Articles: pain-clinics.
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On March 15th 2010, Italy adopted the Law no. 38 "Disposizioni per garantire l'accesso alle cure palliative e alla terapia del dolore" (Provisions aimed at ensuring access to palliative care and pain therapy). The aim of pain therapy is to enable patients with chronic diseases to achieve pain control. Palliative care, as defined by the World Health Organization, aims at "improving the quality of life of patients and families, who face the problems associated with incurable diseases, through prevention and relief from suffering, achieved through an early identification and treatment of pain by pharmacological medication and other physical, psychosocial and spiritual techniques". ⋯ Regarding the headaches, it should be noted that the law 38 cited above includes all forms of pain, and headaches should be integrated into the care networks. In this context, several multi-disciplinary professionals within the centers (hub and spoke) or territory (GPs, specialists from neurologists and other professionals involved) should be integrated to offer the best response to the needs of the citizen. The diagnosis and treatment of various forms of headache have to be integrated into the path of pain, both National and Regional, in line with the rest of the organization.
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Best Pract Res Clin Rheumatol · Apr 2011
ReviewMultidisciplinary approach to fibromyalgia: what is the teaching?
Fibromyalgia (FM) is a rheumatic disease that is characterised by chronic musculoskeletal pain, stiffness, fatigue, sleep and mood disorder. FM patients demonstrate dysregulation of pain neurotransmitter function and experience a neurohormone-mediated association with sleep irregularities. ⋯ It has been shown that interdisciplinary treatment programmes lead to greater improvements in subjective pain and function than monotherapies. Physical exercise and multimodal cognitive behavioural therapy are the most widely accepted and beneficial forms of non-pharmacological therapy.
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J. Pediatr. Hematol. Oncol. · Apr 2011
Optimizing pain care delivery in outpatient facilities: experience in NCI, Cairo, Egypt.
As a result of increasing waiting lists of patients attending National Cancer Institute of Cairo, we are faced to provide high-quality pain care service through our outpatient pain clinic. The program description presented here shows the capacity of a 24 hours/7 days outpatient cancer pain management service to provide rapidly accessible, high-quality care to patients with complex pain and palliative care symptom burdens. In addition, this model avoids inpatient hospital admissions. ⋯ Importantly, the facility provides comprehensive care with professionals available 24 hours/7 days. On-call teams assigned to manage pain and other treatment modalities comprises of staff supervised by the primary cancer clinicians; this arrangement facilitates reaching this goal. This study will illustrate our experience through 25 years, trying to provide the highest care of patients with cancer pain on an outpatient basis.
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J. Pediatr. Hematol. Oncol. · Apr 2011
Opioids for cancer pain in the Middle Eastern countries: a physician point of view.
Cancer is an increasing problem in the Middle Eastern (ME) countries. It is the fourth leading cause of death in this region. At present, resources for cancer control in the ME countries as a whole are not only inadequate but directed almost exclusively to treatment. ⋯ An estimated 60% (27 million) of these people in developing countries would benefit from palliative care, and this number is growing as chronic diseases such as cancer rise rapidly. From the situation analysis of palliative care in the ME countries, suggesting that pain relief is insufficient, improvements in palliative care delivery are a high priority. We reviewed the situation of pain management and pain control in Lebanon and the ME countries, the barriers that are present, and we propose the priorities and a reform for an integrated approach to address the problem of under-treated pain at all levels:
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Referring patients with chronic noncancer pain to pain clinics: survey of Ontario family physicians.
To examine the factors associated with FPs' referrals of patients with chronic noncancer pain to a tertiary care pain clinic. ⋯ Although the results of our survey of FPs identify certain barriers to and reasons for referring patients to pain clinics, the results cannot be generalized owing to the small sample of FPs in our study. Larger studies of randomly selected FPs, who might or might not refer patients to pain clinics, are needed to provide a better understanding of chronic noncancer pain management needs at the primary care level.