Pain medicine : the official journal of the American Academy of Pain Medicine
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Neuropathic pain is a common problem in later life. It remains relatively refractory to treatment and in terms of social consequences may be particularly problematic for older people. ⋯ The study raises important questions concerning the relationship between neuropathic pain, its physical and emotional consequences and social outcomes. The results highlight the importance of viewing neuropathic pain as a social phenomenon in which treatment and management should pay closer attention to the interpersonal and social needs and quality of life outcomes for the spouse or partner and family as well as the patient.
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Multicenter Study Clinical Trial
Impact of breakthrough pain on quality of life in patients with chronic, noncancer pain: patient perceptions and effect of treatment with oral transmucosal fentanyl citrate (OTFC, ACTIQ).
To characterize breakthrough pain (BTP), its qualitative impact on quality of life (QoL), and the effects of BTP treatment on QoL. ⋯ BTP appears to be a clinically important condition in this population and is associated with an adverse impact on QoL. Understanding those QoL domains most affected by BTP and those potentially improved with treatment should help in developing quantitative QoL assessment tools and other outcome measures for BTP management studies.
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Many older people suffer from degenerative and chronic diseases resulting in chronic pain. It is important for health professionals and researchers to gain insights into experiences of chronic pain sufferers, so that they may understand the patient's perspective and instigate appropriate treatments. ⋯ "Keeping going" was a priority for most of the participants. It may be beneficial to identify the ways in which older people persevere despite chronic pain. It is important for health professionals to appreciate the social factors which are important to, and valued by, older people who experience chronic pain.
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Chronic nonmalignant pain is very disabling and carries a heavy financial strain on the individual and society as a whole. This case describes a woman with tuberous sclerosis, in her fourth pregnancy. ⋯ While data are limited, with increasing use of intrathecal opioids for nonmalignant pain, such patients may be seen more regularly in obstetric clinics. With a multidisciplinary team approach, risks can be minimized and outcome for mother and baby optimized.
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Prescription drug diversion involves the unlawful channeling of regulated pharmaceuticals from legal sources to the illicit marketplace, and can occur along all points in the drug delivery process, from the original manufacturing site to the wholesale distributor, the physician's office, the retail pharmacy, or the patient. However, empirical data on diversion are limited. ⋯ While doctor shoppers, physicians and the Internet receive much of the attention regarding diversion, the data reported in this paper suggest that there are numerous active street markets involving patients, Medicaid recipients and pharmacies as well. In addition, there are other data which suggest that the contributions of residential burglaries, pharmacy robberies and thefts, and "sneak thefts" to the diversion problem may be understated.