Pain medicine : the official journal of the American Academy of Pain Medicine
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Comparative Study
Impact of Cigarette Smoking Status on Pain Intensity Among Veterans With and Without Hepatitis C.
Chronic pain is a significant problem in patients living with hepatitis C virus (HCV). Tobacco smoking is an independent risk factor for high pain intensity among veterans. This study aims to examine the independent associations with smoking and HCV on pain intensity, as well as the interaction of smoking and HCV on the association with pain intensity. ⋯ We found that current smoking is more strongly linked to pain intensity among veterans with HCV. Further investigations are needed to explore the impact of smoking status on pain and to promote smoking cessation and pain management in veterans with HCV.
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The Accreditation Council for Graduate Medical Education (ACGME) has recently implemented milestones and competencies as a framework for training fellows in Pain Medicine, but individual programs are left to create educational platforms and assessment tools that meet ACGME standards. ⋯ The many complexities in offering a sophisticated simulated pain curriculum that is valid, reliable, feasible, and acceptable to learners and teachers may only be overcome with coordinated and collaborative efforts among pain medicine training programs and governing institutions.
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To evaluate the impact of the Integrated Pain Team (IPT)-an interdisciplinary chronic pain care intervention embedded in primary care at a large Veterans Affairs health care system. Outcomes evaluated included IPT's impact on the perceived effectiveness of chronic pain care; provider self-confidence; and primary care team satisfaction, stress, and burnout. ⋯ Integrating an interdisciplinary chronic pain care intervention into primary care can provide needed support to care teams and may improve chronic pain care. Elements of the IPT model identified as important to its effectiveness include its interdisciplinary biopsychosocial approach and attentive patient follow-up. However, enhancing providers' confidence and self-efficacy in chronic pain care may require educational and support resources beyond the current IPT model.
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We aimed to evaluate a novel clinical program designed to address unsafe use of opioids prescribed for pain-the Opioid Reassessment Clinic (ORC)-to inform practice and health system improvement. ⋯ Results suggest the ORC was effective in reducing total prescribed opioid doses and in transitioning patients to partial-agonist therapy, but PCP adoption strategies are needed.
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The pharmacist's role and responsibilities in addressing the opioid epidemic have yet to be clearly defined, particularly from the patient's point of view. This qualitative study explores the pharmacist's role in promoting opioid safety from the perspective of pharmacists and patients. ⋯ Feedback from both pharmacists and patient participants suggests that there is uncertainty in the degree to which pharmacists can and should confront the prescription opioid epidemic directly. Ambiguities in the pharmacist's role may be best clarified through structured training promoting enhanced between-party communication.