The Journal of the American Osteopathic Association
-
J Am Osteopath Assoc · Jun 2005
ReviewMedical education in substance abuse: from student to practicing osteopathic physician.
Substance use disorders (SUDs) have had a major impact on the health of the US population during the past decade. Osteopathic physicians have an important role among those who can make a positive impact on this problem. ⋯ This request culminated in the Office of National Drug Control Policy's establishing the Leadership Conference on Medical Education in Substance Abuse in December 2004. The osteopathic medical profession is represented in this critical review and formulation of recommendations for improving education on substance use disorders for the undergraduate, graduate, and practicing physician.
-
J Am Osteopath Assoc · Jun 2005
Randomized Controlled Trial Clinical TrialPreoperative intravenous morphine sulfate with postoperative osteopathic manipulative treatment reduces patient analgesic use after total abdominal hysterectomy.
Administration of opioids for treatment of pain after total abdominal hysterectomy (TAH) is a common postoperative procedure, providing an excellent parameter for evaluating the efficacy of postsurgical osteopathic manipulative treatment (OMT). ⋯ Administration of postoperative OMT enhanced pre- and postoperative morphine analgesia in the immediate 48-hour period following elective TAH, demonstrating that OMT can be a therapeutic adjunct in pain management following this procedure.
-
J Am Osteopath Assoc · Mar 2005
AOA's position against use of placebos for pain management in end-of-life care.
A number of organizations have advised against the use of placebo substitution, including the American Pain Society, Agency for Healthcare Policy and Research, World Health Organization, Healthcare Facilities Accreditation Program, Joint Commission on Accreditation of Healthcare Organizations, Education for Physicians on End-of-Life Care Project (cosponsored by the American Medical Association and The Robert Wood Johnson Foundation), American Nursing Association, and the American Society of Pain Management Nurses. This white paper describes the literature and rationale in support of the American Osteopathic Association's (AOA's) position on the controversial subject of the use of placebos for pain management in terminally ill patients.
-
Methadone hydrochloride is an effective, inexpensive, and relatively safe opioid to use in the treatment of patients with chronic pain. It is especially effective in management of pain during the final stages of life, as it is the only long-acting analgesic available in liquid form. ⋯ Also, they should closely monitor patients during the titration phase and educate them with regard to basic pharmacologic properties and potential side effects. A plan to start at low doses and proceed slowly is applicable to methadone.
-
J Am Osteopath Assoc · Mar 2005
Partnering with hospice to improve pain management in the nursing home setting.
People are living longer but are dying with more disabilities, often in nursing homes. Identification of those who are dying needs to be quicker to allow discussion of goals of care and to meet their individual needs at a higher level. ⋯ Physicians play a critical role in improving communication between the family and the healthcare team during the transition from rehabilitative to palliative care. Hospice can be a valuable partner in the delivery of excellent pain and symptom management in end-of-life care.