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Guidelines for management of chronic pain

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https://www.readbyqxmd.com/read/28435321/a-behavioral-medicine-intervention-for-community-dwelling-older-adults-with-chronic-musculoskeletal-pain-protocol-for-a-randomized-controlled-trial
#1
Sara Cederbom, Eva Denison, Astrid Bergland
BACKGROUND: Chronic musculoskeletal pain is a major health problem among older adults, particularly those who live alone and/or those who are dependent on formal care. Chronic pain is associated with mobility problems, falls, fear of falling, catastrophizing thoughts, and a lower quality of life. Research shows that physical therapy interventions based on behavioral medicine approaches are beneficial for middle-aged adults with chronic pain. However, there appears to be no previous randomized controlled trials (RCTs) based on this theoretical framework that have examined the effect on older adults with chronic musculoskeletal pain who live alone at home and are dependent on formal care to manage their everyday lives...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28427472/optimising-conservative-management-of-chronic-low-back-pain-study-protocol-for-a-randomised-controlled-trial
#2
Katherine J Simson, Clint T Miller, Jon Ford, Andrew Hahne, Luana Main, Timo Rantalainen, Wei-Peng Teo, Megan Teychenne, David Connell, Guy Trudel, Guoyan Zheng, Gary Thickbroom, Daniel L Belavy
BACKGROUND: Lower back pain is a global health issue affecting approximately 80% of people at some stage in their life. The current literature suggests that any exercise is beneficial for reducing back pain. However, as pain is a subjective evaluation and physical deficits are evident in low back pain, using it as the sole outcome measure to evaluate superiority of an exercise protocol for low back pain treatment is insufficient. The overarching goal of the current clinical trial is to implement two common, conservative intervention approaches and examine their impact on deficits in chronic low back pain...
April 20, 2017: Trials
https://www.readbyqxmd.com/read/28394736/what-do-providers-want-to-know-about-opioid-prescribing-a-qualitative-analysis-of-their-questions
#3
Phoebe A Cushman, Jane M Liebschutz, Joseph G Hodgkin, Christopher W Shanahan, Julie L White, Ilana Hardesty, Daniel P Alford
BACKGROUND: In 2012, the US Food and Drug Administration (FDA) responded to the opioid crisis with a Risk Evaluation and Mitigation Strategy, requiring manufacturers of extended-release/long-acting opioids to fund continuing medical education based on the "FDA Blueprint for Prescriber Education." Topics in the Blueprint are "Assessing Patients for Treatment," "Initiating Therapy, Modifying Dosing, and Discontinuing Use," "Managing Therapy," "Counseling Patients and Caregivers about Safe Use," "General Drug Information," and "Specific Drug Information...
April 10, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28384742/how-would-you-manage-opioid-use-in-these-three-patients-grand-rounds-discussion-from-beth-israel-deaconess-medical-center
#4
Daniel P Alford, Marc L Cohen, Eileen E Reynolds
The increase in overdose deaths from prescription opioids and heroin in the United States over the past 20 years is believed to have resulted from increases in prescription of opioids for management of acute and chronic pain. Managing chronic pain is challenging for primary care clinicians for many reasons, including the lack of evidence to guide practice. The Centers for Disease Control and Prevention published a comprehensive guideline in 2016 to help clinicians with opioid prescribing for chronic pain. In this Grand Rounds, the guideline is reviewed and an expert discusses its application to 3 patients prescribed opioids to treat chronic pain...
April 4, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28375916/neuropathic-pain
#5
Lindsay A Zilliox
PURPOSE OF REVIEW: Neuropathic pain is a frequently encountered condition that is often resistant to treatment and is associated with poor patient satisfaction of their treatment. Several medications have been shown to be effective in treating neuropathic pain associated with diabetic neuropathy and postherpetic neuralgia, and these medications are often used to treat neuropathic pain associated with other conditions as well. This article summarizes the diagnosis and assessment of patients with neuropathic pain as well as available pharmacologic and interventional treatment options...
April 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28372534/panel-7-otitis-media-treatment-and-complications
#6
Anne G M Schilder, Tal Marom, Mahmood F Bhutta, Margaretha L Casselbrant, Harvey Coates, Marie Gisselsson-Solén, Amanda J Hall, Paola Marchisio, Aino Ruohola, Roderick P Venekamp, Ellen M Mandel
Objective We aimed to summarize key articles published between 2011 and 2015 on the treatment of (recurrent) acute otitis media, otitis media with effusion, tympanostomy tube otorrhea, chronic suppurative otitis media and complications of otitis media, and their implications for clinical practice. Data Sources PubMed, Ovid Medline, the Cochrane Library, and Clinical Evidence (BMJ Publishing). Review Methods All types of articles related to otitis media treatment and complications between June 2011 and March 2015 were identified...
April 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28371291/relationship-between-using-clinical-practice-guidelines-for-pain-treatment-and-physicians-training-and-attitudes-towards-patients-and-the-effects-on-patient-care
#7
María Dueñas, Alejandro Salazar, Modesto Sánchez, Helena De Sola, Begoña Ojeda, Inmaculada Failde
AIMS: To determine the use of clinical practice guidelines (CPGs) for chronic pain (CP) management; analyze the effects of training in pain and the attitudes of physicians towards pain and CP patients on the adherence to these CPGs; and assess the impact of adherence to CPGs on patient care. METHOD: This was a cross-sectional study in a sample of physicians involved in CP patient management. Information on the use of CPGs for CP management, their training in pain, and their attitudes towards pain, patients, and patient care was collected...
March 30, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28363316/targeting-practitioners-a-review-of-guidelines-training-and-policy-in-pain-management
#8
REVIEW
Kelly S Barth, Constance Guille, Jenna McCauley, Kathleen T Brady
This paper reviews the current literature on clinical guidelines, practitioner training, and government/payer policies that have come forth in response to the national rise in prescription opioid overdoses. A review of clinical opioid prescribing guidelines highlights the need for more research on safe and effective treatment options for chronic pain, improved guidance for the best management of post-operative pain, and evaluation of the implementation and impact of guideline recommendations on patient risk and outcomes...
April 1, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28345742/a-qualitative-exploration-of-chronic-pain-and-opioid-treatment-among-hiv-patients-with-drug-use-disorders
#9
Sarina R Isenberg, Allysha C Maragh-Bass, Kathleen Ridgeway, Mary C Beach, Amy R Knowlton
OBJECTIVE: The study explored high-risk participants' experiences with pain management regarding clinical access to and use of prescription opioids. DESIGN: Qualitative semistructured interviews and focus groups. SETTING: Data were collected August 2014 to May 2015 at an urban community-based research facility in Baltimore City, MD. PARTICIPANTS: HIV participants with chronic pain and a history of illicit drug use. METHODS: Qualitative coding and analysis used an iterative, inductive, and thematic approach and coders achieved inter-coder consistency...
January 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28344786/united-european-gastroenterology-evidence-based-guidelines-for-the-diagnosis-and-therapy-of-chronic-pancreatitis-hapaneu
#10
REVIEW
J Matthias Löhr, Enrique Dominguez-Munoz, Jonas Rosendahl, Marc Besselink, Julia Mayerle, Markus M Lerch, Stephan Haas, Fatih Akisik, Nikolaos Kartalis, Julio Iglesias-Garcia, Jutta Keller, Marja Boermeester, Jens Werner, Jean-Marc Dumonceau, Paul Fockens, Asbjorn Drewes, Gürlap Ceyhan, Björn Lindkvist, Joost Drenth, Nils Ewald, Philip Hardt, Enrique de Madaria, Heiko Witt, Alexander Schneider, Riccardo Manfredi, Frøkjer J Brøndum, Sasa Rudolf, Thomas Bollen, Marco Bruno
BACKGROUND: There have been substantial improvements in the management of chronic pancreatitis, leading to the publication of several national guidelines during recent years. In collaboration with United European Gastroenterology, the working group on 'Harmonizing diagnosis and treatment of chronic pancreatitis across Europe' (HaPanEU) developed these European guidelines using an evidence-based approach. METHODS: Twelve multidisciplinary review groups performed systematic literature reviews to answer 101 predefined clinical questions...
March 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28337689/managing-chronic-pain-in-primary-care-it-really-does-take-a-village
#11
Karen Seal, William Becker, Jennifer Tighe, Yongmei Li, Tessa Rife
Some healthcare systems are relieving primary care providers (PCPs) of "the burden" of managing chronic pain and opioid prescribing, instead offloading chronic pain management to pain specialists. Last year the Centers for Disease Control and Prevention recommended a biopsychosocial approach to pain management that discourages opioid use and promotes exercise therapy, cognitive behavioral therapy and non-opioid medications as first-line patient-centered, multi-modal treatments best delivered by an interdisciplinary team...
March 23, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28315549/substance-abuse-and-addiction-implications-for-pain-management-in-patients-with-cancer%C3%A2
#12
Yu-Ping Chang
BACKGROUND: Substance use disorders (SUDs) are chronic diseases that may complicate the nursing care of patients with cancer, affecting their ability to adhere to treatment protocols, responses to cancer pain, and use of opioids for analgesia. OBJECTIVES: This article explores how the presence of an SUD may affect oncology nursing care and pain management. METHODS: The PubMed and CINAHL® databases were searched for articles from 1980-2016 using the keywords cancer, cancer pain, addiction, substance abuse, and alcoholism...
April 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28277866/treatment-for-chronic-low-back-pain-the-focus-should-change-to-multimodal-management-that-reflects-the-underlying-pain-mechanisms
#13
Gerhard Müller-Schwefe, Bart Morlion, Karsten Ahlbeck, Eli Alon, Stefano Coaccioli, Flaminia Coluzzi, Frank Huygen, Wolfgang Jaksch, Eija Kalso, Magdalena Kocot-Kępska, Hans-Georg Kress, Ana Cristina Mangas, Cesar Margarit Ferri, Philippe Mavrocordatos, Andrew Nicolaou, Concepción Pérez Hernández, Joseph Pergolizzi, Michael Schäfer, Patrick Sichère
Chronic low back pain: Chronic pain is the most common cause for people to utilize healthcare resources and has a considerable impact upon patients' lives. The most prevalent chronic pain condition is chronic low back pain (CLBP). CLBP may be nociceptive or neuropathic, or may incorporate both components. The presence of a neuropathic component is associated with more intense pain of longer duration, and a higher prevalence of co-morbidities. However, many physicians' knowledge of chronic pain mechanisms is currently limited and there are no universally accepted treatment guidelines, so the condition is not particularly well managed...
March 22, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28253909/protocol-for-a-systematic-review-with-network-meta-analysis-of-the-modalities-used-to-deliver-ehealth-interventions-for-chronic-pain
#14
Brian W Slattery, Stephanie Haugh, Kady Francis, Laura O'Connor, Katie Barrett, Christopher P Dwyer, Siobhan O'Higgins, Jonathan Egan, Brian E McGuire
BACKGROUND: As eHealth interventions prove both efficacious and practical, and as they arguably overcome certain barriers encountered by traditional face-to-face treatment for chronic pain, their number has increased dramatically in recent times. However, there is a dearth of research that focuses on evaluating and comparing the different types of technology-assisted interventions. This is a protocol for a systematic review that aims to evaluate the eHealth modalities in the context of psychological and non-psychological (other than non-drug) interventions for chronic pain...
March 3, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28251070/knee-osteoarthritis-therapeutic-alternatives-in-primary-care
#15
Allison L Evaniew, Nathan Evaniew
AIM: To discusses pharmacological and non-pharmacological therapeutic alternatives for managing knee osteoarthritis in primary care by primary health care nurse practitioners. METHODS: A case example is presented, the evidence-based guideline recommendations of the Osteoarthritis Research Society International and the American Academy of Orthopaedic Surgeons are reviewed, and a plan of care is developed. RESULTS: Osteoarthritis is the most common form of arthritis seen in primary care, and it is a major public health issue because the aging population and widespread obesity have drastically increased incidence...
February 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28249051/the-elements-of-pain-care-that-the-guidelines-don-t-address
#16
EDITORIAL
John Hickner
I have managed many patients with chronic pain who were already on hefty doses of narcotics when they became my patients. Rather than refuse to care for them, we should seek to understand their story, continuously try other medications and therapies, repeatedly attempt to reduce dosages, and frequently check substance databases.
March 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28246687/-multimorbidity-management-and-the-physician-s-daily-clinical-dilemma
#17
E Battegay, M Cheetham, B M Holzer, A Nowak, D Schmidt, S Rampini
About 20-25% of all persons and about 90% of all patients who are acutely hospitalized in internal medicine departments have multiple acute or chronic diseases. They are multimorbid. The encounter with multimorbid patients has become the most common situation in the health care system. Theoretically, multimorbidity results in an innumerable potential disease constellations. In addition, the likelihood of interactions between diseases (disease-disease interactions, DDI) and the complexity increases overproportionately with each additional disease...
February 28, 2017: Der Internist
https://www.readbyqxmd.com/read/28241807/clinical-registry-of-dental-outcomes-in-head-and-neck-cancer-patients-orarad-rationale-methods-and-recruitment-considerations
#18
Rajesh V Lalla, Leslie Long-Simpson, James S Hodges, Nathaniel Treister, Thomas Sollecito, Brian Schmidt, Lauren L Patton, Michael T Brennan
BACKGROUND: Most head and neck (H&N) cancer patients receive high-dose external beam radiation therapy (RT), often in combination with surgery and/or chemotherapy. Unfortunately, high-dose RT has significant adverse effects on the oral and maxillofacial tissues, some of which persist for the life of the patient. However, dental management of these patients is based largely on individual and expert opinion, as few studies have followed patients prospectively to determine factors that predict adverse oral sequelae...
February 27, 2017: BMC Oral Health
https://www.readbyqxmd.com/read/28239510/lidocaine-infusion-a-promising-therapeutic-approach-for-chronic-pain
#19
Enas Kandil, Emily Melikman, Bryon Adinoff
Opioid abuse is a national epidemic in the United States, where it is estimated that a prescription drug overdose death occurs every 19 minutes. While opioids are highly effective in acute and subacute pain control, their use for treatment of chronic pain is controversial. Chronic opioids use is associated with tolerance, dependency, hyperalgesia. Although there are new strategies and practice guidelines to reduce opioid dependence and opioid prescription drug overdose, there has been little focus on development of opioid-sparing therapeutic approaches...
January 2017: Journal of Anesthesia & Clinical Research
https://www.readbyqxmd.com/read/28226334/prescription-opioid-abuse-in-chronic-pain-an-updated-review-of-opioid-abuse-predictors-and-strategies-to-curb-opioid-abuse-part-2
#20
Alan D Kaye, Mark R Jones, Adam M Kaye, Juan G Ripoll, Donald E Jones, Vincent Galan, Burton D Beakley, Frank Calixto, Jamie L Bolden, Richard D Urman, Laxmaiah Manchikanti
Chronic pain and prescription opioid abuse are extremely prevalent in the United States and worldwide. The consequences of opioid misuse can be life-threatening with significant morbidity and mortality, exacting a heavy toll on patients, physicians, and society. The risk for misuse of prescribed opioids is much higher in patients with chronic pain, especially those with concurrent substance use and /or mental health disorders. Several reasons can account for the occurrence of opioid abuse and misuse, including self-medication, use for reward, compulsive use related to addiction, and diversion for profit...
February 2017: Pain Physician
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