Articles: pain-management.
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J Pain Palliat Care Pharmacother · Sep 2024
ReviewEvidence of Commonly Used Integrative Approaches with Pharmacotherapy for Chronic Pain Management.
This review examines the integration of traditional pharmacological methods with alternative and complementary therapies in chronic pain management. It delves into neurostimulation techniques, highlighting their clinical outcomes and biological bases. Acupuncture's role in modulating pain pathways is explored, illustrating its balance of tradition and clinical application. ⋯ Additionally, it discusses the psychological and rehabilitative dimensions of pain through psychosocial therapy and counseling. The conclusion underscores the importance of a multidisciplinary approach, integrating diverse therapies into conventional pain management to effectively treat chronic pain. This synthesis highlights the synergistic potential of combining traditional and innovative therapeutic modalities, offering a comprehensive guide for healthcare professionals in enhancing pain management practices.
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Context: Patients with cancer-related pain and concurrent substance use disorder (SUD) present a unique set of challenges for palliative care clinicians. A structured forum for interdisciplinary collaboration is needed to effectively manage this complex population. Objectives: Describe the feasibility and acceptability of a palliative care Complex Pain Board (CPB), an interdisciplinary team meeting to provide concrete care recommendations for patients with cancer-related pain and concurrent SUD and/or psychosocial complexity. ⋯ Among 40 CBP participant surveys, most attendees (n = 38, 95%) were likely or highly likely to continue to attend. Conclusion: CPB is a feasible and acceptable intervention that allows for palliative care clinicians to collaborate and receive interdisciplinary team feedback and peer support on the management of patients with cancer-related pain and concurrent SUD and/or psychosocial complexity in the ambulatory care setting. Key Message: A regular, interdisciplinary team meeting (CPB) is a feasible and acceptable intervention to help palliative care clinicians manage challenging cases involving patients with cancer and concurrent SUD and/or psychosocial complexity.
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Increasing enrollment in Medicare has coincided with reductions in reimbursement for various procedures, including interventional pain procedures. No previous analysis of state-to-state differences in Medicare reimbursement rates for practicing pain management physicians has been performed. ⋯ Medicare reimbursement rates for interventional pain procedures have decreased from 2014 to 2023, both nationally and in each region of the U.S. Our analysis suggests that certain states and territories have experienced less favorable reimbursement trends than others. This issue is worthy of attention as larger proportions of the U.S. population become eligible for Medicare coverage; should these trends continue, interventional pain physicians may consider moving their practices to areas that are less affected. Major efforts are required to preserve the quality of care that Medicare beneficiaries receive and to remedy the problem of depreciating reimbursement.
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Observational Study
Predictors of opioid use for rib fractures in a regional Australian hospital.
Rib fractures (RFs) are the leading type of single serious injury in New South Wales trauma patients. Uncontrolled pain drives the sequelae of atelectasis, pneumonia, respiratory failure, and death in severe cases. Opioids are the mainstay of management; however, they carry numerous adverse effects. Understanding patient or injury factors which predict opioid requirement is important to tailor management. Existing evidence is limited to metropolitan trauma centres (MTCs). ⋯ The model is effective at identifying predictors of opioid use in this regional centre, which are similar to those described in evidence from MTCs. However, the low R2 with wide prediction intervals limits its utility on an individual level.