Pain practice : the official journal of World Institute of Pain
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Healthcare resource utilization (HCRU) and associated costs specific to pain are a growing concern, as increasing dollar amounts are spent on pain-related conditions. Understanding which pain conditions drive the highest utilization and cost burden to the healthcare system would enable providers and payers to better target conditions to manage pain adequately and efficiently. The current study focused on 36 noncancer chronic and 14 noncancer acute pain conditions and measured the HCRU and costs per member over 365 days. ⋯ The conditions ranked highest for both per-member and total healthcare costs were hip fractures, childbirth, and non-hip, non-spine fractures. Among these, hip fractures in the Medicare member population had the highest mean cost per member (adjusted per-member cost was $21,058). Further examination specific to how pain is managed in these high-cost conditions will enable providers and payers to develop strategies to improve patient outcomes through appropriate pain management.
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This study was designed to evaluate incidence and characteristics of acute referred orofacial pain caused by a posterior single tooth pulpitis in an Iranian population. ⋯ The results of the present study show the prevalence of referred pain in the head, face, and neck region is moderately high. Therefore, in patients with orofacial pain, it is essential to carefully examination before carrying out treatment that could be inappropriate.
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Randomized Controlled Trial
A Randomized Controlled Study to Compare the 2% Lignocaine and Aqueous Lubricating Gels for Female Urethral Catheterization.
The 2% lignocaine gel has long been used for male urethral catheterization, but aqueous gel as lubricant has been used for females. However, studies report that females experience pain during urethral catheterization. We compared the effectiveness of 2% lignocaine gel (intervention) and aqueous gel (control) for female urethral catheterization in reducing procedural pain. ⋯ The 2% lignocaine gel significantly reduces the procedural pain of female urethral catheterization as compared with aqueous gel. This study provides evidence for the hospital to change the current practice in the hope of reducing procedural pain for female patients during urethral catheterization.
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Randomized Controlled Trial
Transcutaneous Pulsed Radiofrequency Treatment for Patients with Shoulder Pain Booked for Surgery: A Double-Blind, Randomized Controlled Trial.
Shoulder pain is the third most common musculoskeletal problem and accounts for 5% of general practitioner consultations. Although many treatments are described, there is no consensus on optimal treatment and up to 40% of patients still have pain 12 months after initially seeking help for pain. Previously, the effect of transcutaneous pulsed radiofrequency treatment (TCPRFT) was evaluated in a retrospective audit that showed good pain relief for a mean 395 days and justified this randomized sham controlled trial. ⋯ Pain at both rest and shoulder elevation were not improved by active treatment. No complications were seen. This study of a simple, low risk, outpatient treatment confirms the findings of our earlier study of TCPRFT for knee pain and shoulder pain audit that transcutaneous pulsed radiofrequency treatment may help some people with painful shoulders.
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The management of pain patients with analgesics is challenging, with one of the risks being overdose with prescribed medications and death. In this study, we examined relationships between pain and pain catastrophizing, and past history of intentional overdoses and suicide attempts. ⋯ Although we cannot discern causal relationships, findings indicate that patients with pain complaints and pain catastrophizing have a greater likelihood of having past histories of intentional overdoses and suicide attempts. We discuss the potential implications of these findings.