Articles: pain-clinics.
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Randomized Controlled Trial
Multidisciplinary rehabilitation treatment of patients with chronic low back pain: a prognostic model for its outcome.
(1) To determine if treatment outcome in chronic low back pain can be predicted by a predefined multivariate prognostic model based on consistent predictors from the literature and (2) to explore the value of potentially prognostic factors further. ⋯ The results of this study do not support the construction of a clinical prediction model. Future confirmative studies of homogeneous rehabilitation treatments and outcome measures are needed to shed more light on relevant prognostic factors.
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Multicenter Study
Pain centers professionals' beliefs on non-cancer chronic pain.
The beliefs and attitudes of health professionals affect the care ultimately provided to patients. The objective of this study was to analyze health professionals' beliefs toward chronic no cancer pain in nine (82%) pain centers in the city of S. Paulo. ⋯ The professionals professed a belief in a medical cure for chronic pain, that solicitous displays were desirable behaviors in treating pain, that chronic pain is related to injury and that it is the cause of disability, all of which are erroneous beliefs. Contrary to the expected result, the health professionals with more experience and education did not express more appropriate beliefs. These beliefs may compromise the treatment of patients with chronic pain and should therefore be reviewed.
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Case Reports
MMTP patients with chronic pain switching to pain management clinics. A problem or an acceptable practice?
Among the many patients served by methadone maintenance treatment programs (MMTPs) is a small population with severe, refractory pain that may be effectively managed using long-term opioid therapy. Pain specialists have begun to treat these patients, and in some cases, methadone has been selected as the opioid analgesic administered for pain management. ⋯ We present four patients who illustrate different outcomes associated with one challenging scenario, specifically the expressed desire on the part of the patient to withdraw from the MMTP because the opioid has become available for pain. Research is needed to evaluate the phenomenology of pain and addiction in this population and the outcomes associated with varied therapeutic strategies.
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Anesthesia and analgesia · Mar 2008
A clinical profile of a cohort of patients referred to an anesthesiology-based pediatric chronic pain medicine program.
Pediatric chronic pain is very common and results in significant health care costs. Pediatric chronic pain is both an individual and a public health concern. The primary objective of this study was to generate a descriptive clinical profile of the patients referred to an anesthesiology-based pediatric chronic pain medicine program. This patient profile was intended to serve as a surrogate for a more formal population needs assessment. ⋯ Pediatric chronic pain patients previously under the care of another subspecialist and subsequently referred to an anesthesiology-based pediatric chronic pain medicine program seemed to be experiencing significantly worse health-related quality of life. The routine assessment of chronic pain-related pediatric health-related quality of life seems feasible and worthwhile. Attention also needs to be focused on consistently addressing the strength of a patient's coping mechanisms, the presence of pain-promoting versus pain-reducing parental behaviors, and preexisting parental pain and disability.