scholarly journals Pain, Stress and Anxiety of Chronic Pain Patients Prior to, During and After Political Turmoil in Thailand

2018 ◽  
Vol 36 (4) ◽  
pp. 291
Author(s):  
Sasikaan Nimmaanrat
Keyword(s):  
Chronic Pain ◽  
Pain Score ◽  
Pain Clinic ◽  
P Value ◽  
Military Dictatorship ◽  
Chronic Pain Patients ◽  
The Mean ◽  
Stress Score ◽  
Political Turmoil ◽  
Pain Patients

Objective: Thailand was plagued with serious political turmoil for many years. We would like to know whether this turmoil has had an impact on our chronic pain patients in terms of intensity of pain, stress and anxiety, as well as daily living and sleep.Material and Methods: Patients with at least 3 months of pain prior to 31 October 2013 (the date that the demonstrations started) were enrolled in this study. The data were collected from the patients who attended our pain clinic from December 2014 to May 2015. The patients were asked to complete a questionnaire on their severity of pain, stress and anxiety for the 3 different stages: prior to the demonstrations (period 1), during the demonstrations (period 2) and under military dictatorship or after the demonstrations (period 3).Results: There were 120 patients, 49 males (40.8%) and 71 females (59.2%). The mean age was 56.3±15.8 years old (range 18-88). The majority were Buddhist (108 patients, 90.0%) while 11 patients (9.2%) were Muslim and 1 patient (0.8%) was Christian. The mean duration of pain prior to the beginning of the demonstrations was 62.8 months (range 3-324 months). Regarding the pain score, the mean maximum pain score was significantly different between periods 1 (8), 2 (7.7) and 3 (6.8) (p-value<0.001). Regarding the anxiety score, the mean maximum anxiety score was significantly different between periods 1 (3.8), 2 (4.8) and 3 (2.9) (p-value=0.03). Regarding the stress score, the mean maximum stress score was significantly different between periods 1 (3.8), 2 (4.4) and 3 (2.8) (p-value=0.02). Using multiple logistic regression analysis, no factors (gender, age, religious, duration of pain and levels of anxiety and stress) were found to have contributed to the reduction of pain intensity.Conclusion: The demonstrations during the political turmoil did not increase the severity of pain but led to higher levels of stress and anxiety. On the other hand, under the military dictatorship, lower pain scores as well as stress and anxiety levels in chronic pain patients attending our pain clinic have been found.

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.

scholarly journals Pain Characteristics and Demographics of Patients Attending a University-Affiliated Pain Clinic in Toronto, Ontario

2007 ◽  
Vol 12 (2) ◽  
pp. 93-99 ◽  
Author(s):  
Angela Mailis-Gagnon ◽  
Balaji Yegneswaran ◽  
SF Lakha ◽  
Keith Nicholson ◽  
Amanda J Steiman ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Tertiary Care ◽  
Pain Clinic ◽  
Pain Clinics ◽  
Chronic Pain Patients ◽  
Musculoskeletal Problems ◽  
Pain Duration ◽  
Study Population ◽  
Age Range ◽  
Pain Patients

BACKGROUND: Pain clinics tend to see more complex chronic pain patients than primary care settings, but the types of patients seen may differ among practices.OBJECTIVE: The aim of the present observational study was to describe the pain and demographic characteristics of patients attending a university-affiliated tertiary care pain clinic in Toronto, Ontario.METHODS: Data were collected on 1242 consecutive new patients seen over a three-year period at the Comprehensive Pain Program in central Toronto.RESULTS: Musculoskeletal problems affecting large joints and the spine were the predominant cause of pain (more prevalent in women), followed by neuropathic disorders (more prevalent in men) in patients with recognizable physical pathology. The most affected age group was in the 35- to 49-year age range, with a mean pain duration of 7.8 years before the consultation. While 77% of the Comprehensive Pain Program patients had relevant and detectable physical pathology for pain complaints, three-quarters of the overall study population also had significant associated psychological or psychiatric comorbidity. Women, in general, attended the pain clinic in greater numbers and had less apparent physical pathology than men. Finally, less than one in five patients was employed at the time of referral.CONCLUSIONS: The relevance of the data in relation to other pain clinics is discussed, as well as waiting lists and other barriers faced by chronic pain patients, pain practitioners and pain facilities in Ontario and Canada.

scholarly journals Lack of Correlation Between Opioid Dose Adjustment and Pain Score Change in a Group of Chronic Pain Patients

2013 ◽  
Vol 14 (4) ◽  
pp. 384-392 ◽  
Author(s):  
Lucy Chen ◽  
Trang Vo ◽  
Lindsey Seefeld ◽  
Charlene Malarick ◽  
Mary Houghton ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Score ◽  
Dose Adjustment ◽  
Score Change ◽  
Opioid Dose ◽  
Chronic Pain Patients ◽  
Pain Patients

Codetron in Rehabilitation of Chronic Pain Patients

1989 ◽  
Vol 6 (2) ◽  
pp. 54-56 ◽  
Author(s):  
Angelica Fargas-Babjak
Keyword(s):  
Clinical Trial ◽  
Chronic Pain ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Modern Medicine ◽  
Pain Clinic ◽  
The Novel ◽  
Technological Changes ◽  
Electrical Nerve Stimulation ◽  
Chronic Pain Patients ◽  
Pain Patients

Acupuncture is one of the oldest healing methods which is used in traditional medicine. in modern medicine we are witnessing a renaissance of this ancient treatment applied mainly in the management of chronic pain. A number of modern technological changes are being applied to replace, or modify, the classical needle treatment Among many of the modalities used at present are light, in the form of laser, and electrical stimulation. CODETRON TENS, the novel addition to Transcutaneous Electrical Nerve Stimulation (TENS), has been evaluated in a clinical trial, over a two year period, in a multidisciplinary pain clinic on patients who came for acupuncture therapy. Indications, effectiveness and experiences with this form of treatment are presented.

scholarly journals An Objective Pain Score for Chronic Pain Clinic Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Agnes K. Pace ◽  
Melanio Bruceta ◽  
John Donovan ◽  
Sonia J. Vaida ◽  
Jill M. Eckert
Keyword(s):  
Chronic Pain ◽  
Construct Validity ◽  
Concurrent Validity ◽  
Interrater Reliability ◽  
Pain Scale ◽  
Pain Clinic ◽  
Positive Correlation ◽  
Pain Scales ◽  
Chronic Pain Patients ◽  
Pain Patients

Objectives. Although numerous studies have looked at the numeric rating scale (NRS) in chronic pain patients and several studies have evaluated objective pain scales, no known studies have assessed an objective pain scale for use in the evaluation of adult chronic pain patients in the outpatient setting. Subjective scales require patients to convert a subjective feeling into a quantitative number. Meanwhile, objective pain scales utilize, for the most part, the patient’s behavioral component as observed by the provider in addition to the patient’s subjective perception of pain. This study aims to examine the reliability and validity of an objective Chronic Pain Behavioral Pain Scale for Adults (CBPS) as compared to the traditional NRS. Methods. In this cross-sectional study, patients were assessed before and after an interventional pain procedure by a researcher and a nurse using the CBPS and the NRS. Interrater reliability, concurrent validity, and construct validity were analyzed. Results. Interrater reliability revealed a fair-good agreement between the nurse’s and researcher’s CBPS scores, weighted kappa values of 0.59 and 0.65, preprocedure and postprocedure, respectively. Concurrent validity showed low positive correlation for the preprocedure measurements, 0.34 (95% CI 0.16–0.50) and 0.47 (95% CI 0.31–0.61), and moderate positive correlation for the postprocedure measurements, 0.68 (95% CI 0.56–0.77) and 0.67 (95% CI 0.55–0.77), for the nurses and researchers, respectively. Construct validity demonstrated an equally average significant reduction in pain from preprocedure to postprocedure, CBPS and NRS median (IQR) scores preprocedure (4 (2–6) and 6 (4–8)) and postprocedure (1 (0–2) and 3 (0–5)), p < 0.001 . Discussion. The CBPS has been shown to have interrater reliability, concurrent validity, and construct validity. However, further testing is needed to show its potential benefits over other pain scales and its effectiveness in treating patients with chronic pain over a long-term. This study was registered with ClinicalTrial.gov with National Clinical Trial Number NCT02882971.

scholarly journals Depression Among Non-Cancer Chronic Pain Patients at a Tertiary Hospital in Malaysia

2021 ◽  
Vol 20 (2) ◽  
Author(s):  
Rajesh Kumar Muniandy ◽  
T Kumaravadivel Dharmalingam
Keyword(s):  
Chronic Pain ◽  
Psychological Treatment ◽  
Severe Depression ◽  
Pain Clinic ◽  
Health Concern ◽  
Queen Elizabeth Hospital ◽  
Mild Depression ◽  
Chronic Pain Patients ◽  
Prevalence Of Depression ◽  
Pain Patients

INTRODUCTION: Pain is as important public health concern. Chronic pain patients most frequently present with depression, and this needed to be treated. The aim of the study was to find the prevalence of depression among non-cancer chronic pain patients attending a Pain Clinic in Malaysia, and discuss possible treatment methods to help these patients. MATERIAL AND METHODS: Inclusion criteria were all non- cancer chronic pain patients who visited the Pain Clinic of Queen Elizabeth Hospital (QEH), Kota Kinabalu, Sabah from 2013 till 2017. All patients were required to fill a PainDetect form and a Patient Health Questionnaire-9 (PHQ-9). RESULTS: Two hundred and fifty-four patient’s case notes were analysed. The results show that 29.6 % patients had mild depression, with 34.4% of patients had moderate to severe depression. There was a significant correlation between pain scores and depression. There was also a significant correlation between PainDetect scores and depression. CONCLUSION: There is a high prevalence of depression among non-cancer chronic pain patients. This study shows that psychological treatment for all chronic pain patients is needed.

scholarly journals Effect of a Fixed-Dose Opioid Agonist/ Antagonist on Constipation in Patients on Long-term Opioids for Non-Malignant Pain Unable to Tolerate Laxatives

2014 ◽  
Vol 5;17 (5;9) ◽  
pp. 415-424 ◽  
Author(s):  
Dr Vivek Mehta
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Study Design ◽  
Bowel Function ◽  
Pain Clinic ◽  
Fixed Dose ◽  
Life Questionnaire ◽  
Chronic Pain Patients ◽  
Pain Patients

Background: Chronic pain affects a large number of patients throughout the world and impacts greatly on their quality of life, including the ability of a patient to sleep, go to work, and socialize. Guidance on the use of opioids in chronic pain patients is available from the British Pain Society; however, patients receiving opioid treatment for their pain often suffer from symptoms associated with opioid-induced bowel dysfunction (OIBD), including constipation. The usual treatment of constipation in these patients is laxatives; however, one study has shown that 54% of patients do not receive the desired results from this approach. Oxycodone/naloxone tablets have been shown to provide analgesia to chronic pain patients, while improving the symptoms of OIBD, as the naloxone component blocks the effects of oxycodone at opioid receptors in the gut. Objectives: The objective of the present study was to assess improvements in quality of life and bowel function in patients receiving oxycodone/naloxone tablets for their chronic non-malignant pain. Study Design: This was a 12-week observational follow-up study that included 28 outpatients with chronic non-malignant pain attending the Pain Clinic at St. Bartholomew’s Hospital in London. All patients had recently been prescribed oxycodone/naloxone tablets as treatment for their pain. Methods: Patients were assessed at baseline, week 1, week 4, and week 12 for functioning and well-being using the Patient Assessment of Constipation Quality of Life questionnaire (PAC-QOL), and for bowel function using the Bowel Function Index (BFI). Results: Mean PAC-QOL scores, as well as scores for each of the subscales (worries and concerns, physical discomfort, psychosocial discomfort, and satisfaction) significantly improved from baseline to week 12. Mean BFI scores significantly decreased from baseline to all time-points during the study. Subscale analysis of the BFI scores showed that mean scores for ease of defecation and judgment regarding constipation had significantly decreased at week 12; however, mean scores for feeling of incomplete bowel evacuation had not. Limitations: The results of the current study should be interpreted in relation to the study design. However, the results are consistent with previous studies that included a comparator group, had a longer duration of treatment, and included larger patient numbers. Conclusions: The results of this study indicate that patients receiving oxycodone/naloxone tablets achieved statistically and clinically significant improvements in bowel function as well as quality of life after 12 weeks of treatment. Key words: Non-malignant pain, opioid, opioid-induced constipation, laxatives, oxycodone, naloxone, audit

Suicide attempts in chronic pain patients. A register-based study

2014 ◽  
Vol 5 (1) ◽  
pp. 4-7 ◽  
Author(s):  
Elsebeth Stenager ◽  
Erik Christiansen ◽  
Gitte Handberg ◽  
Børge Jensen
Keyword(s):  
Chronic Pain ◽  
Incidence Rate ◽  
Patient Group ◽  
Suicidal Behaviour ◽  
Suicide Attempts ◽  
University Hospital ◽  
Pain Clinic ◽  
Increased Risk ◽  
Chronic Pain Patients ◽  
Pain Patients

AbstractBackgroundThere are several studies about the relationship between depression and chronic non-malignant pain. These studies have shown that up to 50% of chronic pain patients are suffering from depression.It is, therefore, reasonable to expect that pain patients would also have an increased risk of suicidal behaviour. This problem is not well studied.Since 1990 the Centre for Suicide Research, Odense, Denmark has registered all suicide attempts in patients residing in the Region of Funen, Denmark.The Pain Clinic, Odense University Hospital receives patients with chronic pain from the entire Region of Southern Denmark.PurposeThe purpose of the study has been:To investigate, whether patients treated in the Pain Clinic during the period from 1 January 2004 to 31 December 2009 had an increased risk of suicide attempts compared with the background population.Materials and methodsThe Register for Suicide Attempts (RSA) is a product of the WHO research programme WHO/EURO Multicentre Study on Para suicide. The RSA is a longitudinal person-based register. It contains information about people who have been in contact with the health care system in the County of Funen as a result of a suicide attempt.The Pain Clinic, Odense University Hospital receives patients with non-malignant chronic pain from the Region of Southern Denmark with 1,194,659 inhabitants. Data about age, sex, and time of treatment for patients treated in the Pain Clinic during the period were registered. Time and method of the suicide attempts were registered in the RSA. By registry linkages between the patient registers it was possible to calculate any excess risk of suicide attempts in chronic pain patients in the study period.We used a cohort design and calculated incidence rates (IR) and incidence rate ratios (IRRs) for suicide attempts, based on data from RSA. Poisson Regression analyses were used for calculation of IR and IRR for suicide attempts.ResultsIn the study period from 1 January 2004 to 31 December 2009 1871 patients residing in the Region of Funen in Denmark were referred to The Pain Clinic.In the patient group 258 suicide attempts in 110 persons were registered. In all 6% of the patient group had attempted suicide.An increased risk of suicide attempts was found in the pain population as the incidence rate ratio (IRR) was 3.76 95% CI (3.22; 4.40). No statistical significant differences between men and women were found.ConclusionIn a chronic non-malignant pain population, referred to a pain clinic, the risk of suicide attempts was increased.ImplicationsIt is important to be aware of risk factors for suicidal behaviour, i.e. pain history, depression, anxiety, abuse problems, and social problems when caring for patients with chronic pain. More knowledge and training of the staff caring for chronic pain patients are needed to decrease the risk of suicidal behaviour.

Measuring Pain in Outpatient Surgical Patients: Variation Resulting from Instrument Choice

2012 ◽  
Vol 78 (11) ◽  
pp. 1292-1296 ◽  
Author(s):  
David Goodyear ◽  
Vic Velanovich
Keyword(s):  
Chronic Pain ◽  
Acute Pain ◽  
Linear Regression Analysis ◽  
Bodily Pain ◽  
Pain Scale ◽  
Surgical Patients ◽  
P Value ◽  
Sf 36 ◽  
Chronic Pain Patients ◽  
Pain Patients

Our hypothesis is that the type of instrument will affect variation in pain assessment. A sample of 269 patients administered the visual analog pain scale (VAS) and the generic quality-of-life instrument, and the SF-36 were evaluated for gender, age, the VAS score and the bodily pain domain of the SF-36 (BP-SF-36) score, primary surgical diagnosis, preoperative or postoperative status, and type of operation. Patients were grouped into preoperative (Preop) and postoperative (postop) status and those with chronic pain (CP) conditions and acute/no pain (AP) conditions. Linear regression analysis showed statistically significant (all P value ≤ 0.0006) correlations between the VAS and BP-SF-36 scores all patients, preoperative patients, postoperative patients, acute pain patients, and chronic pain patients. However, the strength of these correlations were moderate (r values between 0.51 and 0.61). Preoperative had more pain compared with postoperative patients as measured by both the VAS and BP-SF-36 ( P = 0.05). Similarly, chronic pain patients had more pain compared with acute pain patients as measured by both scales ( P < 0.0001). Although there are statistically significant associations between the BP-SF-36 and VAS, the correlations are moderate. Different instruments may measure different aspects of pain and the precision with which pain is measured in surgical patients.

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