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Practice guidelines for chronic pain treatment

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https://www.readbyqxmd.com/read/28727701/randomized-placebo-controlled-placebo-trial-to-determine-the-placebo-effect-size
#1
Ludger Gerdesmeyer, Tim Klueter, Volker W Rahlfs, Munjed Al Muderis, Amol Saxena, Hans Gollwitzer, Norbert Harrasser, Martin Stukenberg, Alexander Prehn-Kristensen
BACKGROUND: It is the gold standard to use a placebo treatment as the control group in prospective randomized controlled trials (RCTs). Although placebo-controlled trials can reveal an effect of an active treatment, the pure effect of a placebo treatment alone has never been presented or evaluated. No evidence-based, placebo-therapeutic options are currently available, and no placebo-controlled trials have been performed to elucidate the pure placebo effect. OBJECTIVES: To analyze the pure placebo effect on clinical, chronic pain through a blinded RCT...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28725615/chronic-scrotal-pain-and-microsurgical-spermatic-cord-denervation-tricks-of-the-trade
#2
REVIEW
Alex Tatem, Jason R Kovac
Every practicing urologist encounters patients complaining of chronic scrotal content pain (CSCP). This condition can be equally frustrating for both patients and clinicians as there are no clear treatment guidelines, or pathways, for urologists to follow. As a result, most patients typically seek out multiple providers without improvements in their symptoms. Fortunately, microsurgical spermatic cord denervation (MSCD) is becoming an accepted, reliable and reproducible technique for definitively addressing CSCP in select patients...
May 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28671393/top-20-research-studies-of-2016-for-primary-care-physicians
#3
REVIEW
Mark H Ebell, Roland Grad
This article summarizes the top 20 original research studies and four practice guidelines of 2016, based on regular literature surveillance and as selected by members of the Canadian Medical Association. The studies, known as POEMs (patient-oriented evidence that matters), were rated highly because of their relevance, validity, and potential to change practice. Key hypertension treatment findings include reduced mortality (a benefit not demonstrated in lower-risk persons or persons with diabetes mellitus) but also an increase in harms with a more aggressive blood pressure target in high-risk persons with hypertension and without diabetes...
May 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28670442/managing-patients-with-acute-and-chronic-non-specific-neck-pain-are-danish-chiropractors-compliant-with-guidelines
#4
Simon Sidenius Brockhusen, André Bussières, Simon David French, Henrik Wulff Christensen, Tue Secher Jensen
BACKGROUND: Non-specific neck pain represents a quarter of all chiropractic patient visits in Denmark. Evidence informed practice can help ensure providers use best available treatment, speed up patient recovery rate and reduce healthcare utilization. It is generally believed that Danish chiropractors treat according to best practice, but we do not know if this is true for management of neck-pain. The objective of this study was to investigate how Danish chiropractors treat patients with acute and chronic non-specific neck pain and determine if management is compliant with recent Canadian guideline recommendations...
2017: Chiropractic & Manual Therapies
https://www.readbyqxmd.com/read/28666143/prevalence-of-prescription-opioid-use-disorder-among-chronic-opioid-therapy-patients-after-health-plan-opioid-dose-and-risk-reduction-initiatives
#5
Michael Von Korff, Rod L Walker, Kathleen Saunders, Susan M Shortreed, Manu Thakral, Michael Parchman, Ryan N Hansen, Evette Ludman, Karen J Sherman, Sascha Dublin
BACKGROUND: No studies have assessed the comparative effectiveness of guideline-recommended interventions to reduce risk of prescription opioid use disorder among chronic opioid therapy (COT) patients. We compared the prevalence of prescription opioid use disorder among COT patients from intervention clinics that had implemented opioid dose and risk reduction initiatives for more than 4 years relative to control clinics that had not. METHODS: After a healthcare system in Washington State implemented interventions to reduce opioid dose and risks, we surveyed 1588 adult primary care COT patients to compare the prevalence of prescription opioid use disorder among COT patients from the intervention and control clinics...
June 27, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28530481/hormone-replacement-therapy-in-pre-menopausal-women-undergoing-bilateral-salpingo-oophorectomy-for-benign-disease-a-review-of-practice
#6
Alison Richardson, Emily West, Mike Cust
Introduction The National Institute for Health and Care Excellence (NICE) guideline on the diagnosis and management of the menopause states that women who are likely to go through the menopause as a result of surgical treatment should be offered information about the menopause and the importance of starting hormonal replacement therapy before they have their treatment. Objectives To determine compliance with NICE guidelines at the Royal Derby Hospital. Study design We undertook a retrospective review of all pre-menopausal women undergoing bilateral salpingo-oophorectomy for benign pathology between 1 January 2016 and 30 June 2016...
January 1, 2017: Post Reproductive Health
https://www.readbyqxmd.com/read/28514128/-treatment-for-osteoarthritis-of-the-knee
#7
REVIEW
Uriel Giwnewer, Guy Rubin, Hagay Orbach, Nimrod Rozen
Osteoarthritis is the most common joint disorder in the world and its incidence is rising. In Western populations it is one of the most frequent causes of pain, loss of function and disability in adults. The estimated lifetime risk for knee osteoarthritis is approximately 40% in men and 47% in women. The diagnosis of osteoarthritis is complex due to a lack of specific physical and/or laboratorial findings. The American College of Rheumatology (ACR) has recommended using the following criteria for the diagnosis of knee osteoarthritis: chronic knee pain (lasting for more than 6 weeks) and at least three of the following: • Age over 50 years old...
July 2016: Harefuah
https://www.readbyqxmd.com/read/28502036/perceptions-of-painful-diabetic-peripheral-neuropathy-in-south-east-asia-results-from-patient-and-physician-surveys
#8
Rayaz A Malik, Emre Aldinc, Siew-Pheng Chan, Chaicharn Deerochanawong, Chii-Min Hwu, Raymond L Rosales, Chun-Yip Yeung, Koichi Fujii, Bruce Parsons
There are no data on physician-patient communication in painful diabetic peripheral neuropathy (pDPN) in the Asia-Pacific region. The objective of this study was to examine patient and physician perceptions of pDPN and clinical practice behaviors in five countries in South-East Asia. Primary care physicians and practitioners, endocrinologists, diabetologists, and patients with pDPN completed separate surveys on pDPN diagnosis, impact, management, and physician-patient interactions in Hong Kong, Malaysia, the Philippines, Taiwan, and Thailand...
June 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28473098/acr-appropriateness-criteria-%C3%A2-chronic-hip-pain
#9
Douglas N Mintz, Catherine C Roberts, Jenny T Bencardino, Steven J Baccei, Michelle S Caird, R Carter Cassidy, Eric Y Chang, Michael G Fox, Soterios Gyftopoulos, Mark J Kransdorf, Darlene F Metter, William B Morrison, Zehava S Rosenberg, Nehal A Shah, Kirstin M Small, Naveen Subhas, Siddharth Tambar, Jeffrey D Towers, Joseph S Yu, Barbara N Weissman
Chronic hip pain is a common clinical problem whose cause is often elucidated by imaging. The ACR Appropriateness Criteria for chronic hip pain define best practices of image ordering. Clinical scenarios are followed by the imaging choices and their appropriateness. The information is in ordered tables with an accompanying narrative explanation to guide physicians to order the right test. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28427472/optimising-conservative-management-of-chronic-low-back-pain-study-protocol-for-a-randomised-controlled-trial
#10
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/28372534/panel-7-otitis-media-treatment-and-complications
#11
REVIEW
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-toward-patients-and-the-effects-on-patient-care
#12
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 toward 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 toward 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/28315549/substance-abuse-and-addiction-implications-for-pain-management-in-patients-with-cancer%C3%A2
#13
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/28301454/characteristics-of-initial-prescription-episodes-and-likelihood-of-long-term-opioid-use-united-states-2006-2015
#14
Anuj Shah, Corey J Hayes, Bradley C Martin
Because long-term opioid use often begins with treatment of acute pain (1), in March 2016, the CDC Guideline for Prescribing Opioids for Chronic Pain included recommendations for the duration of opioid therapy for acute pain and the type of opioid to select when therapy is initiated (2). However, data quantifying the transition from acute to chronic opioid use are lacking. Patient records from the IMS Lifelink+ database were analyzed to characterize the first episode of opioid use among commercially insured, opioid-naïve, cancer-free adults and quantify the increase in probability of long-term use of opioids with each additional day supplied, day of therapy, or incremental increase in cumulative dose...
March 17, 2017: MMWR. Morbidity and Mortality Weekly Report
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
#15
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/28239510/lidocaine-infusion-a-promising-therapeutic-approach-for-chronic-pain
#16
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
#17
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
https://www.readbyqxmd.com/read/28226333/prescription-opioid-abuse-in-chronic-pain-an-updated-review-of-opioid-abuse-predictors-and-strategies-to-curb-opioid-abuse-part-1
#18
REVIEW
Alan D Kaye, Mark R Jones, Adam M Kaye, Juan G Ripoll, Vincent Galan, Burton D Beakley, Frank Calixto, Jamie L Bolden, Richard D Urman, Laxmaiah Manchikanti
Chronic pain and prescription opioid abuse are extremely prevalent both in this country and worldwide. Consequences of opioid misuse can be life-threatening with significant morbidity and mortality, exacting a heavy toll on patients, physicians, and society. Individuals with chronic pain and co-occurring substance use disorders and/or mental health disorders, are at a higher risk for misuse of prescribed opioids. Opioid abuse and misuse occurs for a variety of reasons, including self-medication, use for reward, compulsive use because of addiction, and diversion for profit...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28226332/responsible-safe-and-effective-prescription-of-opioids-for-chronic-non-cancer-pain-american-society-of-interventional-pain-physicians-asipp-guidelines
#19
Laxmaiah Manchikanti, Adam M Kaye, Nebojsa Nick Knezevic, Heath McAnally, Konstantin Slavin, Andrea M Trescot, Susan Blank, Vidyasagar Pampati, Salahadin Abdi, Jay S Grider, Alan D Kaye, Kavita N Manchikanti, Harold Cordner, Christopher G Gharibo, Michael E Harned, Sheri L Albers, Sairam Atluri, Steve M Aydin, Sanjay Bakshi, Robert L Barkin, Ramsin M Benyamin, Mark V Boswell, Ricardo M Buenaventura, Aaron K Calodney, David L Cedeno, Sukdeb Datta, Timothy R Deer, Bert Fellows, Vincent Galan, Vahid Grami, Hans Hansen, Standiford Helm Ii, Rafael Justiz, Dhanalakshmi Koyyalagunta, Yogesh Malla, Annu Navani, Kent H Nouri, Ramarao Pasupuleti, Nalini Sehgal, Sanford M Silverman, Thomas T Simopoulos, Vijay Singh, Daneshvari R Solanki, Peter S Staats, Ricardo Vallejo, Bradley W Wargo, Arthur Watanabe, Joshua A Hirsch
BACKGROUND: Opioid use, abuse, and adverse consequences, including death, have escalated at an alarming rate since the 1990s. In an attempt to control opioid abuse, numerous regulations and guidelines for responsible opioid prescribing have been developed by various organizations. However, the US opioid epidemic is continuing and drug dose deaths tripled during 1999 to 2015. Recent data show a continuing increase in deaths due to natural and semisynthetic opioids, a decline in methadone deaths, and an explosive increase in the rates of deaths involving other opioids, specifically heroin and illicit synthetic fentanyl...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28221284/pain-interference-and-physical-function-demonstrate-poor-longitudinal-association-in-people-living-with-pain-a-promis-investigation
#20
Nicholas V Karayannis, John A Sturgeon, Ming Chih-Kao, Corinne Cooley, Sean C Mackey
A primary goal in managing pain is to reduce pain and increase physical function (PF). This goal is also tied to continuing payment for treatment services in many practice guidelines. Pain interference (PI) is often used as a proxy for measurement and reporting of PF in these guidelines. A common assumption is that reductions in PI will translate into improvement in PF over time. This assumption needs to be tested in a clinical environment. Consequently, we used the patient-reported outcomes measurement information system (PROMIS) to describe the topology of the longitudinal relationship between PI in relation to PF...
June 2017: Pain
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