Interdisciplinary management for chronic pain in central neurological disorders: a retrospective study

2020 ◽  
Vol 27 (1) ◽  
pp. 1-7
Author(s):  
Jamie Young ◽  
Steven Mantopoulos ◽  
Megan Blanchard ◽  
Hilarie Tardif ◽  
Malcolm Hogg ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Retrospective Study ◽  
Pain Management ◽  
Outcome Measures ◽  
Neurological Disorders ◽  
Neurological Disorder ◽  
Persistent Pain ◽  
Interdisciplinary Management ◽  
Management Service ◽  
Pain Outcomes

Background/aims Chronic pain in central neurological disorders is common and the current management of chronic pain is through an interdisciplinary approach. The aim of this study was to compare outpatient interdisciplinary-based treatment for chronic pain in patients with central neurological disorders to those without central neurological disorders. Methods This was a retrospective study and pain-related outcome measures were collected from a clinical outcomes registry (electronic Persistent Pain Outcomes Collaboration). This registry contained data on people who attended a pain management service who, for the purpose of this study, were categorised into those with a central neurological disorder and those without a central neurological disorder. The two sample t-test was used to determine the significance of the difference between the groups and statistical significance was defined as P<0.05. Outcome measures compared included the Brief Pain Inventory, Depression, Anxiety and Stress Scale 21, Patient Self-efficacy Questionnaire and Patient Catastrophisation Scale. Results There was a total of 1924 participants with a central neurological disorder. The electronic Persistent Pain Outcomes Collaboration registry shows that after engagement with an interdisciplinary pain management service, there was a reduction in pain severity scores, interference, mean depression, anxiety and stress in both groups at end of an episode of care compared to referral. There was a significant difference in mean changes for pain catastrophising between those with a central neurological disorder (−10.3) and those without (−7.8). Conclusions This study shows that people with central neurological disorders can also benefit from interdisciplinary management and have similar results to those without these conditions.

scholarly journals Brief cognitive analytic therapy for adults with chronic pain: a preliminary evaluation of treatment outcome

2019 ◽  
Vol 14 (1) ◽  
pp. 57-67 ◽  
Author(s):  
Roupen Baronian ◽  
Sarah JE Leggett
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Self Efficacy ◽  
Healthcare Utilisation ◽  
Persistent Pain ◽  
Individual Therapy ◽  
Preliminary Evaluation ◽  
Management Service ◽  
Analytic Therapy ◽  
Cognitive Analytic Therapy

Background: Cognitive analytic therapy (CAT) has diversified in its application to a broad range of presenting difficulties and formats and there has been growing interest in its use in clinical health settings including Pain Management Services. Despite its growing popularity, to date, no studies have examined the application of CAT for chronic pain. Aims: The purpose of this study was to examine the effectiveness of time-limited, individual CAT for adults with chronic pain as delivered in a publicly funded Community Pain Management Service. Methods: This was an observational service evaluation of treatment practice within a routine clinical setting. Participants were 53 adults with chronic pain who completed eight sessions of individual therapy. Individual and group-level outcomes on self-reported distress, pain-related self-efficacy, as well as changes in healthcare utilisation pre- and post-intervention were examined. Results: Large pre–post effects on wellbeing ( d = 1.50) and self-efficacy ( d = 1.13) were observed, while effects on healthcare utilisation were medium to large ( d = 0.67). Moreover, reliable change and clinical significance analyses demonstrated that results were clinically meaningful. The majority of clients (67.9%) showed reliable improvement following the CAT intervention and 28% achieved both reliable and clinically significant improvements in psychological distress. Approximately 4 of 10 clients (43.5%) showed reliably higher perceived self-efficacy at the end of therapy. Conclusion: The results of this evaluation suggest that brief CAT is an encouraging intervention for adults with persistent pain. While preliminary, our findings provide support for a brief approach to persistent pain that focuses not on controlling or eliminating pain but on elucidating and revising unhelpful relational patterns that may impinge upon one’s pain management. Directions for future research are suggested.

scholarly journals Moving With Pain: What Principles From Somatic Practices Can Offer to People Living With Chronic Pain

2021 ◽  
Vol 11 ◽  
Author(s):  
Emma Meehan ◽  
Bernie Carter
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
External Environment ◽  
Persistent Pain ◽  
Self Management ◽  
Chronic Pain Management ◽  
Social Environments ◽  
Subjective Experiences ◽  
Pain Experiences ◽  
Internal Body

This article brings together research from the fields of chronic pain management and somatic practices to develop a novel framework of principles to support people living with persistent pain. These include movement-based approaches to awareness of the internal body (interoception), the external environment (exteroception) and movement in space (proprioception). These significantly work with the lived subjective experiences of people living with pain, to become aware of body signals and self-management of symptoms, explore fear and pleasure of movement, and understand how social environments impact on pain. This analysis has potential to create new ways of supporting, understanding and articulating pain experiences, as well as shaping the future of somatic practices for chronic pain.

Use of multidomain management strategies by community dwelling adults with chronic pain: evidence from a systematic review

2019 ◽  
Vol 19 (1) ◽  
pp. 9-23 ◽  
Author(s):  
David R. Axon ◽  
Mira J. Patel ◽  
Jennifer R. Martin ◽  
Marion K. Slack
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Pain Management ◽  
Adverse Events ◽  
Management Strategies ◽  
Community Dwelling ◽  
Controlled Vocabulary ◽  
Self Management ◽  
Patient Reported ◽  
Pain Outcomes

AbstractBackground and aimsMultidomain strategies (i.e. two or more strategies) for managing chronic pain are recommended to avoid excessive use of opioids while producing the best outcomes possible. The aims of this systematic review were to: 1) determine if patient-reported pain management is consistent with the use of multidomain strategies; and 2) identify the role of opioids and non-steroidal anti-inflammatory drugs (NSAIDs) in patient-reported pain management.MethodsBibliographic databases, websites, and reference lists of included studies were searched to identify published articles reporting community-based surveys of pain self-management from January 1989 to June 2017 using controlled vocabulary (and synonyms): pain; self-care; self-management; self-treatment; and adult. Two independent reviewers screened studies and extracted data on subject demographics, pain characteristics, pain self-management strategies, and pain outcomes. Pain self-management strategies were organized according to our conceptual model. Included studies were assessed for risk of bias. Differences between the researchers were resolved by consensus.ResultsFrom the 3,235 unique records identified, 18 studies published between 2002 and 2017 from 10 countries were included. Twenty-two types of pharmacological strategies were identified (16 prescription, six non-prescription). NSAIDs (15 studies, range of use 10–72%) and opioids (12 studies, range of use 5–72%) were the most commonly reported prescription pharmacological strategies. Other prescription pharmacological strategies included analgesics, acetaminophen, anticonvulsants, antidepressants, anxiolytics, salicylates, β-blockers and calcium channel blockers, disease-modifying anti-rheumatic drugs and steroids, muscle relaxants, topical products, triptans, and others. Twenty-two types of non-pharmacological strategies were identified: four medical strategies (10 studies), 10 physical strategies (15 studies), four psychological strategies (12 studies), and four self-initiated strategies (15 studies). Medical strategies included consulting a medical practitioner, chiropractic, and surgery. Physical strategies included exercise, massage, hot and cold modalities, acupuncture, physical therapy, transcutaneous electrical nerve stimulation, activity modification or restriction, assistive devices, and altering body position/posture. Psychological strategies included relaxation, prayer or meditation, therapy, and rest/sleep. Self-initiated strategies included dietary or herbal supplements, dietary modifications, and complementary and alternative medicine. Overall, the number of strategies reported among the studies ranged from five to 28 (out of 44 identified strategies). Limited data on pain outcomes was reported in 15 studies, and included satisfaction with pain management strategies, pain interference on daily activities, adverse events, lost work or restricted activity days, emergency department visits, and disabilities.ConclusionsA wide variety and large number of pharmacological and non-pharmacological strategies to manage chronic pain were reported, consistent with the use of multidomain strategies. High levels of use of both NSAIDs and opioids also were reported.ImplicationsComprehensive review and consultation with patients about their pain management strategies is likely needed for optimal outcomes. Additional research is needed to determine: how many, when, and why multidomain strategies are used; the relationship between opioid use, multidomain management strategies, and level of pain; how multidomain strategies relate to outcomes; and if adding strategies to a pain management plan increases the risk of adverse events or interactions, and increases an individuals pain management burden.

Persistent Pain Outcomes and Patient Satisfaction With Pain Management After Burn Injury

2011 ◽  
Vol 27 (2) ◽  
pp. 136-145 ◽  
Author(s):  
Allyson L. Browne ◽  
Rachel Andrews ◽  
Stephan A. Schug ◽  
Fiona Wood
Keyword(s):  
Patient Satisfaction ◽  
Pain Management ◽  
Burn Injury ◽  
Persistent Pain ◽  
Pain Outcomes

scholarly journals The Cost of Chronic Pain: An Analysis of a Regional Pain Management Service in Ireland

Pain Medicine ◽  
2013 ◽  
Vol 14 (10) ◽  
pp. 1518-1528 ◽  
Author(s):  
Brenda Gannon ◽  
David P. Finn ◽  
David O'Gorman ◽  
Nancy Ruane ◽  
Brian E. McGuire
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Management Service ◽  
The Cost

scholarly journals “A coalition of the willing”: experiences of co-designing an online pain management programme (iSelf-help) for people with persistent pain

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hemakumar Devan ◽  
Meredith A. Perry ◽  
Mostafa Yaghoubi ◽  
Leigh Hale
Keyword(s):  
Pain Management ◽  
Design Process ◽  
End Users ◽  
Persistent Pain ◽  
Management Programme ◽  
Management Service ◽  
Community Partner ◽  
Team Members ◽  
Common Thread ◽  
Maori Health

Abstract Background Participatory approaches to developing health interventions with end-users are recommended to improve uptake and use. We aimed to explore the experiences of co-designing an online-delivered pain management programme (iSelf-help) for people with persistent pain. Methods A modified participatory action research (PAR) framework was used to co-design contents and delivery of iSelf-help. The PAR team included: (1) a patient advisory group consisting of people living with persistent pain (n = 8), (2) pain management service clinicians (n = 2), (3) health researchers (n = 3), (4) digital health experts (n = 2), (5) a health literacy expert, and (6) two Māori health researchers and our community partner who led the cultural appropriateness of iSelf-help for Māori (the Indigenous population of New Zealand). The iSelf-help co-design processes and activities of the ‘PAR’ team is reported in another paper. In this paper, all PAR team members were invited to share their experiences of the co-design process. Individual interviews were held with 12 PAR team members. Interview transcripts were analysed using the General Inductive Approach. Results Five common themes were identified from the interviews: (1) Shared understanding and values of the co-design process, (2) Mismatched expectations with content creation, (3) Flexibility to share power and decision making, (4) Common thread of knowledge, and (5) Shared determination. Sustaining these themes was an overarching theme of “A coalition of the willing”. Conclusions PAR team members valued the shared determination and responsibility to co-design iSelf-help. They also acknowledged the complexities and challenges during the process related to mismatched expectations, power sharing and establishing a common thread of knowledge. Successful co-design requires a shared commitment and responsibility as a coalition to meet the aspirations of end-users, within the boundaries of time and budget.

scholarly journals Chronic Pain Management Among Older Adults: A Scoping Review

2019 ◽  
Vol 5 ◽  
pp. 237796081987425
Author(s):  
Ampicha Nawai
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Chronic Pain ◽  
Pain Management ◽  
Outcome Measures ◽  
Scoping Review ◽  
Roy Adaptation Model ◽  
Chronic Pain Management ◽  
Adaptation Model

Chronic pain is a significant problem for older adults. The effect of chronic pain on older people’s quality of life needs to be described and identified. For a decade, the Roy Adaptation Model has been used extensively to explain nursing phenomena and guide nursing research in several settings with several populations. The objective of this study was to use the Roy Adaptation Model to describe chronic pain and present a systematic scoping review of the literature about the middle-range theory of chronic pain among older adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses model guided a scoping review search method. A literature search was undertaken using MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Ovid, and ProQuest. The search terms were “chronic pain,” “pain management,” “older adult,” “Roy Adaptation Model,” and “a scope review.” The search included articles written in English published for the period of 2004–2017. All articles were synthesized using concepts of Roy’s Adaptation Model. Twenty-two studies were considered for the present review. Twenty-one articles were reports of quantitative studies, and one was a report of a qualitative study. Two outcome measures were found in this systematic scoping review. The primary outcomes reported in all articles were the reduction of pain due to interventions and an increase in coping with chronic pain. The secondary outcome measures reported in all studies were the improvement of physical function, quality of life, sleep disturbance, spiritual well-being, and psychological health related to pain management interventions among older adults. Many interventions of all studies reported improvement in chronic pain management among older adults. However, to improve chronic pain management, nurses need to understand about nursing theories, the context which instruments work, and develop empirical instruments based on the conceptual model.

scholarly journals Review of the Safety of Bipolar Radiofrequency Ablation in Patients with Chronic Pain with Implantable Cardiac Rhythm Management Devices

2021 ◽  
pp. E169-E176
Keyword(s):  
Chronic Pain ◽  
Radiofrequency Ablation ◽  
Pain Management ◽  
Adverse Events ◽  
Persistent Pain ◽  
Narrative Review ◽  
Cardiac Conduction ◽  
Systematic Assessment ◽  
Bipolar Radiofrequency ◽  
Cardiac Devices

BACKGROUND: Chronic pain, especially low back pain and hip pain, has been a growing public health concern that affects over 100 million Americans annually. Radiofrequency ablation (RFA) has distinct advantages over other chronic pain management modalities and its use has been increasing over the past decade. Among the growing population with comorbid conduction disorders and persistent pain, RFA and its potential interference with implantable cardiac devices is of concern. RFA is becoming a foundational element of persistent pain management and has been shown to be effective in a multitude of chronic pain syndromes. Cardiac implantable electronic devices (CIED), such as cardiac pacemakers or implantable cardioverter defibrillators, have been used in the treatment of cardiac conduction diseases for a number of decades. With our aging population, these diseases have increased in both incidence and prevalence. Chronic pain and cardiac conduction diseases are both common in our increasingly aging population. OBJECTIVES: This study aims to determine if the literature supports the hypothesis that patients with CIEDs can safely use RFA with minimal to no interaction. STUDY DESIGN: Systematic assessment of literature with a modified approach with bipolar RFA. METHODS: A narrative review with systematic assessment of the literature was carried out. In this review, we included randomized controlled trials (RCTs), open non-randomized control studies, prospective studies, retrospective studies, case series, and case reports. All types of radiofrequency utilized for pain management including pulsed and conventional were included. Outcome measures included interactions between the cardiovascular implantable electronic device (CIED) and radiofrequency ablation (RFA), adverse events, RFA efficacy in treating the pain using pain scores, and other complications. RESULTS: Our search criteria yielded 4 studies for inclusion, with inclusion of 33 patients and 71 bipolar radiofrequency for treatments. No adverse events or interactions occurred between the bipolar radiofrequency device and the implanted cardiac devices in any of these patients. Bipolar radiofrequency was utilized in all patients (n = 33). Overall there were no complications or malfunctions. LIMITATIONS: Small sample size, narrative review. CONCLUSIONS: This study provides evidence that bipolar RFA can be safely used in patients with CIEDs for chronic pain provided that proper precautions are employed. Considerations for safe use are provided. KEY WORDS: Chronic pain, CIED, radiofrequency ablation

scholarly journals Evolution of pain management services in Nepal

2020 ◽  
Vol 24 (4) ◽  
Author(s):  
Anil Shrestha ◽  
Roshana Amatya ◽  
Ninadini Shrestha
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Management Service ◽  
Essential Service ◽  
Management Services

Pain is one of the most common symptoms of patients visiting the hospital. The prevalence of chronic pain is estimated to be around 30%. Pain management service is a separate service provided by healthcare institutions to manage such chronic pain and has become essential service in most of the countries. Nepal has also started to provide services for patients with chronic pain through pain management clinics.

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