scholarly journals From Silos to Solidarity: Case Study of a Patient-Centered, Integrative Approach to Opioid Tapering and Chronic Pain Mitigation in a Multidisciplinary AIDS Clinic

2021 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Chronic Pain ◽  
Integrative Approach ◽  
Patient Centered ◽  
Opioid Tapering ◽  
Pain Mitigation

scholarly journals A Brief Screening Tool for Opioid Use Disorder: EMPOWER Study Expert Consensus Protocol

2021 ◽  
Vol 8 ◽  
Author(s):  
Dokyoung S. You ◽  
Aram S. Mardian ◽  
Beth D. Darnall ◽  
Chwen-Yuen A. Chen ◽  
Korina De Bruyne ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Screening Tool ◽  
Opioid Therapy ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Consensus Protocol ◽  
Patient Centered ◽  
Treatment Pathways ◽  
Opioid Tapering

Growing concerns about the safety of long-term opioid therapy and its uncertain efficacy for non-cancer pain have led to relatively rapid opioid deprescribing in chronic pain patients who have been taking opioid for years. To date, empirically supported processes for safe and effective opioid tapering are lacking. Opioid tapering programs have shown high rates of dropouts and increases in patient distress and suicidal ideation. Therefore, safe strategies for opioid deprescribing that are more likely to succeed are urgently needed. In response to this demand, the EMPOWER study has been launched to examine the effectiveness of behavioral medicine strategies within the context of patient-centered opioid tapering in outpatient settings (https://empower.stanford.edu/). The EMPOWER protocol requires an efficient process for ensuring that collaborative opioid tapering would be offered to the most appropriate patients while identifying patients who should be offered alternate treatment pathways. As a first step, clinicians need a screening tool to identify patients with Opioid Use Disorder (OUD) and to assess for OUD severity. Because such a tool is not available, the study team composed of eight chronic pain and/or addiction experts has extended a validated screening instrument to develop a brief and novel consensus screening tool to identify OUD and assess for OUD severity for treatment stratification. Our screening tool has the potential to assist busy outpatient clinicians to assess OUD among patients receiving long-term opioid therapy for chronic pain.

scholarly journals Patient-Centered Prescription Opioid Tapering in Community Outpatients With Chronic Pain

2018 ◽  
Vol 178 (5) ◽  
pp. 707 ◽  
Author(s):  
Beth D. Darnall ◽  
Maisa S. Ziadni ◽  
Richard L. Stieg ◽  
Ian G. Mackey ◽  
Ming-Chih Kao ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Prescription Opioid ◽  
Patient Centered ◽  
Opioid Tapering

scholarly journals Patient-centered prescription opioid tapering in community outpatients with chronic pain: 2- to 3-year follow-up in a subset of patients

PAIN Reports ◽  
2020 ◽  
Vol 5 (5) ◽  
pp. e851
Author(s):  
Maisa Ziadni ◽  
Abby L. Chen ◽  
Parthasarathy Krishnamurthy ◽  
Pamela Flood ◽  
Richard L. Stieg ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Prescription Opioid ◽  
Patient Centered ◽  
Opioid Tapering

scholarly journals Comparative Effectiveness of Cognitive Behavioral Therapy for Chronic Pain and Chronic Pain Self-Management within the Context of Voluntary Patient-Centered Prescription Opioid Tapering: The EMPOWER Study Protocol

Pain Medicine ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. 1523-1531 ◽  
Author(s):  
Beth D Darnall ◽  
Sean C Mackey ◽  
Kate Lorig ◽  
Ming-Chih Kao ◽  
Aram Mardian ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Cognitive Behavioral Therapy ◽  
Study Protocol ◽  
Comparative Effectiveness ◽  
Behavioral Therapy ◽  
Self Management ◽  
Prescription Opioid ◽  
Patient Centered ◽  
Opioid Tapering

Abstract Objective. Evidence to date, while sparse, suggests that patients taking long-term opioids require special considerations and protections to prevent potential iatrogenic harms from opioid de-prescribing, such as increased pain or suffering. Following this study protocol, the EMPOWER study seeks to address multiple unmet needs of patients with chronic pain who desire to reduce long-term opioid therapy, and provide the clinical evidence on effective methodology. Methods. EMPOWER applies patient-centered methods for voluntary prescription opioid reduction conducted within a comprehensive, multi-state, 3-arm randomized controlled comparative effectiveness study of three study arms (1) group cognitive behavioral therapy for chronic pain; (2) group chronic pain self-management; and (3) usual care (taper only). Specialized electronic data capture systems collect patient reported symptoms and satisfaction data weekly and monthly during the taper, with real-time clinical alerts and electronic feedback loops informing, documenting, and steering needed care actions. Conclusion. The EMPOWER study seeks to provide granular evidence on patient response to voluntary opioid tapering, and will provide evidence to inform clinical systems changes, clinical care, patient satisfaction, and patient outcomes for opioid reduction.

Integrative Nursing Management of Pain

2018 ◽  
pp. 291-312
Author(s):  
Susan Thompson ◽  
Judy L. Wagner
Keyword(s):  
Chronic Pain ◽  
Nursing Practice ◽  
Healthcare Systems ◽  
Nursing Management ◽  
Patient Centered ◽  
Significant Challenge ◽  
Socioeconomic Burden ◽  
The Right ◽  
Integrative Therapies

Pain represents a significant challenge for clinicians as their patients seek relief from acute and chronic pain. This chapter reviews the current epidemic of patients with chronic pain, and the socioeconomic burden it imposes on individuals, families, communities, and healthcare systems. Definitions of pain and the complexity of pain management are discussed, along with an overview of the current efforts to address the worldwide opioid crisis. Nurses are uniquely positioned to comprehensively assess and treat pain in their patients. A review of an integrative and patient-centered nursing approach for assessing pain and finding the right therapy for the right situation is discussed. Also included in the chapter are practical examples and a case study, as well as ideas on how to incorporate a variety of integrative therapies into daily nursing practice, such as guided imagery, acupressure, aromatherapy, massage, and movement therapy.

VALLEY OF THE MASTODONS: CASE STUDY OF AN INTEGRATIVE APPROACH TO RESEARCH COLLABORATION, OUTREACH, AND EXHIBITS

2017 ◽  
Author(s):  
Alton C. Dooley ◽  
◽  
Kathlyn M. Smith ◽  
Brittney Stoneburg ◽  
Darla Radford ◽  
...  
Keyword(s):  
Research Collaboration ◽  
Integrative Approach

Impacts on patient-centered outcomes of a chronic pain self-management program in a rural community: A feasibility study

2021 ◽  
Vol 42 (5) ◽  
pp. 1198-1203
Author(s):  
Zenong Yin ◽  
Shiyu Li ◽  
Catherine Ortega ◽  
Raudel Bobadilla ◽  
Paula L. Winkler ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Feasibility Study ◽  
Rural Community ◽  
Management Program ◽  
Self Management ◽  
Patient Centered

Relevance of an integrative approach for taxonomic revision in sponge taxa: case study of the shallow-water Atlanto-Mediterranean Hexadella species (Porifera:Ianthellidae:Verongida)

2012 ◽  
Vol 26 (3) ◽  
pp. 230 ◽  
Author(s):  
Julie Reveillaud ◽  
Céline Allewaert ◽  
Thierry Pérez ◽  
Jean Vacelet ◽  
Bernard Banaigs ◽  
...  
Keyword(s):  
Shallow Water ◽  
Phylogenetic Reconstruction ◽  
Taxonomic Revision ◽  
Integrative Approach ◽  
Cryptic Species Complex ◽  
Surface Network ◽  
Natural Toxicity ◽  
Shallow Water Species ◽  
Water Species

The identification of sponges that lack a mineral skeleton is always highly challenging, especially for Hexadella species, which are also fibreless. Recently, the yellow species Hexadella pruvoti Topsent was identified as a cryptic species complex while the pink coloured Hexadella racovitzai Topsent showed two highly divergent lineages. We performed a COI phylogenetic reconstruction using 27 new Mediterranean Hexadella samples in order to confirm the presence of divergent lineages within both shallow-water species. Specimens were described with an integrative approach combining morphological and cytological investigations, biochemical profiling and assessment of natural toxicity in order to identify diagnostic characters for each taxon. H. topsenti, sp. nov. is distinguished from H. racovitzai by its colour, its surface network shape, divergent secondary metabolite patterns and toxicity values. H. crypta, sp. nov. differs from H. pruvoti by a different encrusting growth form when alive, and by distinctively colouring the ethanol fixative solution. In addition, H. pruvoti and H. crypta show different types of cells with inclusions as well as distinct metabolic fingerprints. Natural toxicity values, however, do not permit the separation of H. pruvoti and H. crypta. Our work shows that only the use of a combination of complementary tools can provide relevant descriptions for some problematic taxa.

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