scholarly journals Factors affecting treatment preferences of chronic pain patients in primary care and current treatment options in chronic pain

2019 ◽  
Vol 16 (3) ◽  
pp. 781-790
Author(s):  
Hayriye Baltaoğlu Alp
Keyword(s):  
Chronic Pain ◽  
Pain Treatment ◽  
Treatment Options ◽  
Research Problem ◽  
Treatment Method ◽  
English Summary ◽  
World Health ◽  
Treatment Preferences ◽  
Chronic Pain Patients ◽  
Pain Patients

Research problem/aim: In a multicenter study of the World Health Organization, 22% of patients who applied to primary health care centers reported that their pain continued for 6 months. Multidisciplinary approach and empathy are important for patients with chronic pain. 20% of first-line outpatient referrals consist of chronic painful cases. When the analgesics are used correctly in the treatment of pain, sufficient pain control can be achieved in 85%. Non-steroidal and steroid analgesics may present with high doses of gastrointestinal side effects. Method: The sociodemographic characteristics of the participants were recorded on the forms prepared by the researchers. Finding: The mean age of the patients was 58.62 ± 10.72.Pain was found to affect sleep. (* p <0.05) Conclusion: The patient sector, which is far from rational drug use, can cause great harm to the country's economy. With the extensive studies to be carried out, the treatment method of the patients and the reasons why they prefer. It will be helpful for the chronic pain patients to get the right information from their doctors about the treatment options. For this reason, family physicians should be equipped with up-to-date information about all methods used in chronic pain treatment. Extended English summary is in the end of Full Text PDF (TURKISH) file.   Özet Araştırma problem/amaç: Dünya Sağlık Örgütünün çok merkezli yapılan bir araştırmasında birinci basamak sağlık merkezlerine başvuran hastaların %22’sinde ağrılarının 6 aydır devam ettiği belirtilmektedir. Kronik ağrısı olan hastalara multidispliner yaklaşım ve empati önemlidir. Birinci basamak poliklinik başvurularının %20’si kronik ağrılı olgulardan oluşmaktadır. Ağrı tedavisinde analjezikler doğru kullanıldığında %85’inde yeterli ağrı kontrolü sağlanabilmektedir. Non-steroid ve steroid analjezikler yüksek dozlarda gastrointestinal yan etkilerle karşımıza çıkabilmektedir. Metot: Katılımcıların sosyodemografik özellikleri araştırmacılar tarafından önceden hazırlanan formlara kaydedildi. Bulgular: Çalışmaya katılan hastaların ortalama yaşları 58.62±10.72 olarak tespit edildi. Ağrının uykuyu etkilediği bulunmuştur.(* p<0,05) Sonuçlar: Akılcı ilaç kullanımından uzak hasta kesimi ülke ekonomisine büyük zararlar verebilmektedir. Yapılacak geniş kapsamlı çalışmalar ile hastaların hangi tedavi yöntemini, neden tercih ettikleri konusu daha açığa kavuşacaktır. Kronik ağrı hastalarının tedavi seçenekleri hakkında doktorlarından doğru bilgi alması kendisine en uygun yöntemi seçmesi konusunda yol gösterici olacaktır. Bunun için de aile hekimlerinin kronik ağrı sağaltımında kullanılan tüm yöntemler hakkında güncel bilgilerle donanımlı olması gerekmektedir.

scholarly journals Sublingual Buprenorphine/Naloxone and Multi-Modal Management for High-Risk Chronic Pain Patients

2021 ◽  
Vol 10 (5) ◽  
pp. 973
Author(s):  
Shane Kaski ◽  
Patrick Marshalek ◽  
Jeremy Herschler ◽  
Sijin Wen ◽  
Wanhong Zheng
Keyword(s):  
Chronic Pain ◽  
High Risk ◽  
Pain Score ◽  
Rating Scale ◽  
Pain Treatment ◽  
Pain Clinic ◽  
Sublingual Buprenorphine ◽  
Significant Downward Trend ◽  
Chronic Pain Patients ◽  
Pain Patients

Patients with chronic pain managed with opioid medications are at high risk for opioid overuse or misuse. West Virginia University (WVU) established a High-Risk Pain Clinic to use sublingual buprenorphine/naloxone (bup/nal) plus a multimodal approach to help chronic pain patients with history of Substance Use Disorder (SUD) or aberrant drug-related behavior. The objective of this study was to report overall retention rates and indicators of efficacy in pain control from approximately six years of High-Risk Pain Clinic data. A retrospective chart review was conducted for a total of 78 patients who enrolled in the High-Risk Pain Clinic between 2014 and 2020. Data gathered include psychiatric diagnoses, prescribed medications, pain score, buprenorphine/naloxone dosing, time in clinic, and reason for dismissal. A linear mixed effects model was used to assess the pain score from the Defense and Veterans Pain Rating Scale (DVPRS) and daily bup/nal dose across time. The overall retention of the High-Risk Pain Clinic was 41%. The mean pain score demonstrated a significant downward trend across treatment time (p < 0.001), while the opposite trend was seen with buprenorphine dose (p < 0.001). With the benefit of six years of observation, this study supports buprenorphine/naloxone as a safe and efficacious component of comprehensive chronic pain treatment in patients with SUD or high-risk of opioid overuse or misuse.

Chronic pain patients’ treatment preferences: a discrete-choice experiment

2014 ◽  
Vol 16 (6) ◽  
pp. 613-628 ◽  
Author(s):  
Axel C. Mühlbacher ◽  
Uwe Junker ◽  
Christin Juhnke ◽  
Edgar Stemmler ◽  
Thomas Kohlmann ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Treatment Preferences ◽  
Chronic Pain Patients ◽  
Pain Patients

Psychological Testing Variables as Predictors of Return to Work by Chronic Pain Patients

1996 ◽  
Vol 83 (3_suppl) ◽  
pp. 1317-1318 ◽  
Author(s):  
Rosemary A. Robbins ◽  
David S. Moody ◽  
Marc B. Hahn ◽  
Michael A. Weaver
Keyword(s):  
Chronic Pain ◽  
Return To Work ◽  
Beck Depression Inventory ◽  
Self Efficacy ◽  
Pain Treatment ◽  
Psychological Testing ◽  
Positive Symptom ◽  
Symptom Checklist ◽  
Chronic Pain Patients ◽  
Pain Patients

After multidisciplinary pain treatment, pretreatment psychological testing variables were compared for 20 chronic pain patients who were working and 42 who were not working. Symptom Checklist-90–R scores for Depression, Anxiety, Phobic Anxiety, Psychoticism, Global Severity, and Positive Symptom Distress were lower for working subjects as were those on the Beck Depression Inventory. In contrast, workers scored higher on self-efficacy to manage pain, self-efficacy to function, self-efficacy to manage other symptoms, and over-all self-efficacy.

scholarly journals Smoking Behavior and Motivation to Quit among Chronic Pain Patients Initiating Multidisciplinary Pain Treatment: A Prospective Study

Pain Medicine ◽  
2014 ◽  
Vol 15 (8) ◽  
pp. 1294-1303 ◽  
Author(s):  
Marina Unrod ◽  
Ronald J. Gironda ◽  
Michael E. Clark ◽  
Kristi E. White ◽  
Vani N. Simmons ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Prospective Study ◽  
Pain Treatment ◽  
Smoking Behavior ◽  
Motivation To Quit ◽  
Chronic Pain Patients ◽  
Multidisciplinary Pain Treatment ◽  
A Prospective Study ◽  
Pain Patients

scholarly journals Mobile Application-Based Interventions for Chronic Pain Patients: A Systematic Review and Meta-Analysis of Effectiveness

2020 ◽  
Vol 9 (11) ◽  
pp. 3557
Author(s):  
Ann-Christin Pfeifer ◽  
Riaz Uddin ◽  
Paul Schröder-Pfeifer ◽  
Felix Holl ◽  
Walter Swoboda ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Mobile Application ◽  
Meta Analysis ◽  
Treatment Options ◽  
Bibliographic Databases ◽  
Final Sample ◽  
Design For All ◽  
Chronic Pain Patients ◽  
Pain Patients

Chronic pain is one of the major causes of disability in the general population. Even though there are effective treatment options available for reducing symptoms, these treatments often do not have consistent lasting effects. As the usage of mobile devices has increased enormously during the last few years, mobile application-based treatment options are widespread. Such app-based programs are not yet empirically proven but might enable patients to become more independent in their pain management in order to prevent relapse. The aim of this meta-analysis was to summarize the literature on mobile application-based interventions for chronic pain patients. Therefore, three electronic bibliographic databases, PubMed, PsycINFO, and Web of Science, were searched for studies that investigated the effectiveness of mobile application-based intervention for chronic pain on pain intensity. The final sample comprised twenty-two studies, with a total of 4679 individuals. Twelve of these twenty-two studies used a randomized control trial (RCT) design, while ten studies only used an observational design. For all twenty-two studies, a small but significant effect (d = −0.40) was found when compared to baseline measures or control groups. The results suggest that apps-based treatment can be helpful in reducing pain, especially in the long-term.

Characteristics and consequences of the co-occurrence between social anxiety and pain-related fear in chronic pain patients receiving multimodal pain rehabilitation treatment

2016 ◽  
Vol 12 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Matilda Wurm ◽  
Sara Edlund ◽  
Maria Tillfors ◽  
Katja Boersma
Keyword(s):  
Chronic Pain ◽  
Social Anxiety ◽  
Anxiety Sensitivity ◽  
Pain Treatment ◽  
Vulnerability Factors ◽  
Treatment Results ◽  
Chronic Pain Patients ◽  
Emotional Vulnerability ◽  
Multimodal Pain Treatment ◽  
Pain Patients

AbstractBackground and aimsChronic pain problems are related to specific pain related fears and maladaptive pain-coping but also commonly co-occur with other anxiety problems. Shared emotional vulnerability factors may explain this comorbidity and may influence treatment outcome. Indeed, pain patients going through multimodal pain treatment are a heterogeneous group and treatment results vary. One understudied anxiety disorder co-occurring with pain is social anxiety. This may be relevant as many pain-related challenges are situated in social contexts. The aim of this study is to investigate the occurrence of subgroups with differential patterns of social anxiety and pain related fear in a sample of chronic pain patients who receive multimodal pain treatment. The aim is also to study the characteristics of these potential subgroups and the consequences of different patterns of social anxiety and pain related fear.Methods180 patients with chronic musculoskeletal pain answered questionnaires before and after a multimodal pain treatment in a hospital rehabilitation setting in middle Sweden. A cluster analysis using pre-treatment scores on the Social Phobia Screening Questionnaire and the Tampa Scale of Kinesiophobia was performed. Subgroups were thereafter validated and compared on impairment due to social anxiety, pain catastrophizing, anxiety, and depression. Moreover, subgroups were described and compared on vulnerability factors (anxiety sensitivity, negative affect) and outcome factors (pain intensity, pain interference, and return to work self-efficacy).ResultsFour distinct clusters emerged: (1) low scores, (2) pain-related fear only, (3) social concern only, and (4) high social anxiety and pain-related fear. Patients high on social anxiety and pain-related fear had significantly higher levels of anxiety sensitivity, negative affect, and higher general emotional symptomatology. They also had remaining problems posttreatment.ConclusionsA subgroup of patients with clinical levels of social anxiety has suboptimal rehabilitation results, with residual emotional problems and high levels of emotional vulnerability.ImplicationsThese patients may be in need of additional treatment efforts that are not being met today. To prevent insufficient treatment results and prolonged work disability, these patients need to be detected during screening and may benefit from pain treatment that takes their emotional problems into account.

scholarly journals An Emerging Dimension in Psychosomatic Research: The Nocebo Phenomenon in the Management of Chronic Pain

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
A. Ciaramella ◽  
M. Paroli ◽  
P. Poli
Keyword(s):  
Chronic Pain ◽  
Pain Treatment ◽  
Placebo Response ◽  
Nocebo Effect ◽  
Cold Pain ◽  
Psychosomatic Research ◽  
Chronic Pain Patients ◽  
The Subject ◽  
Pain Patients ◽  
Clinical Worsening

Introduction. The nocebo effect consists in delivering verbal suggestions of negative outcomes so that the subject expects clinical worsening. Several studies indicate that negative verbal suggestions may result in the amplification of pain. Amplification style is one of the most important dimensions in psychosomatic research. Methods. One group of pain therapy unit patients was evaluated at baseline and again after 6 months from the beginning of the pain treatment. Results. Only 43% of 86 chronic pain patients respond positively to the expectation of sham pain. This group shows at baseline higher pain intensity (t value: 2.72, ) and lower cold pain threshold (t value: 2.18, ) than the group of subjects with any response to sham pain stimulus. Somatoform dimensions influence positively the strength of nocebo response in those predisposed to it. Conclusion. Our study shows that the power of the nocebo phenomenon seems to be a dimension belonging to the investigation in psychosomatic. In contrast to what one might expect, the presence of the nocebo phenomenon affects positively pain relief and the outcome of pain treatment. In a clinical setting, and the meaning of nocebo response does not seem to be different from placebo response.

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

scholarly journals Pharmacological Management of Chronic Pain: How to Deal with the Catch-22 Situation

2021 ◽  
Vol 4 (02) ◽  
Author(s):  
Trine Andresen ◽  
Marieke Niesters ◽  
Albert Dahan ◽  
Bart Morlion ◽  
Tony O´Brien ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Side Effects ◽  
Pain Treatment ◽  
Pharmacological Management ◽  
Chronic Pain Patients ◽  
Education And Awareness ◽  
Integral Element ◽  
Catch 22 ◽  
The Individual ◽  
Pain Patients

Management of chronic pain is multidisciplinary, but pharmacotherapy is one of the mainstays of pain management. As applies in all medical therapies, clinicians must strive to achieve the best possible outcome for patients in terms of maximising benefit and minimizing risks, and ensure that this is conducted for each treatment and as an integral element in selecting appropriate therapies. If the balance between risk and benefits is not achieved and understood by the patient. Chronic pain patients may already experience a degree of stigmatisation, which can be further exacerbated by evolving socio-political pressures in respect of analgesic availability and accessibility.  Hence, we have a Catch-22 situation in which patients become ensnared; they may need supervised access to legitimate analgesic medication(s) but these are not easily accessible because of concerns of the analgesic side-effects and abuse/misuse potential influencing both the individual and wider society.   In this paper, we review the evidence in respect of analgesic use in chronic pain. We highlight the importance of: 1) better education and awareness of the problem, 2) evaluate the balance between effect and side effects rather than focusing on pain intensity alone, and include such composite measures in clinical trials, 3) identification of responders to treatment and systematic monitoring for misuse and 4) the use of big data to guide politicians away from inappropriate regulatory restrictions. Such a strategy will improve pain treatment and due to the major costs associated with chronic pain it will also be of benefit for society.

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