Articles: chronic.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2021
[Pain Management in Non-surgical Inpatients - Treatment Approaches and Competence for Pain Services].
The number of non-surgical patients in the hospital setting with pain due to medical conditions or comorbidities and/or invasive procedures or treatments is high. Compared to perioperative pain management, the portion of patients and/or conditions that require more than an approach focused on pharmacological treatment of nociceptive pain is considerably higher. Rather, treatment often requires the differentiated use of co-analgesics, non-pharmacological treatments, physiotherapy, occupational therapy, psychological assessment and interventsions and educational approaches, ideally in the form of closely coordinated interdisciplinary treatment. The assessment and treatment of acute and especially chronic pain should follow the biopsychosocial concept of pain, especially if risk factors for chronification have been identified, if patients receive high-dose therapy with analgesics or have preexisting a chronic pain disorder.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Sep 2021
[Pain Management in Hospitals - Current Practice, Quality and Organisation in Non-surgical Medical Care].
For many years now, effective pharmacological and non-pharmacological treatment approaches for acute and chronic pain exist, as well as organisational strategies for their implementation in hospitals. Nevertheless, there remain considerable deficits in pain management and the portion of patients with severe or long-lasting pain in non-surgical units is often high. ⋯ This should not be seen as a signal that pain management is less important in non-surgical disciplines. On the contrary - it should raise awareness for more clinical and health services research to further develop and validate appropriate approaches and concepts to improve pain treatment in this field.
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Based on a review of the most current medical literature, this article outlines the basic concepts and classifications of rhinosinusitis, and delineates best practices for clinical diagnoses and the most up-to-date management strategies. Learning to recognize and differentiate these conditions helps facilitate appropriate and timely diagnoses as well as helping practitioners provide their patients with better counseling and care.
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Reducing hospital admissions in patients with multiple complex chronic conditions is both a quality indicator and cost-effective to health care systems. This study assesses and compares utilization rates and cost of encounters between patients referred and seen in an outpatient critical care transition clinic (Healthy Transitions Clinic [HTC]) and those referred and not seen. ⋯ In patients with complex chronic medical conditions with recent hospital admissions, the HTC model appears to reduce both admissions and encounter costs. Further community/regional studies are needed to better define this observation on a longitudinal basis.
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Patients with chronic respiratory failure resulting from chronic obstructive pulmonary disease (COPD-CRF) have limited treatment options and poor health outcomes. We examined the effect of noninvasive ventilation at home (NIVH) treatment on all-cause mortality, hospitalizations, and emergency department (ED) visits. ⋯ Patients with COPD-CRF who received NIVH had statistically significant reductions in hospitalizations and ED visits compared with patients not treated with NIVH. Further research is needed to examine the effect of NIVH on mortality.