Articles: pain-clinics.
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Meta Analysis
Adverse Outcomes Associated with Prescription Opioids for Acute Low Back Pain: A Systematic Review and Meta-Analysis.
Acute low back pain (ALBP) is a common clinical complaint that can last anywhere from 24 hours to 12 weeks. In recent years, there has been an opioid epidemic which is linked to the increased availability of prescription opioids. Though guidelines recommend that in the treatment of ALBP, opioids should be used when other treatments fail, we have seen an increase in opioid prescriptions for ALBP. With this crisis, it is important to examine if there are any adverse outcomes associated with prescribing opioids for ALBP. ⋯ Acute low back pain, opioids, prescriptions, low back pain, long-term use, opioid use disorder.
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Controversy is not uncommon in the diagnosis of discogenic low back pain (DLBP) and in the identification of the location of the pain source for the symptomatic disc in patients with DLBP. Various techniques, from minimally invasive procedures to fusion surgery, are used to treat chronic DLBP, but the clinical outcomes are variable. Percutaneous endoscopic discectomy by transforaminal or interlaminar approach is considered to be an effective method to treat DLBP, but the evidence is limited; the lack of clear evidence may be associated with patient selection and surgical technique. ⋯ Transforaminal, interlaminar, outside-in technique, endoscopic discectomy, discogenic low back pain.
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J Pain Palliat Care Pharmacother · Mar 2019
Referral Pattern to a Tertiary Care Cancer Pain Clinic in India.
The study aimed to identify patterns of patient referral from oncology services, including pain severity, prior analgesics, impact of patient's literacy on referral, and adequacy of pain relief offered by the pain clinic. A retrospective analysis of pain clinic data from August 2014 to February 2015 at the Tata Memorial Hospital was carried out, wherein adult cancer patients referred for the first time to the pain clinic were included. Two thousand patients were included: 38.1% of the referred were at pretreatment stage, 28.8% advanced. ⋯ Pain scores were lower in the literate group, and this group were referred significantly earlier than the illiterate. Literacy could therefore hold the key to better awareness and compliance with pain management. Our findings demonstrate that pain as yet does not receive a much needed priority even at a tertiary care cancer centre.
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To describe a model of clinical pharmacy services as part of a multidisciplinary specialty pain clinic by discussing (1) the role of a clinical pharmacist in a specialty setting, including clinical interventions implemented, and (2) how integration of a clinical pharmacist may translate into an improved patient care model for the management of chronic pain. ⋯ A clinical pharmacist can identify many MRPs and implement interventions in chronic pain management. Integration of clinical pharmacy services may improve practice management by facilitating the completion of MCCAs and increase access to patients' needs outside the clinic.