Pain Medicine
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2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Naveen Rathi ◽  
Mu Pye ◽  
Kai Sin ◽  
Sarah Elizabeth Garza-Levitt ◽  
Akiko Kamimura

Purpose The purpose of this study is to describe the use of complementary and alternative medicine (CAM), pain reliever use and the expectations refugees have of physicians about their practice of CAM use in the USA. Individuals with a refugee background are one of the populations who use CAM for treatment. However, to date, there is insufficient empirical evidence to describe CAM use among refugees resettled in the USA. In addition, collecting information about the use of pain relievers would help better understand the experiences of individuals with a refugee background. Design/methodology/approach Data was collected from August 2018 to November 2019 using a self- or interviewer-administered survey from 94 refugees 18 years of age or older who had settled in the USA. Findings This study found the following: CAM practice is very common among refugees resettled in the USA, most refugees use non-prescription pain medicine and refugees prefer to see physicians who understand CAM. This study contributes valuable findings in the usage of CAM among refugees and determines that CAM is commonly used among refugees resettled in the USA for pain management. Originality/value By better understanding CAM, physicians can address a direct need for the refugee population-seeking health care in the USA and other countries that host refugee resettlement.

2021 ◽  
Maria Matsangidou ◽  
Andreas Liampas ◽  
Melpo Pittara ◽  
Constantinos S. Pattichi ◽  
Panagiotis Zis

ASA Monitor ◽  
2021 ◽  
Vol 85 (S10) ◽  
pp. 35-37
Richard W. Rosenquist ◽  
Edward R. Mariano

2021 ◽  
pp. rapm-2021-103137
Kristopher M Schroeder ◽  
Brian D Sites ◽  
Samer Narouze

Beverley A. Orser ◽  
C. Ruth Wilson ◽  
Daniel Bainbridge

Pain Medicine ◽  
2021 ◽  
Connor Polson ◽  
Parker Siex ◽  
J Michael Anderson ◽  
Michael Weaver ◽  
Will Roberts ◽  

Abstract Objective We sought to determine whether author conflict of interest (disclosed or undisclosed) or industry sponsorship influenced the favorability of reporting of systematic reviews and meta-analyses investigating the use of opioid analgesics for the management of chronic non-cancer pain. Methods Our search included the MEDLINE (Ovid) and Embase (Ovid) databases. Study sponsorship was determined using the funding statement provided in each systematic review. Author COI information was extracted from the COI disclosure statement. This information was cross-referenced with information available on the CMS Open Payments Database, Dollars for Profs, Google Patents, the United States Patent and Trademark Office (USPTO), and previously published COI disclosures. Results Eight systematic reviews authored by 83 authors were included. Of these authors, 19 (23.0%) were found to have a COI, of which the majority (17/19; 89.5%) had at least one undisclosed COI. Despite nearly one-quarter of authors having a COI, we found no association between the presence of a COI and the favorability of results (p = 0.64) or conclusions (p = 0.07). Conclusion COI are common and frequently undisclosed among systematic review authors investigating opioid analgesics for the management of chronic non-cancer pain. Despite a high prevalence of COI, we did not find that these author-industry relationships had a significant influence on the favorability of results and conclusions; however, our findings should be considered a lower bound estimate of the true influence author COI have on outcomes of pain medicine systematic reviews secondary to the low sample size included in the present study.

2021 ◽  
pp. rapm-2021-103046
Mohammad R Rasouli ◽  
Shauna Maty ◽  
Edward R Mariano ◽  
Kellie Jaremko ◽  
Alex Kou ◽  

2021 ◽  
Vol 3 (1) ◽  
Daniel Adams ◽  
Nana Ama Ofei-Tenkorang ◽  
Patrick Connell ◽  
Alexa Owens ◽  
Aaron Gothard ◽  

Abstract Background Since the legalization of medical marijuana (MMJ) in Ohio in 2018, many chronic pain (CP) patients have become interested in it as an alternative or adjunct to prescription opioids. This has not only created a need for pain management specialists to learn about this potential indication for MMJ but also for them to have more detailed knowledge of patient attitudes and willingness to comply with providers’ recommendations regarding its safe use with other pain medications. For this purpose, we surveyed CP patients in a region severely affected by the opioid crisis in order to provide better education, formulate treatment plans, and develop clinical policies. Methods We designed and administered the Medical Marijuana Interest Questionnaire (MMIQ) online to patients of the Western Reserve Hospital Center for Pain Medicine (CPM) with a diagnosis of CP who were not yet using MMJ. Questions addressed demographic and clinical characteristics, willingness to consider MMJ, and compliance with treatment plans and concerns. We then carried out a statistical analysis including Pearson chi-square, Spearman’s rho and Kendall’s tau tests to measure associations between variables to identify factors that may influence willingness to use MMJ. Results After sending 1047 email invitations to complete the MMIQ, 242 (23.1%) completed questionnaires were returned. The average age range of all respondents was 51-60 years, 171 (70.7%) were female and 147 (60.7%) were current opioid users. The 204 (84.3%) respondents who were willing to consider using MMJ were given access to the entire questionnaire. Of these, 138 (67.6%) reported wanting to use less opioids after starting MMJ and 191 (93.6%) were amenable to following their pain specialists’ recommendations about using MMJ concurrently with opioids. Their greatest concern on a 0-5 scale was affordability (2.98) and there was a statistically significant negative correlation between older age and preference for inhaled forms (p = 0.023). Conclusion The MMIQ was successful in eliciting important data regarding patients’ attitudes about MMJ for opioid titration and potential compliance. Our study was limited by being administered online rather than in-person, which skewed the demographic makeup of the sample. The MMIQ can be used to study similar populations or adapted to patients already using MMJ. Similar surveys of MMJ-experienced patients could be combined with chart reviews to study the success of these products for pain control and opioid substitution.

2021 ◽  
pp. bmjspcare-2021-003178
Jenny Lau ◽  
Paolo Mazzotta ◽  
Ciara Whelan ◽  
Mohamed Abdelaal ◽  
Hance Clarke ◽  

ObjectivesDespite the escalating public health emergency related to opioid-related deaths in Canada and the USA, opioids are essential for palliative care (PC) symptom management.Opioid safety is the prevention, identification and management of opioid-related harms. The Delphi technique was used to develop expert consensus recommendations about how to promote opioid safety in adults receiving PC in Canada and the USA.MethodsThrough a Delphi process comprised of two rounds, USA and Canadian panellists in PC, addiction and pain medicine developed expert consensus recommendations. Elected Canadian Society of Palliative Care Physicians (CSPCP) board members then rated how important it is for PC physicians to be aware of each consensus recommendation.They also identified high-priority research areas from the topics that did not achieve consensus in Round 2.ResultsThe panellists (Round 1, n=23; Round 2, n=22) developed a total of 130 recommendations from the two rounds about the following six opioid-safety related domains: (1) General principles; (2) Measures for healthcare institution and PC training and clinical programmes; (3) Patient and caregiver assessments; (4) Prescribing practices; (5) Monitoring; and (6) Patients and caregiver education. Fifty-nine topics did not achieve consensus and were deemed potential areas of research. From these results, CSPCP identified 43 high-priority recommendations and 8 high-priority research areas.ConclusionsUrgent guidance about opioid safety is needed to address the opioid crisis. These consensus recommendations can promote safer opioid use, while recognising the importance of these medications for PC symptom management.

2021 ◽  
Vol 27 ◽  
pp. 242-250
Renuka Shantharam Pai ◽  
Geraldine Monteiro ◽  
Subash D. Tarey

Objectives: The bio-psycho-socio-spiritual model is a common management approach in palliative care (PC) and chronic pain medicine (CPM), adopted by PC Physicians and Pain Physicians (PPs), respectively. There is a dearth of services and personnel of PC in India. As PPs are familiar with pain management and the bio-psycho-socio-spiritual model, we hypothesised that they would be willing to incorporate PC in their practice and therefore, sought to understand their attitudes/aptitudes/barriers/knowledge towards it. Materials and Methods: We did a cross-sectional cohort study through a national survey of Indian PPs. The ten- item validated, survey questionnaire was mailed to 1300 PPs having E mail and registered with Indian Society for Study of Pain. Results: We received responses from 6.6% of the PPs. About 10.39% did not want to practice PC; the rest were either practicing or wanted to, or were unable to. 81.8% had <10 years CPM experience while the rest had 10–15 years. About 53.3% PPs had <10 years’ experience in PC; 10.4% had > 10 years and the rest had not practiced. About 70% were motivated by human suffering or had “personal reasons.” About 40.26% had no barriers; the rest cited stress or lack of infrastructure/knowledge/skills/time/financial compensation. The majority chose institutional courses for training and the popular choice of duration of the course was 3 months. The opinion on financial viability/non-viability of PC was equally divided among the respondents. About 62.3% had “knowledge” but half of them lacked “skills;” 27.6% lacked both; the rest had no inclination towards PC. About a third felt multi-disciplinary care was feasible while half felt that it was partially feasible. Conclusion: Policy-makers, at regional to global levels are strategizing options for popularizing PC since it supports the dualistic model of cure and care, most essential for both, chronic-debilitating or life-limiting illnesses. The poor response to our survey was a major limiting factor. However, among the respondents, the majority showed both aptitude and a favourable attitude for PC practice. The inability to identify major barriers for not choosing PC did not support our hypothesis. However, we feel that PPs are a cohort who can be motivated/ encouraged to take up some form of brief, comprehensive courses in PC so that they can be conversant with the specific knowledge and skills needed to practice the multi-dimensional aspects of PC in their own settings.

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