Der Schmerz
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Interdisciplinary multimodal pain treatment (IMPT) is an essential element in the treatment of people with chronic pain. Although IMST is defined in terms of content, it is evident that its practical design is very heterogeneous. This refers not only to the composition of the contents of the treatment but also to the concrete distribution of tasks among the professions involved. This article deals with the attribution of the effect of the activities of the three professional groups involved in IMPT: medicine, psychology and physiotherapy. The aim of this work is to examine how the professions of medicine, psychology and physiotherapy assess the effectiveness of their work and the effectiveness of the other two disciplines in the care of chronic pain patients. ⋯ Professionals in medicine, psychology and physiotherapy have clear expectations of their own and the other professions mentioned here with respect to their effectiveness in certain areas of change. Overall, the three professions agree in their assessment of the contribution of medicine, psychology and physiotherapy to the areas of pain reduction, gain in strength and movement and functional pain coping.
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Opioid rotation can be indicated due to drug side effects, drug interactions or inadequate effect of treatment with opioids. For the determination of the oral morphine equivalence, a practice tool has been published with the long-term use of opioids in chronic nontumor-related pain (LONTS) guidelines. In contrast, several apps are available that have not yet been evaluated. ⋯ Although the apps and web applications simplify conversion between opioids, there is high variance in conversion factors and sometimes a relevant deviation from evidence-based tables. Overall, there is a high risk of false opioid dosing.