scholarly journals ANALYSIS OF THE EFFECTIVENESS OF COUNSELING AND DIGITAL BOOKLET BY PHARMACIST ON ADHERENCE AND PAIN CONTROL OF CANCER PATIENTS AT DHARMAIS CANCER HOSPITAL

Author(s):  
RURYNTA FERLY SHAVIRA ◽  
RETNOSARI ANDRAJATI ◽  
RISANI ANDALASIA PUTRI

Objective: This study aimed to compare the effectiveness of counseling and digital booklet on the level of treatment adherence through reduced pain scale, Morisky Medication Adherence Scale (MMAS-8) scores, and pill count scores in patients with cancer pain using opioid analgesics. Methods: The author conducted this study at Dharmais Cancer Hospital with a quasi-experimental design. The study sample consisted of 134 respondents who met the inclusion and exclusion criteria, underwent a counseling intervention, and received a digital booklet. The author divided the sample into two groups, the counseling group (n=67) and the digital booklet group (n=67). Adherence level was measured using MMAS-8 and pill count. The pain scale was measured using the Numerical Rating Scale. Those measurements were conducted before the intervention (pre-test) and after 2 weeks of provisioning counseling and receipt of the digital booklet (post-test). Results: The results showed that each counseling and digital booklet improve adherence (p<0.05) and decrease pain scale (p<0.05). There was a significant difference in changes in the level of adherence (p=0.027) between the two groups. However, there was no significant difference in changes in the pain scale (p=0.132) between the two groups. Conclusions: The analysis showed a significant difference (p<0.05) between adherence level and pain scale before and after intervention by both counseling and digital booklet. Nevertheless, adherent increasing and pain scale reduction by counseling is better than a digital booklet.

Author(s):  
Lia Fitria ◽  
Anisa Febrianti ◽  
Arifah Arifin ◽  
Arifatul Hasanah ◽  
Dianatul Firdausiyeh

Adolescent girls will experience changes in the reproductive system marked by menstruation. Menstruation experienced in adolescents is often accompanied by complaints of menstrual pain. Menstrual pain can interfere with daily activities, so it requires treatment to reduce menstrual pain. One way of handling that can be done is with aromatherapy. Lavender and peppermint aromatherapy is a treatment that uses lavender and peppermint essential oils which contain linalool and linalyl acetate which are useful for reducing menstrual pain. The purpose of this study was to determine the effectiveness of lavender aromatherapy with peppermint on the menstrual pain scale in adolescent girls. The research design used was quantitative, quasi-experimental method with a two-group pre-test and post-test design with a sample of 14 respondents, 7 respondents in the lavender aromatherapy group and 7 respondents in the peppermint aromatherapy group. The sampling technique used consecutive sampling. The instrument used is a numerical rating scale (NRS). Data were processed by Wilcoxon test and Mann Whitney test. The results of this study indicate that lavender aromatherapy and lemon aromatherapy are effective in reducing menstrual pain scale with p value 0.001 (p < 0.05). Levender aromatherapy and peppermint aromatherapy were effective in reducing menstrual pain scale, but there was no significant difference in reducing pain scale in both lavender and peppermint therapy groups.


2020 ◽  
Author(s):  
Behdokht Aleali ◽  
Mohammad Hossein Sharifi ◽  
Malihe Sousani ◽  
Alireza Salehi

Abstract BackgroundLow back pain (LBP) is one of the most prevalent diseases in the developed and developing countries, which imposes high socioeconomic burden on both the individual and the community. There are limited studies that explain the clinically meaningful impact of chiropractic modality in chronic LBP.MethodThis is a quasi-experimental study. Participants were patients who had referred to Shiraz private chiropractic clinics with more than three month chronic LBP and had no pathologic abnormalities. Data were collected in two stages, baseline visit and 8 weeks after treatment. The effect of intervention measured throughout three questionnaire including Roland Morris Disability Questionnaire (RMDQ), Numerical Rating Scale (NRS) and self-assessment Global Rating of Change (GRC) questionnaires.Result141 patients analyzed, the mean age of participants was 40.18 ± 10.42 years of old and 40 (28.4%) were male. The mean duration of LBP was 56.73 ± 45.11 months. Before and after intervention, based on RMDQ and NRS data, indicated that the mean difference ± Standard Deviation was 5.54 ± 4.95 and 2.44 ± 1.64 the statistically significant difference (P < 0.001) and (P < 0.001) among all demographic and clinical characteristic variables, except job status. The mean ± SD of GRC was 56.13 ± 33.03%. Based on the RMDQ cut-off point, 88 participants (62%; 95% CI: 50–70) have been affected by chiropractic with a clinically meaningful effect. In addition, the chiropractic may be an effective therapeutic modality in treating patients with mild, moderate, or even severe MRI findings.ConclusionComplementary chiropractic treatment amongst chronic LBP patients may be an appropriate adjuvant to conventional treatments to improve disability and pain intensity reduction in both genders.


2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Afshin Farhanchi ◽  
Behrouz Karkhanei ◽  
Negar Amani ◽  
Mashhood Aghajanloo ◽  
Elham Khanlarzadeh ◽  
...  

Introduction. In this study we are aiming to evaluate the changes of serum serotonin and its association with pain in patients suffering from chronic low back pain before and after lumbar discectomy surgery. Patients and Methods. A prospective study was performed on the patients referring to the outpatient clinic in Besat hospital, Hamadan University of Medical Sciences, Hamadan, Iran, during 2016. A 2 mL fasting blood sample was collected from each patient at preoperative day 1 and postoperative day 14 and they were measured for level of serum serotonin. Besides, all patients were asked for severity of their low back pain in preoperative day 1 and postoperative day 14 and scored their pain from zero to ten using a Numerical Rating Scale. Results. Forty patients with the mean age of 47 ± 13 yrs/old (range 25–77) including 15 (37.5%) males were enrolled into the study. The overall mean score of preoperative pain was significantly decreased from 7.4 ± 2.18 (range 4–10) to the postoperative pain score 3.87 ± 2.92 (range 0–10) (P < .001). The overall levels of pre- and postoperative serum serotonin were 3.37 ± 1.27 (range 1.1–6.4) and 3.58 ± 1.32 (range .94–7.1) ng/mL, respectively, with no significant difference (P = .09). The levels of pre- and postoperative serum serotonin were significantly higher in males and patients older than 50 yrs/old compared to the females and patients younger than 50 yrs/old, respectively (P = .03 and .005, respectively). A significant inverse correlation between the postoperative levels of pain and serum serotonin was observed (r = -.36 and P = .02). Conclusion. A negative medium strength linear relationship may exist between the postoperative serum serotonin and low back pain.


2017 ◽  
Vol 10 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Katharine Hamlin ◽  
Christopher Munro ◽  
Scott L. Barker ◽  
Sean McKenna ◽  
Kapil Kumar

Background Optimal surgical treatment of lateral epicondylitis remains uncertain. Recently, radiofrequency microtenotomy (RFMT) has been proposed as a suitable treatment. We compared RFMT with standard open release (OR) in this prospective randomized controlled trial. Methods In total, 41 patients with symptoms for at least 6 months were randomized into two groups: 23 patients had RFMT and 18 had OR. Two patients from RFMT withdrew. Each patient underwent Numerical Rating Scale (NRS) pain score, grip strength and Disabilities of the Arm, Shoulder and Hand (DASH) scores pre-operatively and at 6 weeks. Pain and DASH scores were repeated at 6 months and 12 months. Results NRS pain scores improved by 4.8 points for RFMT and by 3.9 points for OR. There was a significant improvement in both groups from pre-operative scores, although there was no statistically significant difference between the groups at 1 year. Grip strength improved by 31% in the RFMT group compared to 38% in OR. There was no significant difference between the initial and 6 weeks scores or between treatments. At 1 year, DASH was 39.8 points for RFMT and 24.4 points for OR. There was a significant improvement in both groups from pre-operative scores, although there was no statistically significant difference between the groups at 1 year. Conclusions Both groups showed significant improvements and similar benefit to the patient. The results of the present study do not show any benefit of RFMT over the standard OR. As a result of the extra expense of RFMT, we therefore recommend that OR is offered as the standard surgical management.


2019 ◽  
Vol 5 (4) ◽  
pp. 00153-2019 ◽  
Author(s):  
David C. Currow ◽  
Toby Hunt ◽  
Sandra Louw ◽  
Danny Eckert ◽  
Peter Allcroft ◽  
...  

Question addressed by the studyEndogenous opioids (endorphins) have been reported to modulate exercise-induced breathlessness, but the relative contribution of peripheral opioid receptors has not been tested.Materials, participants and methodsThis was a double-blind, randomised, three-arm, cross-over trial in outpatients with spirometry-verified moderate to severe chronic obstructive pulmonary disease. Participants undertook an incremental symptom-limited treadmill test followed by five endurance treadmill tests at 75% of their maximal work rate; two tests for familiarisation and three tests 30 min after intravenous injection of either methylnaltrexone 0.3 mg·kg−1 (blocking peripheral opioid receptors only) or naloxone 0.1 mg·kg−1 (blocking both central and peripheral opioid receptors) or normal saline, in randomised order. The primary end-point was the regression slope between breathlessness intensity (0–10 numerical rating scale) and oxygen consumption (V′O2) during the walk tests, comparing methylnaltrexone and placebo using a paired t-test.Results17 participants completed the trial: median (range) 66 (55–82) years; 15 males; mean±sd forced expiratory volume (FEV1) 53.8±17.6% predicted; FEV1/forced vital capacity ratio 0.55±15.9. There was no statistically or clinically significant difference in the primary end-point (regression slope of breathlessness intensity and V′O2) for methylnaltrexone (p=0.498) or naloxone (p=0.804), compared to placebo. Secondary outcomes were similar between the three treatment groups, including peak and mean breathlessness intensity and unpleasantness, exercise capacity, endurance time and leg fatigue.Answer to the questionBlocking peripheral opioid receptors (methylnaltrexone) or peripheral and central opioid receptors (naloxone) did not appear to modulate breathlessness intensity nor exercise capacity when compared with placebo (no blockade).


2020 ◽  
Vol 14 (03) ◽  
pp. 393-396
Author(s):  
Benjamin Mahmoodi ◽  
Adriano Azaripour ◽  
Kawe Sagheb ◽  
Keyvan Sagheb ◽  
Brita Willershausen ◽  
...  

Abstract Objectives Reciprocating endodontic one-file systems are a comparatively new method for root canal shaping. Even though the mechanical properties are comparable to modern rotating mechanical systems, data about subjective assessment and application quality are scarce. This study evaluates the reciprocating one-file system in undergraduate education. Materials and Methods A total of 42 undergraduate students without experience regarding reciprocating file systems filled in a questionnaire in four different points in time (t 1–t 4) anonymously. The questionnaire was based on a numerical rating scale ranging from 0 to 10. Statistical Analysis A least significant difference post-hoc analysis comparing the group average values was performed. The adjusted level of significance was p < 0.004 after Bonferroni correction. Results All rating scores increased after the first theoretical instruction. After the first practical training in artificial root canals in resin blocks and extracted teeth (t 2), the estimation of “time efficiency” (p = 0.002), “handling” (p < 0.001), and “overall impression” (p < 0.001) improved significantly. The “overall impression” remained constant and showed no significant changes after the first practical training. Conclusions Reciprocating systems seem to show a good acceptance among first time users. Initial concerns about “work safety” decrease during every step of the educational process. Reciprocating one-file systems are a safe and well-accepted method in undergraduate teaching.


Pain Medicine ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 326-332 ◽  
Author(s):  
Hiroshi Oka ◽  
Kenji Miki ◽  
Iwao Kishita ◽  
David F Kong ◽  
Takahiro Uchida

Abstract Objectives Existing treatments for fibromyalgia have limited efficacy, and only a minority of individuals clinically respond to any single intervention. This study was a prospective, multicenter, randomized, double-blind, controlled clinical trial to evaluate the feasibility of alternating magnetic field therapy in fibromyalgia patients by comparing the Angel Touch device (AT-02) with a sham control (S-01). Methods Two sites enrolled 44 subjects with diagnosed fibromyalgia. After informed consent, subjects taking prohibited concomitant drugs underwent a washout period of two or more weeks. All subjects then began a one-week run-in period. Numerical rating scale (NRS) pain scores were collected without device intervention for one day, followed by S-01 application to four or more painful sites for 10 minutes at each site, twice daily for six days. Subjects were then randomized to AT-02 or S-01, applied to four or more painful sites for 10 minutes at each site, twice daily for eight weeks. NRS scores were obtained twice daily during the entire treatment period. Results The primary end point (change in NRS ± SD at week 8 vs baseline) was –0.94 ± 1.33 in the AT-02 group and –0.22 ± 1.38 in the S-01 group. A trend toward a between-group difference in eight-week NRS scores favored the AT-02 group (–0.73, 95% confidence interval = –1.56 to 0.11, P = 0.086). An adjusted repeated measure analysis detected a significant difference in NRS scores (P = 0.039). Conclusions The reduction in NRS scores for AT-02 relative to sham was comparable to reductions observed in meta-analyses of fibromyalgia drug therapy. The unadjusted results and the persistence of the pain score reductions remain encouraging.


Pain Medicine ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. 1562-1571 ◽  
Author(s):  
Lucyna Tomaszek ◽  
Dariusz Fenikowski ◽  
Piotr Maciejewski ◽  
Halina Komotajtys ◽  
Danuta Gawron

Abstract Objective To determine whether the use of perioperative gabapentin reduces postoperative pain and anxiety, decreases ropivacaine consumption and side effects, and improves patient satisfaction. Design Randomized, placebo-controlled, phase 4 trial. Blinding Participants, care providers, investigators, data analysts. Setting Department of Thoracic Surgery of the Institute of Tuberculosis and Lung Disease, Rabka Zdrój Branch, Poland. Subjects Forty patients undergoing the Ravitch procedure. Methods Patients aged nine to 17 years were randomized into a gabapentin (preoperative 15 mg/kg, treatment) or placebo group. Postoperative analgesia included gabapentin (7.5 mg/kg) or placebo two times per day for three days, epidural ropivacaine + fentanyl, paracetamol, nonsteroidal anti-inflammatory drugs, and metamizol as a “rescue drug.” Pain, anxiety, analgesic consumption, side effects, and patient satisfaction were recorded. Results There was no statistically significant difference in median pain scores (numerical rating scale &lt; 1/10) or incidence of adverse side effects between the gabapentin group (N = 20) and the placebo group (N = 20). Postoperative anxiety scores were significantly lower than before surgery in the gabapentin group (6 [4–8] vs 7 [6–8.5], P &lt; 0.01) and remained unchanged in the placebo group (6 [5–6.5] vs 6 [5–7], P = 0.07). Gabapentin-treated patients received a lower number of doses of ondansetron when compared with the placebo group (6 [5–6] vs 7 [6–9], P = 0.02). A significant negative association was found between patient satisfaction and postoperative state anxiety in the gabapentin group (R = –0.51, P = 0.02). Conclusions Perioperative administration of gabapentin resulted in a decrease of postoperative anxiety in pediatric patients undergoing the Ravitch procedure.


2019 ◽  
pp. 14
Author(s):  
M.D. Nisha

Background: Osteoarthritis is a major cause of many medical conditions and disability in people above 50’s and leads to reduced activity in older people. Global statistics revels that over 100 million people worldwide suffers from Osteoarthritis. Materials and methods: A quasi experimental pretest - posttest control group design was used. 200 geriatric clients with osteoarthritis residing in selected geriatric homes at Pathanamthitta were selected and assessed by using a Numerical Pain Intensity Scale, an Observational check list and a three point rating scale for pain, functional mobility and anxiety. Results: There was a significant difference between the mean pain score( t = 10.758 p = 0.01, df – 198), functional mobility ( t = 7.73 p = 0.01, df – 198) and anxiety (t = 7.665 ,df –198, p=0.01in experimental and control group after intervention ( t = 10.758 p = 0.01, df – 198).Statistically no significant association was found between pain, functional mobility and anxiety with variables such as gender, religion, marital status, number of children’s and duration of stay.The pain and anxiety correlation value was ‘r’ = 0.89. The functional mobility and anxiety correlation value was ‘r’ = 0.80. The functional mobility and pain correlation value was ‘r’ = 0.83. It shows that statistically positive correlation is present between the geriatric clients’ pain and anxiety, functional mobility and anxiety and functional mobility and pain at p<0.05% level of significance. Conclusion: Exercise is one of the best methods to treat Osteoarthritis. This study proved that isometric exercises are beneficial to improve the functional mobility of joints in old age people. When the mobility increases, intensity of joint pain decreases.


2018 ◽  
Vol 5 (1) ◽  
pp. 23 ◽  
Author(s):  
Vincent Bounes, MD ◽  
Jean Louis Ducassé, MD ◽  
Annie Momo Bona, MD ◽  
Florent Battefort, MD ◽  
Charles-Henri Houze-Cerfon, MD ◽  
...  

Objective: To evaluate the efficacy and safety of inhaled morphine delivered in patients experiencing severe acute pain in an emergency setting.Patients and Methods: Patients were eligible for inclusion if they were aged 18 years or older, with a severe acute pain defined by a numerical rating scale (NRS) score of 60/100 or higher. The intervention involved administering a single dose of 0.2 mg/kg morphine nebulized using a Misty-Neb nebulizer system. NRSs were recorded and were repeated at 1, 3, 5, and 10 minute after the end of inhalation (T10). The protocol-defined primary outcome measure was pain relief (defined by an NRS score of 30/100 or lower) at T10. Secondary outcomes included differences between pain scores at baseline and at T10 and incidence of adverse events.Results: A total of 28 patients were included in this study. No patient experienced pain relief 10 minutes after the end of inhalation, and no adverse effects were recorded. Respective initial and final median NRS scores were 80 (70-90) and 70 (60-80), p < 0.0001. Despite achieving statistical significance, the value of this point estimate is less than the 14 NRS difference that was defined a priori as representing a minimum clinically significant difference in pain severity.Conclusion: 0.2 mg/kg nebulized morphine is not effective in managing acute pain in an emergency setting. In spite of the potential advantages of the pulmonary route of administration, opioids should be intravenous prescribed at short fixed intervals to control severe acute pain in an emergency setting.


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