scholarly journals Frequency, nature and management of patient-reported severe acute pain episodes in the over-the-counter setting: results of an online survey

2019 ◽  
Vol 9 (4) ◽  
pp. 379-387 ◽  
Author(s):  
Connie Hersch ◽  
Camille Denis ◽  
Dalma Sugár
Keyword(s):  
Acute Pain ◽  
Online Survey ◽  
Over The Counter ◽  
Patient Reported

scholarly journals Free-Living User Perspectives on Musculoskeletal Pain and Patient-Reported Mobility With Passive and Powered Prosthetic Ankle-Foot Components: A Pragmatic, Exploratory Cross-Sectional Study

2022 ◽  
Vol 2 ◽  
Author(s):  
Andreas Kannenberg ◽  
Arri R. Morris ◽  
Karl D. Hibler
Keyword(s):  
Musculoskeletal Pain ◽  
Knee Pain ◽  
Online Survey ◽  
Rating Scales ◽  
Living Environment ◽  
Rank Test ◽  
Recall Bias ◽  
Free Living ◽  
The Past ◽  
Patient Reported

IntroductionStudies with a powered prosthetic ankle-foot (PwrAF) found a reduction in sound knee loading compared to passive feet. Therefore, the aim of the present study was to determine whether anecdotal reports on reduced musculoskeletal pain and improved patient-reported mobility were isolated occurrences or reflect a common experience in PwrAF users.MethodsTwo hundred and fifty individuals with transtibial amputation (TTA) who had been fitted a PwrAF in the past were invited to an online survey on average sound knee, amputated side knee, and low-back pain assessed with numerical pain rating scales (NPRS), the PROMIS Pain Interference scale, and the PLUS-M for patient-reported mobility in the free-living environment. Subjects rated their current foot and recalled the ratings for their previous foot. Recalled scores were adjusted for recall bias by clinically meaningful amounts following published recommendations. Statistical comparisons were performed using Wilcoxon's signed rank test.ResultsForty-six subjects, all male, with unilateral TTA provided data suitable for analysis. Eighteen individuals (39%) were current PwrAF users, whereas 28 subjects (61%) had reverted to a passive foot. After adjustment for recall bias, current PwrAF users reported significantly less sound knee pain than they recalled for use of a passive foot (−0.5 NPRS, p = 0.036). Current PwrAF users who recalled sound knee pain ≥4 NPRS with a passive foot reported significant and clinically meaningful improvements in sound knee pain (−2.5 NPRS, p = 0.038) and amputated side knee pain (−3 NPRS, p = 0.042). Current PwrAF users also reported significant and clinically meaningful improvements in patient-reported mobility (+4.6 points PLUS-M, p = 0.016). Individuals who had abandoned the PwrAF did not recall any differences between the feet.DiscussionCurrent PwrAF users reported significant and clinically meaningful improvements in patient-reported prosthetic mobility as well as sound knee and amputated side knee pain compared to recalled mobility and pain with passive feet used previously. However, a substantial proportion of individuals who had been fitted such a foot in the past did not recall improvements and had reverted to passive feet. The identification of individuals with unilateral TTA who are likely to benefit from a PwrAF remains a clinical challenge and requires further research.

scholarly journals Examining relationships between sleep posture, waking spinal symptoms and quality of sleep: A cross sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260582
Author(s):  
Doug Cary ◽  
Angela Jacques ◽  
Kathy Briffa
Keyword(s):  
Sleep Quality ◽  
Online Survey ◽  
General Information ◽  
Control Group ◽  
Quality Of Sleep ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
Patient Reported ◽  
Sleep Posture

Introduction Research with a focus on sleep posture has been conducted in association with sleep pathologies such as insomnia and positional obstructive sleep apnoea. Research examining the potential role sleep posture may have on waking spinal symptoms and quality of sleep is however limited. The aims of this research were to compare sleep posture and sleep quality in participants with and without waking spinal symptoms. Methods Fifty-three participants (36 female) were, based on symptoms, allocated to one of three groups; Control (n = 20, 16 female), Cervical (n = 13, 10 female) and Lumbar (n = 20, 10 female). Participants completed an online survey to collect general information and patient reported outcomes and were videoed over two consecutive nights to determine sleep posture using a validated classification system including intermediate sleep postures. Results Participants in the symptomatic groups also reported a lower sleep quality than the Control group. Compared to Control group participants, those in the Cervical group had more frequent posture changes (mean (SD); 18.3(6.5) versus 23.6(6.6)), spent more time in undesirable/provocative sleep postures (median IQR; 83.8(16.4,105.2) versus 185.1(118.0,251.8)) minutes and had more long periods of immobility in a provocative posture, (median IQR: 0.5(0.0,1.5) versus 2.0 (1.5,4.0)). There were no significant differences between the Control and Lumbar groups in the number of posture changes (18.3(6.5) versus 22.9(9.1)) or the time spent in provocative sleep postures (0.5(0.0,1.5) versus 1.5(1.5,3.4)) minutes. Discussion This is the first study using a validated objective measure of sleep posture to compare symptomatic and Control group participants sleeping in their home environment. In general, participants with waking spinal symptoms spent more time in provocative sleep postures, and experienced poorer sleep quality.

scholarly journals Patient-Reported Opioid Pill Consumption After an ED Visit: How Many Pills Are People Using?

Pain Medicine ◽  
2020 ◽  
Author(s):  
Danielle M McCarthy ◽  
Howard S Kim ◽  
Scott I Hur ◽  
Patrick M Lank ◽  
Christine Arroyo ◽  
...  
Keyword(s):  
Emergency Department ◽  
Back Pain ◽  
Acute Pain ◽  
Renal Colic ◽  
Opioid Consumption ◽  
Fracture Dislocation ◽  
Opioid Use ◽  
Use Patterns ◽  
Patient Demographics ◽  
Patient Reported

Abstract Objectives Recent guidelines advise limiting opioid prescriptions for acute pain to a three-day supply; however, scant literature quantifies opioid use patterns after an emergency department (ED) visit. We sought to describe opioid consumption patterns after an ED visit for acute pain. Design Descriptive study with data derived from a larger interventional study promoting safe opioid use after ED discharge. Setting Urban academic emergency department (>88,000 annual visits). Subjects Patients were eligible if age >17 years, not chronically using opioids, and newly prescribed hydrocodone-acetaminophen and were included in the analysis if they returned the completed 10-day medication diary. Methods Patient demographics and opioid consumption are reported. Opioid use is described in daily number of pills and daily morphine milligram equivalents (MME) both for the sample overall and by diagnosis. Results Two hundred sixty patients returned completed medication diaries (45 [17%] back pain, 52 [20%] renal colic, 54 [21%] fracture/dislocation, 40 [15%] musculoskeletal injury [nonfracture], and 69 [27%] “other”). The mean age (SD) was 45 (15) years, and 59% of the sample was female. A median of 12 pills were prescribed. Patients with renal colic used the least opioids (total pills: median [interquartile range {IQR}] = 3 [1–7]; total MME: median [IQR] = 20 [10–50]); patients with back pain used the most (total pills: median [IQR] = 12 [7–16]; total MME: median [IQR] = 65 [47.5–100]); 92.5% of patients had leftover pills. Conclusions In this sample, pill consumption varied by illness category; however, overall, patients were consuming low quantities of pills, and the majority had unused pills 10 days after their ED visit.

scholarly journals Mixed methods study of clinicians’ perspectives on barriers to implementation of treat to target in psoriatic arthritis

2020 ◽  
Vol 79 (8) ◽  
pp. 1031-1036 ◽  
Author(s):  
Emma Dures ◽  
Julie Taylor ◽  
Sasha Shepperd ◽  
Sandeep Mukherjee ◽  
Joanna Robson ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Psoriatic Arthritis ◽  
Focus Group ◽  
Online Survey ◽  
Service Providers ◽  
Integrated Approach ◽  
Outcome Data ◽  
Treat To Target ◽  
It Systems ◽  
Patient Reported

ObjectivesIn treat to target (T2T), the patient is treated to reach and maintain specified and sequentially measured goals, such as remission or low disease activity. T2T in psoriatic arthritis (PsA) has demonstrated improved clinical and patient-reported outcomes and is recommended in European guidelines. However, most clinicians do not use T2T in PsA. This study examined the barriers and enablers to implementation in practice.MethodsSequential mixed methods comprising a qualitative design (interviews and focus group) to inform a quantitative design (survey). Qualitative data were analysed thematically, and quantitative statistics were analysed descriptively.ResultsNineteen rheumatology clinicians participated in telephone interviews or a face-to-face focus group. An overarching theme ‘Complexity’ (including ‘PsA vs Rheumatoid Arthritis’, ‘Measurement’ and ‘Resources’) and an underpinning theme ‘Changes to current practice’ (including ‘Reluctance due to organisational factors’ and ‘Individual determination to make changes’) were identified. 153 rheumatology clinicians responded to an online survey. Barriers included limited clinical appointment time to collect outcome data (54.5%) and lack of training in assessing skin disease (35%). Enablers included provision of a protocol (86.4%), a local implementation lead (80.9%), support in clinic to measure outcomes (83.3%) and training in T2T (69.8%). The importance of regular audit with feedback, specialist PsA clinics and a web-based electronic database linked to hospital/national information technology (IT) systems were also identified as enablers.ConclusionsImplementation of T2T in PsA requires an integrated approach to address the support, training and resource needs of individual clinicians, rheumatology teams, local IT systems and service providers to maximise success.

Identifying education, knowledge and communication gaps in biomarker testing between YO-CRC patients, caregivers, and their medical team.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16115-e16115
Author(s):  
Kim Lynn Newcomer ◽  
Danielle Peterson ◽  
Ronit Yarden ◽  
Keyword(s):  
Online Survey ◽  
Medical Information ◽  
Treatment Plan ◽  
Treatment Options ◽  
Stage Iv ◽  
Public Health Issue ◽  
Medical Team ◽  
Cross Sectional ◽  
Patient Reported ◽  
Biomarker Testing

e16115 Background: The proportion of new young-onset colorectal cancer (YO-CRC) cases diagnosed in young people (20-49) had doubled over the past 3 decades, and it is becoming an alarming public health issue. YO-CRC patients face unique clinical challenges, as many are diagnosed at advanced stages of the disease and subjected to aggressive treatments. With the increase of targeted therapies and precision medicine available, NCCN and ASCO guidelines recommend that all stage IV, metastatic CRC patients be tested for 4 biomarkers in addition to MSI-H. However, not all eligible patients benefit from biomarker testing and biomarker-driven therapies. Methods: We conducted an online survey to assess patients, survivors and caregivers’ knowledge and understanding of biomarker testing and whether they feel empowered to discuss with their doctor different treatment options based on their unique tumor characteristics and their preferences. Results: The cross-sectional study was completed by patients and survivors (N = 885) and unrelated caregivers of YO-CRC patients (N = 203). The median age of patients and survivors was 42, and the median age of caregivers was also 42. The majority of the participants were college graduates. Although 82% of stage IV, YO-CRC patients felt informed before treatment began, only 70% indicated their tumor was tested for biomarkers, and 54% of them received biomarker testing before treatment initiation. Only 33% of patients reported they became aware of biomarkers by their medical team while others indicated resources such as internet searches, family and friends, or patient navigators. Many of the caregivers who reported that they served as a liaison between patients and medical information retrieval felt that they did not fully understand the critical aspects of the patients' medical treatment plan. Conclusions: Multiple studies have shown that patient-centered care improves patients’ outcomes. Our organization encourages patients and their families to use medical information to navigate their journey. Our patient-reported study suggests that there are gaps in patients’ and caregiver’s understanding of biomarker testing that may hinder patient's empowerment for reaching evidence-based shared-decision treatment plan together with their physicians.

scholarly journals Issues and Challenges With Integrating Patient-Reported Outcomes in Clinical Trials Supported by the National Cancer Institute–Sponsored Clinical Trials Networks

2007 ◽  
Vol 25 (32) ◽  
pp. 5051-5057 ◽  
Author(s):  
Deborah Watkins Bruner ◽  
Charlene J. Bryan ◽  
Neil Aaronson ◽  
C. Craig Blackmore ◽  
Michael Brundage ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Patient Reported Outcomes ◽  
Online Survey ◽  
Cancer Control ◽  
The United States ◽  
Cancer Clinical Trials ◽  
Cooperative Group ◽  
Cooperative Groups ◽  
End Points ◽  
Patient Reported

Purpose The objective of this report is to provide a historical overview of and the issues and challenges inherent in the incorporation of patient-reported outcomes (PROs) into multinational cancer clinical trials in the cancer cooperative groups. Methods An online survey of 12 cancer cooperative groups from the United States, Canada, and Europe was conducted between June and August of 2006. Each of the cooperative groups designated one respondent, who was a member of one of the PRO committees within the cooperative group. Results There was a 100% response rate, and all of the cancer clinical trial cooperative groups reported conducting PRO research. PRO research has been conducted in the cancer cooperative groups for an average of 15 years (range, 6 to 30 years), and all groups had multidisciplinary committees focused on the design of PRO end points and the choice of appropriate PRO measures for cancer clinical trials. The cooperative groups reported that 5% to 50% of cancer treatment trials and an estimated 50% to 75% of cancer control trials contained PRO primary and secondary end points. There was considerable heterogeneity among the cooperative groups with respect to the formal and informal policies and procedures or cooperative group culture towards PROs, investigator training/mentorship, and resource availability for the measurement and conduct of PRO research within the individual cooperatives. Conclusion The challenges faced by the cooperative groups to the incorporation of PROs into cancer clinical trials are varied. Some common opportunities for improvement include the adoption of standardized training/mentorship mechanisms for investigators for the conduct of PRO assessments and data collection and the development of minimal criteria for PRO measure acceptability. A positive cultural shift has occurred in most of the cooperative groups related to the incorporation of PROs in clinical trials; however, financial and other resource barriers remain and need to be addressed.

Defying Tradition

2017 ◽  
Vol 26 (1) ◽  
pp. 22-30 ◽  
Author(s):  
Leena Anand ◽  
Steve N. Du Bois ◽  
Tamara G. Sher ◽  
Karolina Grotkowski
Keyword(s):  
Gender Role ◽  
Online Survey ◽  
Measurement Information ◽  
Long Distance ◽  
Gender Role Socialization ◽  
Health Indices ◽  
Role Socialization ◽  
Patient Reported ◽  
N 93 ◽  
Amazon's Mechanical Turk

The marriage–health association has been investigated extensively among proximal couples (i.e., those living geographically near each other). On average, married men trend toward better health and relationship outcomes from their marital status compared to married women. This may be attributed to gender role socialization that encourages women to adopt a caretaking role toward their partners. Current literature has not addressed whether there are differential relationship or health outcomes by gender within long-distance relationship (LDR). The present study investigated LDR relationship and health indices by gender. Using Qualtrics and Amazon’s Mechanical Turk, married LDR participants ( n = 93, 21 years or older, English speakers) completed an online survey. Relationship measures assessed satisfaction, maintenance, stress, and sex. Health variables included the Patient Reported Outcomes Measurement Information System-29, Perceived Stress Scale, and surveys examining substance use, diet, and exercise. t Tests were used to measure group differences by gender. Women in LDR reported few relationship and health benefits relative to men in LDR. Men reported higher levels of relational distress and increased smoking, yet better physical functioning. Men also trended toward higher levels of relational maintenance and healthier eating as a function of partner presence. This study provides counterevidence for the gender role socialization model within the LDR framework.

Feasibility of a healthcare system-based tetralogy of Fallot patient registry

2017 ◽  
Vol 28 (2) ◽  
pp. 269-275
Author(s):  
Audrey L. Khoury ◽  
Eric G. Jernigan ◽  
Muntasir H. Chowdhury ◽  
Laura R. Loehr ◽  
Jennifer S. Nelson
Keyword(s):  
Tetralogy Of Fallot ◽  
Patient Reported Outcomes ◽  
Online Survey ◽  
Data Entry ◽  
Epidemiological Studies ◽  
Adult Patients ◽  
Birth Mother ◽  
Information Privacy Concerns ◽  
Recruitment Challenges ◽  
Patient Reported

AbstractBackgroundPatient-reported outcomes and epidemiological studies in adults with tetralogy of Fallot are lacking. Recruitment and longitudinal follow-up investigation across institutions is particularly challenging. Objectives of this study were to assess the feasibility of recruiting adult patients with tetralogy of Fallot for a patient-reported outcomes study, describe challenges for recruitment, and create an interactive, online tetralogy of Fallot registry.MethodsAdult patients living with tetralogy of Fallot, aged 18–58 years, at the University of North Carolina were identified using diagnosis code query. A survey was designed to collect demographics, symptoms, history, and birth mother information. Recruitment was attempted by phone (Part I, n=20) or by email (Part II, n=20). Data analysis included thematic grouping of recruitment challenges and descriptive statistics. Feasibility threshold was 75% for recruitment and for data fields completed per patient.ResultsIn Part I, 60% (12/20) were successfully contacted and eight (40%) were enrolled. Demographics and birth mother information were obtained for all enrolled patients. In Part II, 70% (14/20) were successfully contacted; 30% (6/20) enrolled and completed all data fields linked to REDCap database; the median time for survey completion was 8 minutes. Half of the patients had cardiac operations/procedures performed at more than one hospital. Automatic electronic data entry from the online survey was uncomplicated.ConclusionsAlthough recruitment (54%) fell below our feasibility threshold, enrolled individuals were willing to complete phone or online surveys. Incorrect contact information, privacy concerns, and patient-reported time constraints were challenges for recruitment. Creating an online survey and linked database is technically feasible and efficient for patient-reported outcomes research.

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