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Undertreated pain

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https://www.readbyqxmd.com/read/29432292/acute-pain-management-in-children-challenges-and-recent-improvements
#1
Catherine E Ferland, Eduardo Vega, Pablo M Ingelmo
PURPOSE OF REVIEW: The evidence regarding the efficacy of analgesics available to guide postoperative pain treatment in pediatric patients is limited. Opioid medications are very often an important component of pediatric postoperative pain treatment but have been associated with perioperative complications. We will focus on initiatives aiming to provide effective treatment minimizing the use of opioids and preventing the long-term consequences of pain. RECENT FINDINGS: Interpatient variability in postoperative pain is currently managed by applying protocols or by trial and error, thus often leading to patients being either undertreated or overtreated...
February 9, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29416865/a-week-of-pain-in-the-emergency-department
#2
Hilary Sarah Thornton, Joseph Reynolds, Timothy J Coats
Background: Pain is a common complaint in patients attending the emergency department (ED), and historically, it is under-assessed and undertreated. Previous research is heterogeneous and does not well describe pain in EDs over time. Our aim was to describe pain in a UK ED using a sample that included every adult attendance over the course of 1 week. Methods: We retrospectively reviewed every adult attendance (N = 1872) over 1 week to the ED of a large English NHS District General Hospital...
February 2018: British Journal of Pain
https://www.readbyqxmd.com/read/29318334/physiotherapy-for-pelvic-pain-and-female-sexual-dysfunction-an-untapped-resource
#3
REVIEW
Bary Berghmans
INTRODUCTION AND HYPOTHESIS: Chronic pelvic pain (CPP) in women is a complex syndrome. Pain sensation and intensity often do not correspond with the identified lesion location but are felt elsewhere, leading to muskuloskeletal and myofascial disorders and sexual dysfunction (SD). Although physical aspects are prevalent, they are often underdiagnosed and undertreated due to lack of understanding regarding its origin and distribution. Frequently, patients experience pelvic pain as psychological distress resulting in physical complaints, leading clinicians to prescribe medication or surgical intervention to correct or alleviate these symptoms, often with insufficient results...
January 9, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29278266/regional-nerve-blockade-for-early-analgesic-management-of-elderly-patients-with-hip-fracture-a-narrative-review
#4
REVIEW
A Scurrah, C T Shiner, J A Stevens, S G Faux
Elderly patients with hip fracture experience high morbidity and mortality, and are often undertreated for pain. Acute pain management in the elderly is challenging, with physiological frailty, medical comorbidities and cognitive impairment commonly compounding pain assessment and treatment. Guidelines outlining current best practice for acute pain management in the elderly now exist, but evidence suggests that practice remains variable and there continues to be scope for improvement. We conducted a narrative review of the literature to examine the challenges of acute pain management in the elderly, and to evaluate evidence for the role of regional nerve blocks for acute pain associated with hip fracture in the elderly...
December 26, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29251636/ce-managing-postoperative-pain
#5
Renee C B Manworren, Debra B Gordon, Robert Montgomery
: Acute postoperative pain remains undertreated despite the dramatic increase in opioid prescribing in the United States over the past 20 years. Inadequately relieved postoperative pain may be a risk factor for persistent postoperative pain, chronic pain, and disability. In an effort to promote evidence-based strategies for optimal postoperative pain management, the American Pain Society published a new postoperative pain management guideline in 2016. Its 32 recommendations for interdisciplinary and multimodal postoperative pain management are stratified according to risks and benefits, based on varying levels of evidence...
January 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29238216/improved-health-related-quality-of-life-participation-and-autonomy-in-patients-with-treatment-resistant-chronic-pain-after-an-intensive-social-cognitive-intervention-with-the-participation-of-support-partners
#6
Peter Joseph Jongen, Rob P Ruimschotel, Y M Museler-Kreijns, Tmc Dragstra, L Duyverman, J Valkenburg-Vissers, J Cornelissen, R Lagrand, Rogier Donders, A Hartog
Despite the availability of various specific treatments, most patients with chronic pain (CP) consider their pain problem as undertreated. Recently, multiple sclerosis (MS) patients who were given an intensive 3-day social cognitive treatment with the participation of support partners experienced lasting improvements in health-related quality of life (HRQoL) and self-efficacy. In this study, a similar intervention was given to treatment-resistant CP patients with stressors, relational problems with support partner, and distress, anxiety or depression...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29224058/systematic-assessment-and-characterization-of-chronic-pain-in-multiple-sclerosis-patients
#7
Diana Ferraro, Domenico Plantone, Franca Morselli, Giulia Dallari, Anna M Simone, Francesca Vitetta, Patrizia Sola, Guido Primiano, Viviana Nociti, Matteo Pardini, Massimiliano Mirabella, Catello Vollono
Pain is one of the most disabling clinical symptoms in patients with multiple sclerosis (MS). Several studies have already assessed the prevalence of pain in MS patients, reporting variable results, probably due to methodological differences. The aim of this single-centre cross-sectional study was to define the prevalence and characteristics of chronic pain in a population of MS patients using validated tools, and to analyse these data in relation to demographic and clinical features, including disease duration and disability (EDSS and its single functional system scores)...
December 9, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/29216521/the-use-of-palliative-medications-before-death-from-prostate-cancer-swedish-population-based-study-with-a-comparative-overview-of-european-data
#8
Magdalena Lycken, Linda Drevin, Hans Garmo, Pär Stattin, Jan Adolfsson, Ingela Franck Lissbrant, Lars Holmberg, Anna Bill-Axelson
BACKGROUND: Symptoms of terminal cancer have previously been reported as undertreated. The aim of this study was to assess the use of palliative medications before death from prostate cancer. METHODS: This Swedish register study included men who died from 2009 to 2012 with prostate cancer as the underlying cause of death. We assessed the proportion who collected a prescription of androgen deprivation therapy, non-steroidal anti-inflammatory drugs, paracetamol, opioids, glucocorticoids, antidepressants, anxiolytics and sedative-hypnotics and the differences in treatment related to age, time since diagnosis, educational level, close relatives and comorbidities...
January 2018: European Journal of Cancer
https://www.readbyqxmd.com/read/29189621/predictors-of-nurses-intentions-to-administer-as-needed-opioid-analgesics-for-pain-relief-to-postoperative-orthopaedic-patients-in-the-acute-care-setting
#9
Colleen Y Taylor, Jiunn-Jye Sheu, Huey-Shys Chen, Tavis Glassman, Joseph Dake
BACKGROUND: Patients undergoing orthopaedic surgery experience severe postoperative pain that is frequently undertreated. No study was found that examined the predictors of nurses' intentions to administer as needed (PRN) opioid analgesics for postoperative pain relief. PURPOSE: The purpose of this study was to determine what constructs from the Integrated Behavioral Model (IBM) can predict nurses' intentions to administer PRN opioid analgesics for pain relief to hospitalized postoperative orthopaedic patients...
November 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/29164932/development-of-the-spanish-language-houston-pain-outcome-instrument-for-spanish-speakers
#10
Jeanette McNeill, Gwen Sherwood
PURPOSE: To address reported disparities in pain management among Hispanic patients, this article reports the psychometrics of the newly developed Spanish language Houston Pain Outcome Instrument (HPOI) with postoperative Hispanic patients. METHODS: Findings from qualitative interviews conducted with 35 self-identified Hispanics in Phase 1 of the overall project were used to generate items for a new Spanish language instrument, Cuestionario de Houston Sobre el Dolor (HPOI)...
January 1, 2017: Hispanic Health Care International: the Official Journal of the National Association of Hispanic Nurses
https://www.readbyqxmd.com/read/29155288/investigation-of-the-practices-legislation-supply-chain-and-regulation-of-opioids-for-clinical-pain-management-in-southern-africa-a-multi-sectoral-cross-national-mixed-methods-study
#11
Eve Namisango, Matthew J Allsop, Richard A Powell, Stefan J Friedrichsdorf, Emmanuel Bk Luyirika, Fatia Kiyange, Edward Mukooza, Chris Ntege, Eunice Garanganga, Mavis Ntombifuthi Ginindza-Mdluli, Faith Mwangi-Powell, Lidia Justino Mondlane, Richard Harding
CONTEXT: Sub-Saharan Africa faces an increasing incidence and prevalence of life-limiting and life-threatening conditions. These conditions are associated with a significant burden of pain linked to high morbidity and disability that is poorly assessed and undertreated. Barriers to effective pain management partly relate to lack of access to opioid analgesia and challenges in their administration. OBJECTIVES: To identify country-specific and broader regional barriers to access, as well as the administration of opioids, and generate recommendations for advancing pain management in Southern Africa...
November 15, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29153920/pain-assessment-and-management-for-older-patients-with-dementia-in-hospitals-an-integrative-literature-review
#12
REVIEW
I-Pei Tsai, Sarah Yeun-Sim Jeong, Sharyn Hunter
Previous studies have suggested that pain in older people with dementia is often underestimated and undertreated in acute hospitals. Undermanaged pain negatively affects a person's recovery and prolongs hospital stays. However, the issues related to pain assessment and management by nurses for this group have not been fully understood. (1) To synthesize evidence about pain assessment and management for older people with dementia in hospital settings, and (2) to discuss implications for nurses and their practice...
November 16, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29103867/impact-of-analgesics-on-executive-function-and-memory-in-the-alzheimer-s-disease-neuroimaging-initiative-database
#13
Lisa Doan, Daniel Choi, Richard Kline
BACKGROUND AND AIMS: Pain is common in older adults but may be undertreated in part due to concerns about medication toxicity. Analgesics may affect cognition. In this retrospective cohort study, we used the Alzheimer's Disease Neuroimaging Initiative (ADNI) database to examine the interaction of cognitive status and medications, especially non-steroidal anti-inflammatory drugs (NSAIDs). We hypothesized NSAID use would be associated with cognition and that this could be mediated through changes in brain structure...
November 2, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29077871/from-mechanism-to-cure-renewing-the-goal-to-eliminate-the-disease-of-pain
#14
Theodore J Price, Michael S Gold
Objective: Persistent pain causes untold misery worldwide and is a leading cause of disability. Despite its astonishing prevalence, pain is undertreated, at least in part because existing therapeutics are ineffective or cause intolerable side effects. In this review, we cover new findings about the neurobiology of pain and argue that all but the most transient forms of pain needed to avoid tissue damage should be approached as a disease where a cure can be the goal of all treatment plans, even if attaining this goal is not yet always possible...
October 25, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29030932/a-prospective-audit-of-pain-profiles-following-general-and-urological-surgery-in-children
#15
Caroline A Wilson, David Sommerfield, Thomas F E Drake-Brockman, Claudia Lagrange, Anoop Ramgolam, Britta S von Ungern-Sternberg
BACKGROUND: Postoperative pain is frequently undertreated in children both in hospital and at home following discharge. Pain has both short- and long-term consequences for children, their families, and the healthcare system. A greater understanding of procedure-specific postoperative pain trajectories is required to improve pain management. AIM: To determine the duration and severity of acute postoperative pain experienced by children undergoing 8 different general and urological procedures (primary outcomes)...
November 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29019634/pain-assessment-in-newborns-infants-and-children
#16
Alexandra Beltramini, Kolia Milojevic, Dominique Pateron
Pain in children is underestimated and undertreated because of lack of pain assessment tools. Pain assessment depends on the cognitive development of the child being tested, clinical context, and pain typology. For children older than age 6 years, pain assessment is based on a self-report. For children younger than age 6 years, behavioral pain scales are needed to assess pain. Numerous pain scales exist. Many are reliable and some are recommended, but all have specific conditions for their use. In this article, we review the available pain scales for children from birth to adolescence...
October 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28980440/self-report-pain-assessment-tools-for-cognitively-intact-older-adults-integrative-review
#17
Youjeong Kang, George Demiris
BACKGROUND: Pain is common in older adults, but it is often underreported or undertreated partly because many consider pain to be a normal consequence of ageing. Among the plethora of available self-report pain assessment tools, there is no synthetised evidence which tools are indicated for use among cognitively intact older adults. PURPOSE OF THE STUDY: To understand documented self-report pain assessment tools that have been used among cognitively intact older adults, and to describe their characteristics including overall performance as well as studies demonstrating their use...
October 5, 2017: International Journal of Older People Nursing
https://www.readbyqxmd.com/read/28975575/oncologist-s-knowledge-and-implementation-of-guidelines-for-breakthrough-cancer-pain-in-spain-conoce-study
#18
R López López, C Camps Herrero, P Khosravi-Shahi, V Guillem Porta, A Carrato Mena, J Garcia-Foncillas, J J Cruz Hernández, P Gascón Vilaplana, A Antón Torres, E Diaz-Rubio, M Feyjoo Saus, E Aranda Aguilar
PURPOSE: Breakthrough cancer pain (BTcP) has been shown to be a prevalent and poor prognostic factor for oncologic patients, which remain under diagnosed and undertreated. In 2012, the Spanish Society of Medical Oncology (SEOM) published a clinical practice guideline (CPG) for the treatment of cancer pain which specifically addressed the management of BTcP. METHODS: Fundación ECO designed a qualitative study using an Internet-based survey to investigate the attitudes toward, compliance with, and use of SEOM Guideline...
October 3, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28918691/measuring-musculoskeletal-pain-in-infants-children-and-adolescents
#19
Zoe A Michaleff, Steven J Kamper, Jennifer N Stinson, Lise Hestbaek, Christopher M Williams, Paul Campbell, Kate M Dunn
Synopsis Accurate, reliable, and timely assessment of pain is critical for effective management of musculoskeletal pain conditions. The assessment of pain in infants, children, and adolescents with and without cognitive impairment can be particularly challenging to clinicians for a number of reasons, including factors related to the consultation (eg, heterogeneous patient population, time constraints), the clinician (eg, awareness/knowledge of available pain scales), standardized assessment scales (eg, availability, psychometric properties, and application of each scale), the patient (eg, developmental stage, ability to communicate), and the context in which the interaction took place (eg, familiarity with the setting and physiological and psychological state)...
October 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28831272/pain-reporting-and-analgesia-management-in-270-children-with-a-progressive-neurologic-metabolic-or-chromosomally-based-condition-with-impairment-of-the-central-nervous-system-cross-sectional-baseline-results-from-an-observational-longitudinal-study
#20
Stefan J Friedrichsdorf, Andrea C Postier, Gail S Andrews, Karen Es Hamre, Rose Steele, Harold Siden
Little is known about the prevalence, characterization and treatment of pain in children with progressive neurologic, metabolic or chromosomal conditions with impairment of the central nervous system. The primary aims of this study were to explore the differences between parental and clinical pain reporting in children with life-limiting conditions at the time of enrollment into an observational, longitudinal study and to determine if differences in pain experiences were associated with patient- or treatment-related factors...
2017: Journal of Pain Research
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