1
|
Dueñas M, De Sola H, Salazar A, Esquivia A, Rubio S, Failde I. Prevalence and epidemiological characteristics of chronic pain in the Spanish population. Results from the pain barometer. Eur J Pain 2024. [PMID: 39046161 DOI: 10.1002/ejp.4705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 07/09/2024] [Accepted: 07/10/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND Chronic pain (CP) is a public health problem worldwide. AIM To update the prevalence of CP and compare the clinical and social characteristics of people with CP with those with non-chronic continuous pain and a group without pain. METHODS An observational cross-sectional study was carried out in a representative sample of 7058 adults from the Spanish population. Sociodemographic data, the presence of CP and non-chronic continuous pain, characteristics of pain, limitations on activities of daily living (ADL), the presence and level of anxiety and depression (HADS), quality of life (SF-12v2) and social support (DUKE) were collected. Descriptive and bivariate analyses were performed. RESULTS The prevalence of CP was 25.9% (95% CI;24.8-26.9) and that of non-chronic continuous pain was 7.7% (95% CI;7.1-8.3). Women presented a higher prevalence of both CP (30.5% vs. 21.3%) and non-chronic continuous pain (8.8% vs. 6.6%). CP was more common in the group between 55 and 75 years old (30.6%, 95% CI = 28.6-32.6%), non-chronic continuous pain affected most the population between 18 and 34 years old (11.2%, 95% CI = 9.6-12.7%). The median duration of CP was 4 years. The lumbar was the most frequent pain site (58.1%), and 27.1% did not know the cause. A greater frequency of limitations on ADL, more anxiety and depression, and worse quality of life were shown among the subjects with CP. CONCLUSION CP affects one in four Spanish people and impairs the mental, physical and social health. Differences exist by sex and age in its frequency. Identifying subjects with non-chronic continuous pain is fundamental to prevent their pain from becoming chronic. SIGNIFICANCE STATEMENT Indicating the main aspects where this work adds significantly to existing knowledge in the field, and if appropriate to clinical practice. Due to its high prevalence and impact on quality of life, chronic pain has become one of the main health problems nowadays. Attention must be paid to it both from a clinical and social perspective, trying to raise awareness among the population of its possible causes and consequences. In routine clinical practice, greater consideration is given to groups of people with a higher prevalence of chronic pain, such as women and people with middle age, and with no chronic pain to prevent the appearance of chronic pain.
Collapse
Affiliation(s)
- M Dueñas
- Observatory of Pain, Grünenthal Foundation-University of Cadiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Cádiz, Spain
- Department of Statistics and Operational Research, University of Cádiz, Puerto Real, Spain
| | - H De Sola
- Observatory of Pain, Grünenthal Foundation-University of Cadiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Cádiz, Spain
- Department of General Economics, Area of Sociology, University of Cádiz, Jerez de la Frontera, Spain
| | - A Salazar
- Observatory of Pain, Grünenthal Foundation-University of Cadiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Cádiz, Spain
- Department of Statistics and Operational Research, University of Cádiz, Puerto Real, Spain
| | - A Esquivia
- Medical Department, Grünenthal Pharma, S.A, San Blas-Canillejas, Spain
| | - S Rubio
- Market Access Department, Grünenthal Pharma, S.A, San Blas-Canillejas, Spain
| | - I Failde
- Observatory of Pain, Grünenthal Foundation-University of Cadiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Cádiz, Spain
- Preventive Medicine and Public Health Area, University of Cádiz, Cádiz, Spain
| |
Collapse
|
2
|
Wang Z, Wang F, Jiang X, Wang W, Xing Y, Qiu X, Sun C, Tang L. Nitrous Oxide to Reduce Wound Care-Related Pain in Adults: A Systematic Review and Meta-Analysis. Adv Wound Care (New Rochelle) 2024. [PMID: 38511513 DOI: 10.1089/wound.2023.0211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Abstract
Significance: As an essential procedure, wound care comes with acute pain, which is short but high in intensity, causing patients to fear and affecting subsequent treatment. Nitrous oxide (N2O) is used to relieve pain related to wound care; however, evidence regarding its application is conflicting. Thus, this systematic review and meta-analysis was performed to evaluate the efficacy of N2O in wound care-related pain. Recent Advances: Randomized controlled trials that investigated the effect of N2O in adults undergoing wound care were systematically searched from PubMed, Embase, the Cochrane Library, Web of Science, Scopus, and ClinicalTrials.gov up to February 2023. The primary outcome was the pain score. Secondary outcomes included patients' satisfaction and side effects. Critical Issues: Through screening the 265 identified articles, seven and six studies were finally included in the systematic review and meta-analysis, respectively. Pooled analysis suggested that there was no significant difference in reducing wound care-related pain between the N2O group and the control group (mean difference [MD], -0.02, 95% confidence interval [CI], -1.46, 1.42; p = 0.98, I2 = 96%). Subgroup analyses indicated that there was a significant difference in favor of N2O for burns, not for ulcers, and N2O was superior to oxygen and similar to topical or intravenous anesthesia. There was no significant difference in patients' satisfaction or the incidence of side effects between groups. Future Directions: This review suggests that N2O might be effective for pain management in patients undergoing wound care. Caution must be taken when interpreting these results due to the high risk of biased methods in the included studies.
Collapse
Affiliation(s)
- Ziyang Wang
- Department of Stomatology, The 960th Hospital of People' s Liberation Army of China (PLA), Jinan, People's Republic of China
- School of Nursing, Weifang Medical University, Weifang, People's Republic of China
| | - Fei Wang
- Department of Anesthesiology, The 960th Hospital of People's Liberation Army of China (PLA), Jinan, People's Republic of China
| | - Xiaochen Jiang
- Department of Stomatology, The 960th Hospital of People' s Liberation Army of China (PLA), Jinan, People's Republic of China
- School of Nursing, Weifang Medical University, Weifang, People's Republic of China
| | - Weifeng Wang
- Department of Stomatology, The 960th Hospital of People' s Liberation Army of China (PLA), Jinan, People's Republic of China
- School of Nursing, Weifang Medical University, Weifang, People's Republic of China
| | - Yihui Xing
- Department of Stomatology, The 960th Hospital of People' s Liberation Army of China (PLA), Jinan, People's Republic of China
- School of Nursing, Weifang Medical University, Weifang, People's Republic of China
| | - Xueling Qiu
- Department of Stomatology, The 960th Hospital of People' s Liberation Army of China (PLA), Jinan, People's Republic of China
- School of Nursing, Shandong First Medical University, Tai'an, People's Republic of China
| | - Chenxi Sun
- Department of Stomatology, The 960th Hospital of People' s Liberation Army of China (PLA), Jinan, People's Republic of China
- Graduate Training Base of Jinzhou Medical University, The 960th Hospital of People's Liberation Army of China, Jinzhou, People's Republic of China
| | - Lu Tang
- Department of Stomatology, The 960th Hospital of People' s Liberation Army of China (PLA), Jinan, People's Republic of China
| |
Collapse
|
3
|
Ng APP, Cheng JKY, Lam JSM, Wong CKH, Cheng WHG, Tse ETY, Chao DVK, Choi EPH, Wong RSM, Lam CLK. Patient enablement and health-related quality of life for patients with chronic back and knee pain: a cross-sectional study in primary care. Br J Gen Pract 2023; 73:e867-e875. [PMID: 37845085 PMCID: PMC10587904 DOI: 10.3399/bjgp.2022.0546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 05/12/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Chronic back and knee pain impairs health- related quality of life (HRQoL) and patient enablement can improve HRQoL. AIM To determine whether enablement was a moderator of the effect of chronic back and knee pain on HRQoL. DESIGN AND SETTING A cross-sectional study of Chinese patients with chronic back and knee problems in public primary care clinics in Hong Kong. METHOD Each participant completed the Chinese Patient Enablement Instrument-2 (PEI-2), the Chinese Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Pain Rating Scale (PRS). Multivariable regression examined the effects of PRS score and PEI-2 score on WOMAC total score. A moderation regression model and simple slope analysis were used to evaluate whether the interaction between enablement (PEI-2) and pain (PRS) had a significant effect on HRQoL (WOMAC). RESULTS Valid patient-reported outcome data from 1306 participants were analysed. PRS score was associated with WOMAC total score (β = 0.326, P<0.001), whereas PEI-2 score was associated inversely with WOMAC total score (β = -0.260, P<0.001) and PRS score. The effect of the interaction between PRS and PEI-2 (PRS × PEI-2) scores on WOMAC total score was significant (β = -0.191, P<0.001) suggesting PEI-2 was a moderator. Simple slope analyses showed that the relationship between PRS and WOMAC was stronger for participants with a low level of PEI-2 (gradient 3.056) than for those with a high level of PEI-2 (gradient 1.746). CONCLUSION Patient enablement moderated the impact of pain on HRQoL. A higher level of enablement can lessen impairment in HRQoL associated with chronic back and knee pain.
Collapse
Affiliation(s)
- Amy Pui Pui Ng
- Department of Family Medicine, University of Hong Kong-Shenzhen Hospital, Shenzhen, China; Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - John King Yiu Cheng
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Joyce Sau Mei Lam
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Carlos King Ho Wong
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong; Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong; Laboratory of Data Discovery for Health (D4H) Hong Kong Science and Technology Park, Sha Tin, Hong Kong SAR, China
| | - Will Ho Gi Cheng
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Emily Tsui Yee Tse
- Department of Family Medicine, University of Hong Kong-Shenzhen Hospital, Shenzhen, China; Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - David Vai Kiong Chao
- Department of Family Medicine & Primary Health Care, Kowloon East Cluster, Hospital Authority, Hong Kong SAR, China
| | - Edmond Pui Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Rosa Sze Man Wong
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Cindy Lo Kuen Lam
- Department of Family Medicine, University of Hong Kong-Shenzhen Hospital, Shenzhen, China; Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| |
Collapse
|
4
|
Ma X, Zhang H, Xu T. Whether ambulatory electroencephalogram and visual tracking system could be the new strategy for pain assessment? Front Neurosci 2023; 17:1122614. [PMID: 36733334 PMCID: PMC9887010 DOI: 10.3389/fnins.2023.1122614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 01/04/2023] [Indexed: 01/18/2023] Open
Abstract
The human pain experience is a complex multi-faceted symptom. Effective pain management begins with a comprehensive assessment. However, a plethora of existing assessment tools for pain assessment focus more on self-report of pain intensity but lack of multi-dimensional impersonal assessment. These unidimensional scales, which capture self-reported levels of pain intensity, not only underestimate the complexity of the pain experience, but also lack stability and objectivity in their own assessments of pain intensity. Therefore, we propose a hypothesis that using scientific and technological means, such as visual tracking and surveillance system, ambulatory electroencephalogram and other techniques, combined with psychological assessment pictures and existing scales, to comprehensively evaluate pain may provide a new method for more effective clinical treatment of pain, especially chronic severe pain.
Collapse
Affiliation(s)
- Xiaqing Ma
- Department of Anesthesiology, Suzhou Hospital of Anhui Medical University, Suzhou, Anhui, China,Department of Anesthesiology, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, China
| | - Hong Zhang
- Department of Anesthesiology, Tongzhou People’s Hospital, Nantong, Jiangsu, China
| | - Tao Xu
- Department of Anesthesiology, Suzhou Hospital of Anhui Medical University, Suzhou, Anhui, China,Department of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China,Department of Anesthesiology, Tongzhou People’s Hospital, Nantong, Jiangsu, China,*Correspondence: Tao Xu,
| |
Collapse
|
5
|
Zhang W, Sun T, Wang S, Zhang J, Yang M, Li Z. Influence of preoperative depression on clinical outcomes after cervical laminoplasty: A retrospective study. Front Surg 2023; 9:1098043. [PMID: 36700019 PMCID: PMC9869422 DOI: 10.3389/fsurg.2022.1098043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/14/2022] [Indexed: 01/11/2023] Open
Abstract
Background Depression is a highly prevalent mental disorder, and we found that patients with preoperative depression had worse postoperative improvement in lumbar fusion. Are mental factors related to the prognosis of laminoplasty? Objective To analyze the relationship between depression and clinical outcomes after laminoplasty for the treatment of multilevel CSM. Methods In this retrospective study, 115 patients with multilevel cervical spondylotic myelopathy (CSM), who underwent laminoplasty and were followed up for more than 1 year, were enrolled in this study from October 2018 to October 2021. Patients with the scores of 21-item Beck Depression Inventory (BDI) ≥ 15 or Hamilton Depression Scale-24 (HAMD-24) > 20 were included in the depression group. The clinical outcomes were evaluated by the changes and recovery rate (RR) of Japanese Orthopaedic Association Scores (JOA) and Neck Disability Index (NDI) respectively. Univariate and multiple linear regression analyses were performed to reveal the relationship between preoperative depressive states and clinical outcomes. Results Fourteen patients were diagnosed with depression by BDI and twenty-nine by HAMD-24. Between the depression group and the non-depression group, the age, gender, smoking history, and duration of symptoms were statistically significant (P < 0.05). Multiple linear regression showed that the BDI scores had a negative relationship with the changes and RR of JOA and NDI, and the HAMD-24 scores had a negative relationship with the changes and RR of JOA. Conclusions Preoperative depression in patients with multilevel CSM can lead to worse prognosis. In order to improve the curative effect of the operation, we should pay attention to the psychological state monitoring and intervention of patients before they receive laminoplasty.
Collapse
Affiliation(s)
- Wentao Zhang
- Department of Orthopaedics, First Affiliated Hospital of Dalian Medical University, Dalian, China.,Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopaedic Diseases, Dalian, China
| | - Tianze Sun
- Department of Orthopaedics, First Affiliated Hospital of Dalian Medical University, Dalian, China.,Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopaedic Diseases, Dalian, China
| | - Shiyuan Wang
- Department of Medical Engineering, The 967th Hospital of Chinese People's Liberation Army, Dalian, China
| | - Jing Zhang
- Department of Orthopaedics, First Affiliated Hospital of Dalian Medical University, Dalian, China.,Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopaedic Diseases, Dalian, China
| | - Ming Yang
- Department of Orthopedics, Southwest Hospital, Army Medical University, Chongqing, China
| | - Zhonghai Li
- Department of Orthopaedics, First Affiliated Hospital of Dalian Medical University, Dalian, China.,Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopaedic Diseases, Dalian, China
| |
Collapse
|
6
|
Zhou Z, Xu G, Huang L, Shu Y, Tian H, Huang F, Liu Y, Liang F, Sun M. Effectiveness and Safety of Acupuncture-Related Therapies for Chronic Musculoskeletal Pain: A Protocol for Systematic Review and Network Meta-Analysis. J Pain Res 2022; 15:3959-3969. [PMID: 36561644 PMCID: PMC9767024 DOI: 10.2147/jpr.s387756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Chronic pain is one of the major health problems worldwide in recent years, and acupuncture-related therapies have been reported to have definite analgesic effects. However, it is still unclear which treatment is the most effective. Our systematic review and network meta-analysis protocol aims to summarize the evidence and determine the most effective method to treat the chronic musculoskeletal pain. Methods and Analysis Our literature search will be performed in five electronic databases-the Cochrane Library, EMBASE, and PubMed, AMED, CINAHL, until May 20, 2022. All randomized controlled trials of acupuncture-related therapies for chronic musculoskeletal pain will be included. The primary outcomes will be common pain-related scales, and the secondary outcomes will include quality of life and incidence of adverse events. Excel 2019 will be used for data extraction, RoB2 will be used for bias risk assessment. R 3.6.2 and WinBUGS V.1.4.3 software will be used for network data synthesis and to produce related plots. During the study, literature selection, data extraction, quality assessment and bias risk assessment will be independently completed by two reviewers, and differences will be judged by the third reviewer. Finally, the risk of bias and sources of heterogeneity in the study will be analyzed and explained in order to obtain reliable results. Results Our study will evaluate the effectiveness and safety of acupuncture-related therapies for the treatment of chronic musculoskeletal pain, and we will rank all methods to recommend the best appropriate treatment option. Conclusion This study will provide a good foundation for complementary and alternative medicine to treat chronic musculoskeletal pain. It will be also helpful to promote the clinical practice by providing evidence-based medical evidence.
Collapse
Affiliation(s)
- Zhuo Zhou
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Guixing Xu
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Liuyang Huang
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Yunjie Shu
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Hao Tian
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Fengyuan Huang
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Yilin Liu
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Fanrong Liang
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, People’s Republic of China,Correspondence: Fanrong Liang, Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, People’s Republic of China, Tel +86 136 0805 8216, Fax +86-28-87683962, Email
| | - Mingsheng Sun
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| |
Collapse
|
7
|
Sochal M, Ditmer M, Gabryelska A, Białasiewicz P. The Role of Brain-Derived Neurotrophic Factor in Immune-Related Diseases: A Narrative Review. J Clin Med 2022; 11:6023. [PMID: 36294343 PMCID: PMC9604720 DOI: 10.3390/jcm11206023] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/05/2022] [Accepted: 10/10/2022] [Indexed: 07/26/2023] Open
Abstract
Brain-derived neurotrophic factor (BDNF) is a neurotrophin regulating synaptic plasticity, neuronal excitability, and nociception. It seems to be one of the key molecules in interactions between the central nervous system and immune-related diseases, i.e., diseases with an inflammatory background of unknown etiology, such as inflammatory bowel diseases or rheumatoid arthritis. Studies show that BDNF levels might change in the tissues and serum of patients during the course of these conditions, e.g., affecting cell survival and modulating pain severity and signaling pathways involving different neurotransmitters. Immune-related conditions often feature psychiatric comorbidities, such as sleep disorders (e.g., insomnia) and symptoms of depression/anxiety; BDNF may be related as well to them as it seems to exert an influence on sleep structure; studies also show that patients with psychiatric disorders have decreased BDNF levels, which increase after treatment. BDNF also has a vital role in nociception, particularly in chronic pain, hyperalgesia, and allodynia, participating in the formation of central hypersensitization. In this review, we summarize the current knowledge on BDNF's function in immune-related diseases, sleep, and pain. We also discuss how BDNF is affected by treatment and what consequences these changes might have beyond the nervous system.
Collapse
|
8
|
Galvez-Sánchez CM, Montoro CI. Chronic Pain: Clinical Updates and Perspectives. J Clin Med 2022; 11:3474. [PMID: 35743542 PMCID: PMC9225290 DOI: 10.3390/jcm11123474] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 06/15/2022] [Indexed: 12/31/2022] Open
Abstract
The International Association for the Study of Pain (IASP) has defined pain as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage, which also comprises a subjective component [...].
Collapse
|
9
|
Turner HN, Oliver J, Compton P, Matteliano D, Sowicz TJ, Strobbe S, St Marie B, Wilson M. Pain Management and Risks Associated With Substance Use: Practice Recommendations. Pain Manag Nurs 2021; 23:91-108. [PMID: 34965906 DOI: 10.1016/j.pmn.2021.11.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 11/13/2021] [Indexed: 01/08/2023]
Abstract
Assessing and managing pain while evaluating risks associated with substance use and substance use disorders continues to be a challenge faced by health care clinicians. The American Society for Pain Management Nursing and the International Nurses Society on Addictions uphold the principle that all persons with co-occurring pain and substance use or substance use disorders have the right to be treated with dignity and respect, and receive evidence-based, high quality assessment, and management for both conditions. The American Society for Pain Management Nursing and International Nurses Society on Addictions have updated their 2012 position statement on this topic supporting an integrated, holistic, multidimensional approach, which includes nonopioid and nonpharmacological modalities. Opioid use disorder is used as an exemplar for substance use disorders and clinical recommendations are included with expanded attention to risk assessment and mitigation with interventions targeted to minimize the risk for relapse or escalation of substance use. Opioids should not be excluded for anyone when indicated for pain management. A team-based approach is critical, promotes the active involvement of the person with pain and their support systems, and includes pain and addiction specialists whenever possible. Health care systems should establish policies and procedures that facilitate and support the principles and recommendations put forth in this article.
Collapse
Affiliation(s)
| | - June Oliver
- Swedish Hospital, Northshore University Healthsystem, Chicago, IL.
| | | | | | | | | | - Barbara St Marie
- University of Iowa College of Nursing, Washington State University, College of Nursing
| | - Marian Wilson
- Oregon Health & Science University School of Nursing; Washington State University, College of Nursing
| |
Collapse
|