Response to Pain Management among Patients with Active Cancer, No Evidence of Disease, or Chronic Nonmalignant Pain in an Outpatient Palliative Care Clinic

2014 ◽  
Vol 17 (9) ◽  
pp. 990-994 ◽  
Author(s):  
Cara Jennings ◽  
Brian Cassel ◽  
Devon Fletcher ◽  
Aiping Wang ◽  
Kellie J. Archer ◽  
...  
Keyword(s):  
Palliative Care ◽  
Pain Management ◽  
Care Clinic ◽  
Nonmalignant Pain ◽  
Chronic Nonmalignant Pain ◽  
Active Cancer

Health Care Providers' Liability Exposure for Inappropriate Pain Management

1996 ◽  
Vol 24 (4) ◽  
pp. 360-364 ◽  
Author(s):  
Robyn S. Shapiro
Keyword(s):  
Health Care ◽  
Pain Management ◽  
Cancer Patients ◽  
Health Care Providers ◽  
Nursing Home Residents ◽  
Hospitalized Patients ◽  
Care Providers ◽  
Experienced Pain ◽  
Nonmalignant Pain ◽  
Chronic Nonmalignant Pain

Recent studies have exposed the startling inadequacy of health care providers knowledge about and practice of effective pain management. For example, in one study, it was reported that 79 percent of a random sample of 454 medical-surgical inpatients experienced pain during hospitalization, and that 58 percent of patients with pain considered the pain horrible or excruciating. In another study, 67 percent of 2,415 randomly selected hospitalized patients had pain during the twenty-four hours prior to being interviewed, and 50 percent reported pain at the time of the interview. In a study of seriously ill hospitalized patients reported in 1996, half of the patients complained of pain, and one-sixth reported that they experienced extremely severe pain at least half the time. According to one literature review, 75 percent of cancer patients have reported suffering pain, and one study estimates that 25 percent of cancer patients die with severe unrelieved pain. Chronic nonmalignant pain has been described as an extremely prevalent problem, and over two-thirds of nursing home residents experience serious pain.

Academic family medicine physicians' confidence and comfort with opioid analgesic prescribing for patients with chronic nonmalignant pain

2014 ◽  
Vol 10 (4) ◽  
pp. 255 ◽  
Author(s):  
Allison A. Macerollo, MD ◽  
Donald O. Mack, MD ◽  
Rupal Oza, MD, MPH ◽  
Ian M. Bennett, MD, PhD ◽  
Lorraine S. Wallace, PhD
Keyword(s):  
Pain Management ◽  
Family Medicine ◽  
Family Physicians ◽  
Opioid Analgesics ◽  
Comfort Level ◽  
Opioid Prescription ◽  
Opioid Prescribing ◽  
Nonmalignant Pain ◽  
Chronic Nonmalignant Pain ◽  
Level Of Concern

Objective: To examine academic family medicine physicians' current practices, experiences, beliefs, level of concern about negative outcomes, and confidence and comfort when prescribing opioid analgesics for chronic nonmalignant pain management. Design: Electronic cross-sectional survey.Participants: This study was part of the Council of Academic Family Medicine (CAFM) Educational Research Alliance omnibus survey of active academic US family physicians.Main outcome measures: Respondents completed survey items addressing their 1) sociodemographic and practice characteristics, 2) current opioid prescribing practices, 3) experiences and beliefs toward prescribing opioid analgesics for chronic nonmalignant pain management, 4) level of concern about negative opioid-related outcomes, and 5) confidence and comfort when prescribing opioid analgesics.Results: The majority of the sample (n = 491) were male (57.8 percent) with 84.1 percent identifying themselves as non-Hispanic white. Nearly all respondents (91.0 percent) reported currently prescribing opioids to patients with chronic nonmalignant pain. Most respondents reported being confident (88.4 percent) and comfortable (76.2 percent) in their prescribing for patients with chronic nonmalignant pain. Family physicians who were comfortable in their opioid prescribing skills were more likely to report satisfaction in prescribing opioids to patients with chronic pain (ρ = 0.494, p < 0.001), while those who were confident in their opioid prescribing skills were more likely to identify pain management as high priority (ρ = -0.287, p < 0.001).Conclusions: Most academic family physicians currently prescribed opioid analgesics to patients with chronic nonmalignant pain. There was a strong inverse relationship between confidence regarding opioid prescription and concern about negative consequences. Similarly, comfort level was tied to increased satisfaction with the overall process of opioid prescription.

Literacy Demands and Formatting Characteristics of Opioid Contracts in Chronic Nonmalignant Pain Management

2007 ◽  
Vol 8 (10) ◽  
pp. 753-758 ◽  
Author(s):  
Steven E. Roskos ◽  
Amy J. Keenum ◽  
Lindsay M. Newman ◽  
Lorraine S. Wallace
Keyword(s):  
Pain Management ◽  
Nonmalignant Pain ◽  
Chronic Nonmalignant Pain

scholarly journals Exploring the Role of Chronic Pain Clinics: Potential for Opioid Reduction

2018 ◽  
Vol 1 (21;1) ◽  
pp. E603-E610
Author(s):  
Mohab Ibrahim
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Pain Clinic ◽  
High Dose ◽  
Opioid Use ◽  
Pain Clinics ◽  
Nonmalignant Pain ◽  
Chronic Nonmalignant Pain ◽  
And Function

Background: The management of chronic nonmalignant pain with high-dose opioids has partially contributed to the current opioid epidemic, with some responsibility shared by chronic pain clinics. Traditionally, both primary care providers and patients used chronic pain clinics as a source for continued medical management of patients on high-dose opioids, often resulting in tolerance and escalating doses. Although opioids continue to be an important component of the management of some chronic pain conditions, improvement in function and comfort must be documented. Pain clinics are ideally suited for reducing opioid usage while improving pain and function with the use of a multimodal approach to pain management. We assessed whether the application of multimodal treatment directed by pain specialists in a pain clinic provides for improved function and reduced dosages of opioid analgesics. Objective: We evaluated the role of a pain clinic staffed by fellowship-trained pain physicians in reducing pain and opioid use in chronic nonmalignant pain patients. Study Design: This study used a retrospective design. Setting: The research took place in an outpatient pain clinic in a tertiary referral center/teaching hospital. Methods: Of 1268 charts reviewed, 296 patients were on chronic opioids at the time of first evaluation. After a thorough evaluation, the patients were treated with nonopioid pharmacotherapy and interventional pain procedures as necessary. The data utilized from patients’ latest follow-up visit included current pain level using the Numerical Rating Scale (NRS-11), opioid usage, and various functional parameters. Results: NRS-11 scores decreased by 33.8% from 6.8 (± 0.1)/10 to 4.5 (± 0.2)/10. The pain frequency and number of pain episodes improved by 36.8 ± 2 and 36.2 ± 2.1, respectively. Additionally, the ability to sleep, work, and perform chores significantly improved. Total opioid use decreased by about 55.4% from 53.8 ± 4 to about 24 ± 2.8 MME/patient/day. Limitation: This study is not a randomized prospective controlled study. The patients analyzed are still getting therapy and their pain status may change. Some opioids are underrepresented in the analyzed cohort. Finally, this study lacks in-depth stratification by type of pain, age, gender, and duration of opioid use. Conclusion: Chronic pain clinics can play a pivotal role in reducing opioid usage while improving pain and function in patients on chronic opioids. We wish to emphasize the importance of allocating resources toward nonopioid treatments that may improve the function and well-being of patients. Key words: Pain clinic, pain management, multimodal pain management, chronic pain, opioid reduction, improved pain, improved functional capacity

Development and Pilot Test of a New Set of Good Practice Indicators for Chronic Nonmalignant Pain Management

Pain Practice ◽  
2018 ◽  
Vol 19 (1) ◽  
pp. 37-51
Author(s):  
Pedro Jesus Saturno ◽  
Daniel Ángel-García ◽  
Ismael Martínez-Nicolás ◽  
Francisco López Soriano ◽  
Maria Pilar Escolar Reina ◽  
...  
Keyword(s):  
Pain Management ◽  
Good Practice ◽  
Pilot Test ◽  
Nonmalignant Pain ◽  
Chronic Nonmalignant Pain
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