The impact of structural therapy on functioning and pain in chronic pain patients: A pilot study1

Objective: The primary objectives of this pre-post session study, was to evaluate the impact of a pharmacist-led education session on the perceived benefits and safety of cannabis among patients with chronic pain, as well as determine the influence of pharmacist education on the selection of safer cannabis products and dosage forms for medical use among patients. Methods: A retrospective analysis of completed pre-post session questionnaires was conducted among chronic pain patients attending a mandatory education session led by a pharmacist, prior to being authorized cannabis in clinic. All questionnaire data was analyzed using SPSS v. 25. Demographic and sample characteristics were reviewed using univariate analyses. Chi-Square tests were employed to determine if the group-based education significantly affected knowledge, perception of efficacy and safety of cannabis. Results: Of the 260 session participants, 203 completed pre-post session questionnaires. After the session, a majority of current cannabis users (33.8%) and cannabis naïve/past users (56.9%) reported they would use a low THC product in the future, and a majority of current users (54.5%) would use a high CBD product in the future. After education, participants were more likely to report cannabis as having the potential for addiction (chi-square =42.6, p <0.0001) and harm (chi-square =34.0, p <0.0001). Conclusions: Pharmacist counselling and education has the potential to influence patient selection and use of cannabis, from more harmful to safer products, as well as moderate the potential perceived benefits of use.

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The Anxiety and Pain of Fibromyalgia Patients during the COVID-19 Pandemic

10.1101/2020.11.24.20188011 ◽

2020 ◽

Author(s):

A. Y. Kharko ◽

K. J. Hansford ◽

P. L. Furlong ◽

S. D. Hall ◽

M. E. Roser

Keyword(s):

Chronic Pain ◽

Online Survey ◽

Mixed Effects ◽

Caffeine Intake ◽

Health Decline ◽

Chronic Pain Patients ◽

The Impact ◽

Pain Patients ◽

Mild Analgesics

AbstractBackgroundEarly research on the impact of the COVID-19 pandemic found persistent related anxiety in the general population. We hypothesised that this anxiety will be associated with increased pain in chronic pain patients diagnosed with fibromyalgia (FM).MethodsTo study this, we carried out a 10-day online survey with 58 female participants, diagnosed with FM and no other pain condition. We identified which aspects of the COVID-19 pandemic evoked anxiety. We then asked participants to provide daily ratings of both anxiety and pain on 101-point visual analogue scales (VAS). Key participant characteristics were included as mediators in a mixed-effects analysis, where the primary outcome was pain VAS.ResultsWe found that participants were most often anxious about “impact on relationships”, “a family member contracting COVID-19”, and “financial hardships”, but on average rated “financial hardship”, “access to medication”, and “home loss/eviction” as evoking the strongest anxiety. Mixed-effects modelling showed that an increase in pain was significantly associated with an increase in anxiety, when taking into account individual variance and daily caffeine intake. Age and intake of some mild analgesics were also linked to stronger pain.ConclusionOur results extend the initial findings from the literature about the effects of COVID-19 pandemic on chronic pain sufferers. We found that not only is pandemic anxiety in FM patients present, but it is associated with amplified self-assessed chronic pain.SignificanceThe long-term support of fibromyalgia patients is challenging for healthcare professionals due to the nature of the condition. The new normal introduced by the pandemic particularly hinders pain management, which is the leading request from this patient group. Our study demonstrates that mental health decline during the COVID-19 pandemic is directly related to the worsening of pain in fibromyalgia. Core stressors that evoke the strongest anxiety were identified thus providing guidance for where to focus patient support.

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The impact of the stimulation method on differences in pain thresholds and brain responses between chronic pain patients and healthy controls

European Journal of Pain ◽

10.1002/ejp.565 ◽

2014 ◽

Vol 18 (10) ◽

pp. 1365-1366

Author(s):

Martin Diers

Keyword(s):

Chronic Pain ◽

Healthy Controls ◽

Pain Thresholds ◽

Brain Responses ◽

Chronic Pain Patients ◽

Stimulation Method ◽

The Impact ◽

Pain Patients

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Development and Validation of the French-Canadian Chronic Pain Self-Efficacy Scale

Pain Research and Management ◽

10.1155/2015/832875 ◽

2015 ◽

Vol 20 (2) ◽

pp. 75-83 ◽

Cited By ~ 7

Author(s):

Anaïs Lacasse ◽

Patricia Bourgault ◽

Yannick Tousignant-Laflamme ◽

Roxanne Courtemanche-Harel ◽

Manon Choinière

Keyword(s):

Chronic Pain ◽

Chronic Disease ◽

Internal Consistency ◽

Self Efficacy ◽

Self Management ◽

French Canadian ◽

Management Interventions ◽

Chronic Pain Patients ◽

The Impact ◽

Pain Patients

BACKGROUND: Perceived self-efficacy is a non-negligible outcome when measuring the impact of self-management interventions for chronic pain patients. However, no validated, chronic pain-specific self-efficacy scales exist for studies conducted with French-speaking populations.OBJECTIVES: To establish the validity of the use of the French-Canadian Chronic Pain Self-efficacy Scale (FC-CPSES) among chronic pain patients.METHODS: The Chronic Disease Self-Efficacy Scale is a validated 33-item self-administered questionnaire that measures perceived self-efficacy to perform self-management behaviours, manage chronic disease in general and achieve outcomes (a six-item version is also available). This scale was adapted to the context of chronic pain patients following cross-cultural adaptation guidelines. The FC-CPSES was administered to 109 fibromyalgia and 34 chronic low back pain patients (n=143) who participated in an evidence-based self-management intervention (the PASSAGE program) offered in 10 health care centres across the province of Quebec. Cronbach’s alpha coefficients (α) were calculated to determine the internal consistency of the 33- and six-item versions of the FC-CPSES. With regard to convergent construct validity, the association between the FC-CPSES baseline scores and related clinical outcomes was examined. With regard to the scale’s sensitivity to change, pre- and postintervention FC-CPSES scores were compared.RESULTS: Internal consistency was high for both versions of the FC-CPSES (α=0.86 to α=0.96). Higher self-efficacy was significantly associated with higher mental health-related quality of life and lower pain intensity and catastrophizing (P<0.05), supporting convergent validity of the scale. There was a statistically significant increase in FC-CPSES scores between pre- and postintervention measures for both versions of the FC-CPSES (P<0.003), which supports their sensitivity to clinical change during an intervention.CONCLUSIONS: These data suggest that both versions of the FC-CPSES are reliable and valid for the measurement of pain management self-efficacy among chronic pain patients.

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Perioperative management of opioid-tolerant chronic pain patients

Journal of Opioid Management ◽

10.5055/jom.2006.0052 ◽

2006 ◽

Vol 2 (6) ◽

pp. 353 ◽

Cited By ~ 8

Author(s):

Dima Rozen, MD ◽

Noah P. DeGaetano, MD

Keyword(s):

Chronic Pain ◽

Personal Experience ◽

Clinical Utility ◽

Perioperative Management ◽

Anesthetic Management ◽

Chronic Pain Management ◽

Opioid Use ◽

Chronic Pain Patients ◽

The Impact ◽

Pain Patients

Opioids occupy a position of unsurpassed clinical utility in the treatment of many types of painful conditions. In recent years there has been a noticeable shift regarding the use of opioids for the treatment of both benign and malignancy-related pain. As acceptance of the prescribing of opioids for chronically painful conditions has grown, many more opioid-tolerant patients are presenting for surgical procedures. It is therefore imperative that practicing anesthesiologists become familiar with currently available opioid formulations, including data regarding drug interactions and side effects, in order to better plan for patients’ perioperative anesthetic needs and management. Unfortunately, there is a lack of scientifically rigorous studies in this important area, and most information must be derived from anecdotal reports and the personal experience of anesthesiologists working in this field. In this review, we shall discuss current chronic pain management and the impact of opioid use and tolerance on perioperative anesthetic management.

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