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Undertreatment pain

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https://www.readbyqxmd.com/read/28739059/postoperative-pain-and-analgesia-in-children-undergoing-palatal-surgery-a-retrospective-chart-review
#1
Marissa Milchak, Priti G Dalal, Diane E McCloskey, Thomas Samson
PURPOSE: Pediatric patients undergoing palatal surgery may experience significant postoperative pain. Undertreatment of acute postoperative pain may impact postoperative bleeding and recovery. The primary objectives of this study were to evaluate the severity of acute postoperative pain scores, analgesia management, and discharge times after palatal surgery. DESIGN AND METHODS: A retrospective chart review was performed for all patients aged <18 years, born with cleft palate who underwent palatal surgery over a 1-year period...
August 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28717725/minding-the-gaps-in-cancer-pain-management-education-a-multicenter-study-of-clinical-residents-and-fellows-in-a-low-versus-high-resource-setting
#2
Charles Amoatey Odonkor, Ernest Osei-Bonsu, Oswald Tetteh, Andy Haig, Robert Samuel Mayer, Thomas J Smith
PURPOSE: Inadequate pain management training has been reported as a major cause of undertreatment of cancer pain. Yet, past research has not comprehensively compared the quality of cancer pain management education among physicians in training in high-resource countries (HRCs) with those in low-resource countries (LRCs). The purpose of this study was to examine and compare gaps in cancer pain management education among physician trainees in an HRC (United States) versus an LRC (Ghana)...
December 2016: Journal of Global Oncology
https://www.readbyqxmd.com/read/28562301/pain-assessment-and-treatment-in-children-with-significant-impairment-of-the-central-nervous-system
#3
Julie Hauer, Amy J Houtrow
Pain is a frequent and significant problem for children with impairment of the central nervous system, with the highest frequency and severity occurring in children with the greatest impairment. Despite the significance of the problem, this population remains vulnerable to underrecognition and undertreatment of pain. Barriers to treatment may include uncertainty in identifying pain along with limited experience and fear with the use of medications for pain treatment. Behavioral pain-assessment tools are reviewed in this clinical report, along with other strategies for monitoring pain after an intervention...
June 2017: Pediatrics
https://www.readbyqxmd.com/read/28561731/pain-and-opioids-in-cancer-care-benefits-risks-and-alternatives
#4
Mike Bennett, Judith A Paice, Mark Wallace
Pain remains common in the setting of malignancy, occurring as a consequence of cancer and its treatment. Several high-quality studies confirm that more than 50% of all patients with cancer experience moderate to severe pain. The prevalence of pain in cancer survivors is estimated to be 40%, while close to two-thirds of those with advanced disease live with pain. Progress has occurred in the management of cancer pain, yet undertreatment persists. Additionally, new challenges are threatening these advances. These challenges are numerous and include educational deficits, time restraints, and limited access to all types of care...
2017: American Society of Clinical Oncology Educational Book
https://www.readbyqxmd.com/read/28520735/pain-in-methadone-patients-time-to-address-undertreatment-and-suicide-risk-anrs-methaville-trial
#5
Sandra Nordmann, Antoine Vilotitch, Caroline Lions, Laurent Michel, Marion Mora, Bruno Spire, Gwenaelle Maradan, Marc-Karim Bendiane, Alain Morel, Perrine Roux, Patrizia Carrieri
BACKGROUND: Pain in opioid-dependent patients is common but data measuring the course of pain (and its correlates) using validated scales in patients initiating methadone treatment are sparse. We aimed to assess pain and its interference in daily life, associated correlates, and undertreatment before and during methadone treatment. METHODS: This is a secondary analysis using longitudinal data of a randomized trial comparing two methadone initiation models. We assessed the effect of methadone initiation and other correlates on pain intensity and interference (using the Brief Pain Inventory) at months 0, 6 and 12 using a mixed multinomial logistic regression model...
2017: PloS One
https://www.readbyqxmd.com/read/28479410/impact-of-undertreatment-of-cancer-pain-with-analgesic-drugs-on-patient-outcomes-a-nationwide-survey-of-outpatient-cancer-patient-care-in-taiwan
#6
Wen-Chi Shen, Jen-Shi Chen, Yu-Yun Shao, Kuan-Der Lee, Tzeon-Jye Chiou, Yung-Chuan Sung, Kun-Ming Rau, Chia-Jui Yen, Yu-Min Liao, Ta-Chih Liu, Ming-Fang Wu, Ming-Yang Lee, Ming-Sun Yu, Wen-Li Hwang, Pang-Yu Lai, Cheng-Shyong Chang, Wen-Chi Chou, Ruey-Kuen Hsieh
CONTEXT: Undertreatment of cancer pain among outpatient cancer patients needs to be addressed to enhance care and improve patients' quality of life (QoL). OBJECTIVES: This prospective, cross-sectional, patient-focused study aimed to explore the prevalence of pain and undertreatment of cancer pain in outpatients in Taiwan. METHODS: A total of 2652 non-selected outpatients with cancer and aged 20 years or older from 16 medical centers across Taiwan were included in this survey...
July 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28359711/painful-discrimination-in-the-emergency-department-risk-factors-for-underassessment-of-patients-pain-by-nurses
#7
Jorien G J Pierik, Maarten J IJzerman, Menno I Gaakeer, Miriam M R Vollenbroek-Hutten, Carine J M Doggen
INTRODUCTION: Unrelieved acute musculoskeletal pain continues to be a reality of major clinical importance, despite advancements in pain management. Accurate pain assessment by nurses is crucial for effective pain management. Yet inaccurate pain assessment is a consistent finding worldwide in various clinical settings, including the emergency department. In this study, pain assessments between nurses and patients with acute musculoskeletal pain after extremity injury will be compared to assess discrepancies...
May 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28306569/pain-prevalence-in-cancer-patients-status-quo-or-opportunities-for-improvement
#8
Johan Haumann, E Bert A Joosten, Marieke H J van den Beuken-van Everdingen
PURPOSE OF REVIEW: Cancer incidence increases worldwide and thus more patients will suffer from cancer pain. As cancer pain severely affects quality of life, the decrease of pain should be of high priority for every clinician. In the last decade, attention for cancer pain and for its treatment has increased, and new pharmacological based treatment options became available. This gave reason to hypothesize a decrease in pain prevalence in cancer patients over the last decade. RECENT FINDINGS: Despite increased attention to cancer pain, pain prevalence in cancer patients has not significantly changed over the last decade as compared to the four decades before...
June 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28251524/pain-management-of-patients-with-substance-abuse-in-the-ambulatory-setting
#9
REVIEW
Nalini Vadivelu, Alice M Kai, Vijay Kodumudi, Richard Zhu, Roberta Hines
PURPOSE OF REVIEW: Abuse of illicit substances and prescription opioids is a growing problem that presents challenges for pain management in the inpatient and outpatient setting. With future patient care models shifting toward shorter hospital stays and more same-day surgeries, it is crucial that clinicians learn to manage this patient population and strike a balance between the overtreatment of pain that can subsequently worsen tolerance and addiction, and the undertreatment of pain that can lead to pseudoaddiction...
February 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28244943/mixed-pain-can-be-discerned-in-the-primary-care-and-orthopedics-settings-in-spain-a-large-cross-sectional-study
#10
Pedro J Ibor, Isabel Sánchez-Magro, Jesús Villoria, Ana Leal, Ana Esquivias
OBJECTIVES: To assess the value of the concept of mixed pain by investigating its acceptance and interpretation by health care professionals and the differential characteristics in patients with mixed pain. MATERIALS AND METHODS: Data from 5024 patients suffering pain from 551 sites in Primary Care and Orthopedics settings were analyzed in this cross-sectional study. Pain characteristics, other factors influencing pain, health care-related data and health-related quality of life were summarized and compared among 3 groups of patients according to the type of pain (nociceptive, neuropathic, or mixed), as assigned by the investigators after considering the pathophysiological mechanisms involved...
February 27, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28240097/soluble-intercellular-adhesion-molecule-1-a-potential-biomarker-for-pain-intensity-in-chronic-pain-patients
#11
Benjamin Luchting, Ludwig Christian Giuseppe Hinske, Banafscheh Rachinger-Adam, Leo Anthony Celi, Simone Kreth, Shahnaz Christina Azad
AIM: Pain therapy is strongly guided by patients' self-reporting. However, when self-reporting is not an option, pain assessment becomes a challenge and may lead to undertreatment of painful conditions. Pain is a complex and multifactorial phenomenon. Recent work has connected pain pathophysiology also with the inflammatory system. We therefore hypothesized that pain intensity could be predicted by cytokine-levels. PATIENTS & METHODS: In this observational, single-center study, we investigated 30 serum cytokines to predict pain intensity in a screening/follow-up set of 95 chronic pain patients and controls...
March 2017: Biomarkers in Medicine
https://www.readbyqxmd.com/read/28224474/pain-severity-and-pharmacologic-pain-management-among-community-living-older-adults-the-mobilize-boston-study
#12
Ampicha Nawai, Suzanne G Leveille, Robert H Shmerling, Guusje van der Leeuw, Jonathan F Bean
BACKGROUND: Concerns about polypharmacy and medication side effects contribute to undertreatment of geriatric pain. This study examines use and effects of pharmacologic treatment for persistent pain in older adults. METHODS: The MOBILIZE Boston Study included 765 adults aged ≥70 years, living in the Boston area, recruited from 2005 to 2008. We studied 599 participants who reported chronic pain at baseline. Pain severity, measured using the Brief Pain Inventory (BPI) severity subscale, was grouped as very mild (BPI <2), mild (BPI 2-3...
February 21, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28162386/-164-pain-among-community-dwelling-older-adults-with-dementia-factors-associated-with-undertreatment
#13
E Thakur, A Amspoker, S Sansgiry, A Snow, M Stanley, J Freshour, M Kunik
No abstract text is available yet for this article.
April 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28111729/-opioid-use-and-the-management-of-cancer-patient-pain-in-palliative-care-clinic
#14
Gülçin Şenel, Gonca Oğuz, Nesteren Koçak, Şerife Karaca, Menşure Kaya, Nihal Kadıoğulları
OBJECTIVES: Pain is one of the most important symptoms in palliative care, and has a major impact on the quality of life of cancer patients. In developing countries, difficult access to opioids and the lack of well-established palliative care organizations result in undertreatment of pain. Turkey is one of the countries with statistical evidence of inadequate morphine consumption per capita. In 2010, the adequacy of opioid analgesic consumption was only 7%, based on a per capita consumption of 14...
October 2016: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
https://www.readbyqxmd.com/read/28077451/the-increasing-use-of-cannabis-among-older-americans-a-public-health-crisis-or-viable-policy-alternative
#15
Brian Kaskie, Padmaja Ayyagari, Gary Milavetz, Dan Shane, Kanika Arora
Cannabis use among older Americans is increasing. Although much of this growth has been attributed to the entry of a more tolerant baby boom cohort into older age, recent evidence suggests the pathways to cannabis are more complex. Some older persons have responded to changing social and legal environments and are increasingly likely to take cannabis recreationally. Other older persons are experiencing age-related health care needs, and some take cannabis for symptom management, as recommended by a medical doctor...
January 11, 2017: Gerontologist
https://www.readbyqxmd.com/read/27898134/quality-pain-care-for-older-adults-in-an-era-of-suspicion-and-scrutiny
#16
Barbara St Marie, Paul Arnstein
In two decades, the pendulum has swung from focusing on the undertreatment of pain by prescribers who fail to use medically necessary opioid agents to an intense focus on overprescribing opioid medications and the harms they cause. Within these two extremes rests the older adult with pain and in need of safe and effective care. Today, health care providers are practicing in an era of scrutiny, with new guidelines and regulations superseding their compassion and clinical judgment about the best treatment options when older adults have pain across the care continuum...
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27853929/longitudinal-assessment-of-pain-management-with-the-pain-management-index-in-cancer-outpatients-receiving-chemotherapy
#17
Akiko Fujii, Yu Yamada, Koichi Takayama, Takako Nakano, Junji Kishimoto, Tatsuya Morita, Yoichi Nakanishi
PURPOSE: The adequacy of pain management for individuals with cancer who receive outpatient chemotherapy is unclear. The primary objective of this study was to assess pain prevalence and intensity in such patients. The secondary objectives included assessment of pain management with the pain management index (PMI) and exploration of predictors of inadequate pain management. METHODS: Cancer patients who received outpatient chemotherapy were enrolled. Patients were required to complete questionnaires covering demographic data and including the Brief Pain Inventory and the Distress Thermometer and Impact Thermometer...
March 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27694534/pain-among-community-dwelling-older-adults-with-dementia-factors-associated-with-undertreatment
#18
Elyse R Thakur, Amber B Amspoker, Shubhada Sansgiry, A Lynn Snow, Melinda Stanley, Nancy Wilson, Jessica Freshour, Mark E Kunik
OBJECTIVE:  To identify factors associated with no analgesic treatment in community-dwelling older adults with mild-to-moderate dementia and moderate-to-severe pain. DESIGN:  Secondary analysis of a randomized controlled trial. SETTING:  Michael E. DeBakey Veterans Affairs Medical Center. SUBJECTS : Two hundred and two older adults (mean age = 79.27 years). METHODS:  Guided by the Behavioral Model of Health Service Utilization, participants completed questionnaires regarding predisposing (age, gender, race, educational level, care partner relationship), enabling (income), and need (pain interference, depressive symptoms, cognitive functioning) characteristics...
September 30, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27663460/adherence-to-national-comprehensive-cancer-network%C3%A2-guidelines-for-testicular-cancer
#19
Kevin M Wymer, Shane M Pearce, Kelly T Harris, Phillip M Pierorazio, Siamak Daneshmand, Scott E Eggener
PURPOSE: Testicular cancer is the most common malignancy among young men and well established treatment guidelines exist to optimize outcomes. We characterized errors in the management of testicular cancer observed among patients seen at 3 referral centers in the United States. MATERIALS AND METHODS: We retrospectively reviewed data from 593 patients presenting with testicular cancer to 3 academic medical centers from 2007 to 2016. Nonguideline directed care was defined as management differing from National Comprehensive Care Network guideline recommendations...
March 2017: Journal of Urology
https://www.readbyqxmd.com/read/27626624/opioid-prescribing-for-patients-with-cancer-in-the-last-year-of-life-a-longitudinal-population-cohort-study
#20
Lucy Ziegler, Matthew Mulvey, Alison Blenkinsopp, Duncan Petty, Michael I Bennett
We linked UK cancer registry data with the corresponding electronic primary care medical records of 6080 patients who died of cancer over a 7-year period in a large United Kingdom city. We extracted all prescriptions for analgesics issued to each patient in the linked cohort during the 12 months before death and analysed the extent and duration of strong opioid treatment with clinical and patient characteristics. Strong opioids were prescribed for 48% of patients in the last year of life. Median interval between first prescription of a strong opioid and death was 9 weeks (interquartile range 3-23)...
November 2016: Pain
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