo-Iscar ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Primary Care ◽  
Health System ◽  
Public Health System ◽  
Experimental Treatment ◽  
Control Group ◽  
Therapeutic Exercise ◽  
Care Programme

Female family caregivers (FFCs) constitute one of the basic supports of socio-health care for dependence in developed countries. The care provided by FFCs may impact their physical and mental health, negatively affecting their quality of life. In order to alleviate the consequences of providing care on FFCs, the Spanish Public Health System has developed the family caregiver care programme (FCCP) to be applied in primary care (PC) centres. The effectiveness of this programme is limited. To date, the addition of a physical therapeutic exercise (PTE) programme to FCCP has not been evaluated. A randomised multicentre clinical trial was carried out in two PC centres of the Spanish Public Health System. In total, 68 FFCs were recruited. The experimental group (EG) performed the usual FCCP (4 sessions, 6 h) added to a PTE programme (36 sessions in 12 weeks) whereas the control group performed the usual FCCP performed in PC. The experimental treatment improved quality of life (d = 1.17 in physical component summary), subjective burden (d = 2.38), anxiety (d = 1.52), depression (d = 1.37) and health-related physical condition (d = 2.44 in endurance). Differences between the groups (p < 0.05) were clinically relevant in favour of the EG. The experimental treatment generates high levels of satisfaction.

scholarly journals Evaluation of the quality of life of mono or bimaxillary edentulous individuals seeking care in the public health system.

2017 ◽  
Vol 74 (4) ◽  
pp. 279
Author(s):  
Tatiana Ganzer Da Rosa ◽  
Vagner Flávio Reginato ◽  
Angélica Maroli ◽  
Mateus Bertolini Fernandes Dos Santos ◽  
Alfonso Sanchez-Ayala ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Public Health System ◽  
Complete Dentures ◽  
Removable Partial Denture ◽  
Partial Denture ◽  
The Public ◽  
Spss Software ◽  
Edentulous Patients

Objective: the objective of this study was to evaluate the influence of partial or total edentulism on the quality of life of elderly patients. Material and Methods: the sample consisted of 120 individuals, divided into edentulous patients with bi-maxillary complete dentures (CD) (n = 60) or partially edentulous individuals with maxillary CD and mandibular removable partial denture (RPD) (n = 60). Patients' quality of life was assessed using the OHIP-EDENT-19 questionnaire and the data were analyzed using the SPSS software. Results: patients using RPD presented higher quality of life compared to users of double CD, according to the values presented in OHIP-EDENT. Statistically significant differences were found when comparing the groups between complaints related to chewing (difficulty chewing, discomfort when eating, avoiding eating, interruption of meals), psychological discomfort and incapacity (unable to eat), social incapacity (unsatisfactory life), and painful mouth and discomfort (unsuitable prostheses, sore mouth). Conclusion: the type of prosthesis used may influence self-reported quality of life.

The Reality of Accessibility in the Public Health Systems

2013 ◽  
pp. 691-719
Author(s):  
Guillermo López Cala ◽  
Yolanda María de la Fuente Robles ◽  
Rosa María Fernández Alcalá
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Empirical Study ◽  
Health Centers ◽  
The Public ◽  
Basic Health ◽  
Important Concept ◽  
Use Of Technology ◽  
Information And Communication

This chapter deals with accessibility, a relevant and important concept for every citizen in the improvement of their quality of life in any environment or daily situation. Specifically, an empirical study about accessibility in the public health centers of a Basic Health Area (BHA) of Jaén is carried out. From this study, accessibility deficiencies in health buildings are revealed, and explicit proposals are provided with the aim of improving accessibility in different scopes such as information and communications. The improvement plans based on the use of Technology, Information, and Communication (TIC) tools help sensory disabled users that attend to the Health Center.

scholarly journals The Impact of a Primary Care, Pharmacist-Driven Intervention in Patients with Chronic Non-Cancer Pain—A Pilot Study

Pharmacy ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 113
Author(s):  
Mo Chen ◽  
Tejal Patel ◽  
Feng Chang
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Chronic Pain ◽  
Cancer Pain ◽  
Family Health ◽  
Primary Care Settings ◽  
Pain Intervention ◽  
Family Health Team ◽  
The Impact

Background: Chronic pain is a prevalent condition, experienced by 15.3% to 55% of Canadians, that is difficult to manage. With their broad accessibility and expertise on drugs, primary care pharmacists can help patients optimize their pain management. Methods: The objective of this study is to examine the effectiveness of a primary care, pharmacist-driven chronic pain intervention on pain and quality of life in patients with chronic non-cancer pain. A three-month naturalistic prospective study was conducted in primary care settings (five community pharmacies and one Family Health Team) across Ontario, Canada with a total of six pharmacists and 19 study participants. The primary care, pharmacist-driven chronic pain intervention consisted of patient assessments, medication reviews, care plan recommendations, and patient education. In order to evaluate the effectiveness of the intervention, pain intensity, pain interference, and quality of life were evaluated at baseline and at follow up (week 2 and month 3). Results: Trends towards improvement in pain and quality of life were found, however, these improvements were not statistically significant at follow up (month 3). Conclusions: This study provides the foundational research required to better understand the impact of Ontario pharmacists’ extended role in pain management in non-cancer patients within multiple primary care settings (e.g., Family Health Team, etc.) and has illustrated the importance of modifying and customizing care plans in patients with chronic pain. A larger sample size with tailored outcome measures may be necessary to better highlight significant improvements in pain and quality of life in patients with chronic non-cancer pain using a primary care, pharmacist-driven intervention.

scholarly journals Group Interprofessional Chronic Pain Management in the Primary Care Setting: A Pilot Study of Feasibility and Effectiveness in a Family Health Team in Ontario

2013 ◽  
Vol 18 (5) ◽  
pp. 237-242 ◽  
Author(s):  
Ricardo N Angeles ◽  
Dale Guenter ◽  
Lisa McCarthy ◽  
Martha Bauer ◽  
Miriam Wolfson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Resource Utilization ◽  
Health Resource ◽  
Health Resource Utilization ◽  
Significant Difference ◽  
The Mean

BACKGROUND: Approximately 18.9% of Canadians live with chronic pain. Primary care reform in Ontario presents unique opportunities to assess approaches to help these patients.OBJECTIVE: To assess the feasibility of an interprofessional primary care-based program for patients living with chronic pain, and to examine the potential impact of such a program on quality of life and health resource utilization.METHODS: >An embedded mixed-methods evaluation (randomized controlled trial with waiting list control and semistructured interviews) of an eight-week series of small group sessions exploring multifactoral aspects of pain management was performed. Participants were randomly assigned to early intervention (EI) or delayed intervention (DI) groups. All participants received the intervention; the DI group served as a control group for comparison with the EI group. Outcomes included the Short Form-36 Health Survey version 2 (SF-36v2), medication use and health care utilization. Qualitative interviews were conducted to identify areas for program improvement.RESULTS: A total of 240 patients were recruited and 63 agreed to participate. The mean (± SD) age of the participants was 55±14.1 years and 62.3% were female. There was no significant difference in the mean change in SF-36v2 summary scores between the EI and DI groups. However, the SF-36v2 subscale score for bodily pain was significantly improved in the EI group compared with the DI group after six months of observation (mean difference = 13.1 points; P<0.05). There was also significant improvement in this score when both groups were pooled and aggregate preintervention and postintervention scores were compared. There was a significant decrease in the mean number of clinic visits in the six-month period following the intervention compared with the six-month period before the intervention (P=0.043).CONCLUSION: An interprofessional program in primary care for patients living with chronic pain may lead to improvements in quality of life and health resource utilization. The challenges to the feasibility of the program and its evaluation are recruitment and retention of patients, leading to the conclusion that the program, as it was conducted in the present study, is not appropriate for this setting.

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