Articles: chronic-pain.
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Knowledge about functional ability, including activities of daily living (ADL), in patients with chronic widespread pain (CWP) and fibromyalgia (FMS) is largely based on self-report. The purpose of this study was to assess functional ability by using standardised, observation-based assessment of ADL performance and to examine the relationship between self-reported and observation-based measures of disability. A total of 257 women with CWP, 199 (77%) fulfilling the American College of Rheumatology tender point criteria for FMS, were evaluated with the Assessment of Motor and Process Skills (AMPS), an observation-based assessment providing linear measures of ADL motor and ADL process skill ability (unit: logits). ⋯ Only weak to moderate correlations between self-reported functional ability and observation-based AMPS ability measures were observed. The results of the study support the notion of considerable performance difficulties in women with CWP. The everyday life problems are substantial and place the individual at risk of need of support for community living.
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Postgraduate medicine · Nov 2011
ReviewA critical assessment of opioid treatment adherence using urine drug testing in chronic pain management.
To determine the current status of performing urine drug tests (UDTs) for monitoring chronic pain therapy, with an emphasis on their use in opioid treatment and the need for improved physician education about UDTs. ⋯ Despite the acknowledged utility of UDTs, there is a critical need for physician education on the use of different UDTs for adherence monitoring because early detection of opioid nonadherence is key to optimal chronic pain management.