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Dumain M, Jaglin P, Wood C, Rainville P, Pageaux B, Perrochon A, Lavallière M, Vendeuvre T, Romain D, Langlois P, Cardinaud N, Tchalla A, Rigoard P, Billot M. Long-Term Efficacy of a Home-Care Hypnosis Program in Elderly Persons Suffering From Chronic Pain: A 12-Month Follow-Up. Pain Manag Nurs 2021; 23:330-337. [PMID: 34344593 DOI: 10.1016/j.pmn.2021.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 05/04/2021] [Accepted: 06/16/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Pain is a major public health concern in the aging population. However, medication brings about negative effects that compel healthcare professionals to seek alternative management techniques to alleviate pain. Hypnosis has been recognized as an effective technique to manage pain, but its long-term efficacy has yet to be examined in older adults. AIMS The aim was to assess the effectiveness, over a 12-month period, of home-care hypnosis in elderly participants suffering from chronic pain. DESIGN Real-life retrospective one-arm study with a 12-month follow-up. SETTINGS Elderly Persons Suffering From Chronic Pain enrolled in a clinical health care program that offered home medical follow-up. PARTICIPANTS/SUBJECTS Fourteen elderly women (mean age 81 years) with chronic pain participated in the home-care hypnosis program. All participants presented chronic pain (≥6 months) with average pain score >4/10. METHODS Participants took part in seven 15-minute hypnosis sessions within 12 months. The Brief Pain Inventory questionnaire was used to evaluate pain perception and pain interference at baseline and at 3-, 6-, and 12-month follow-up period. RESULTS Hypnosis home-care program significantly decreased pain perception and pain interference compared to baseline after 3 months (-29% and -40%, p < .001), and remained lower at 6 (-31% and -54%, p < .001) and 12 (-31% and -47%, p < .001) months. CONCLUSIONS Seven sessions of 15 minutes allocated throughout a 12-month period produced clinically significant decreases in pain perception and pain interference. Hypnosis could be considered as an optimal additional way for health practitioners to manage chronic pain in an elderly population with long-term efficacy. This study offers a new long-term option to improve chronic pain management at home in elderly populations through a low-cost nonpharmacological intervention.
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Affiliation(s)
- Marion Dumain
- From the PRISMATICS Lab (Predictive Research In Spine/Neurostimulation Management And Thoracic Innovation in Cardiac Surgery), Poitiers University Hospital, Poitiers, France
| | - Pauline Jaglin
- Rehabilitation Centre André Lalande - Fondation Partage et Vie, Noth, France
| | - Chantal Wood
- From the PRISMATICS Lab (Predictive Research In Spine/Neurostimulation Management And Thoracic Innovation in Cardiac Surgery), Poitiers University Hospital, Poitiers, France
| | - Pierre Rainville
- Department of Stomatology, University of Montreal, Montreal, Quebec, Canada; Centre de recherche de l'institut universitaire de gériatrie de Montréal, Montréal, Québec, Canada
| | - Benjamin Pageaux
- Centre de recherche de l'institut universitaire de gériatrie de Montréal, Montréal, Québec, Canada; École de kinésiologie et des sciences de l'activité physique (EKSAP), Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
| | - Anaick Perrochon
- HAVAE EA 6310 Laboratory, University of Limoges, Limoges, France
| | - Martin Lavallière
- Laboratoire de Recherche Biomécanique & Neurophysiologique en Réadaptation Neuro-Musculo-Squelettique-Lab BioNR, Department of Health Sciences, Centre Intersectoriel en Santé Durable (CISD), Module de Kinésiologie, Université du Québec à Chicoutimi, Saguenay, QC, Canada
| | - Tanguy Vendeuvre
- From the PRISMATICS Lab (Predictive Research In Spine/Neurostimulation Management And Thoracic Innovation in Cardiac Surgery), Poitiers University Hospital, Poitiers, France; Department of Spine Surgery and Neuromodulation, Poitiers University Hospital, Poitiers, France; Pprime Institute UPR 3346, CNRS - University of Poitiers - ISAE-ENSMA, Poitiers, France; Department of Orthopaedic Surgery and Traumatology, Poitiers University Hospital, Poitiers, France
| | - David Romain
- From the PRISMATICS Lab (Predictive Research In Spine/Neurostimulation Management And Thoracic Innovation in Cardiac Surgery), Poitiers University Hospital, Poitiers, France; Physical and Rehabilitation Medicine Unit, Poitiers University Hospital, University of Poitiers, Poitiers, France
| | - Pascaline Langlois
- From the PRISMATICS Lab (Predictive Research In Spine/Neurostimulation Management And Thoracic Innovation in Cardiac Surgery), Poitiers University Hospital, Poitiers, France
| | - Noelle Cardinaud
- Department of Clinical Geriatric, University Hospital Center, Limoges, France; UPSAV, Department of Clinical Geriatric, University Hospital Center, Limoges, France
| | - Achille Tchalla
- Department of Clinical Geriatric, University Hospital Center, Limoges, France
| | - Philippe Rigoard
- From the PRISMATICS Lab (Predictive Research In Spine/Neurostimulation Management And Thoracic Innovation in Cardiac Surgery), Poitiers University Hospital, Poitiers, France; Pprime Institute UPR 3346, CNRS - University of Poitiers - ISAE-ENSMA, Poitiers, France; Department of Orthopaedic Surgery and Traumatology, Poitiers University Hospital, Poitiers, France
| | - Maxime Billot
- From the PRISMATICS Lab (Predictive Research In Spine/Neurostimulation Management And Thoracic Innovation in Cardiac Surgery), Poitiers University Hospital, Poitiers, France.
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Opioids, Polypharmacy, and Drug Interactions: A Technological Paradigm Shift Is Needed to Ameliorate the Ongoing Opioid Epidemic. PHARMACY 2020; 8:pharmacy8030154. [PMID: 32854271 PMCID: PMC7559875 DOI: 10.3390/pharmacy8030154] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/20/2020] [Accepted: 08/21/2020] [Indexed: 12/17/2022] Open
Abstract
Polypharmacy is a common phenomenon among adults using opioids, which may influence the frequency, severity, and complexity of drug–drug interactions (DDIs) experienced. Clinicians must be able to easily identify and resolve DDIs since opioid-related DDIs are common and can be life-threatening. Given that clinicians often rely on technological aids—such as clinical decision support systems (CDSS) and drug interaction software—to identify and resolve DDIs in patients with complex drug regimens, this narrative review provides an appraisal of the performance of existing technologies. Opioid-specific CDSS have several system- and content-related limitations that need to be overcome. Specifically, we found that these CDSS often analyze DDIs in a pairwise manner, do not account for relevant pharmacogenomic results, and do not integrate well with electronic health records. In the context of polypharmacy, existing systems may encourage inadvertent serious alert dismissal due to the generation of multiple incoherent alerts. Future technological systems should minimize alert fatigue, limit manual input, allow for simultaneous multidrug interaction assessments, incorporate pharmacogenomic data, conduct iterative risk simulations, and integrate seamlessly with normal workflow.
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Wan TTH, Gurupur V, Patel A. A Longitudinal Analysis of Total Pain Scores for a Panel of Patients Treated by Pain Clinics. Health Serv Res Manag Epidemiol 2019; 6:2333392818788420. [PMID: 31001571 PMCID: PMC6454651 DOI: 10.1177/2333392818788420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 06/16/2018] [Accepted: 06/16/2018] [Indexed: 11/27/2022] Open
Abstract
Background: There is a critical necessity to identify psychometric properties of the total pain
score as a measurement of pain management effectiveness in the clinic. Purpose: In this article, we perform the analysis of the global pain scores from a panel of
patients treated by 10 pain management physicians in a single group practice. Basic Procedures: The pain measurement consists of 4 pain subscales, namely physical pain, emotions,
clinical outcome, and activities. A panel of 130 patients with 4 pain measurements is
available to perform longitudinal analysis of the total pain scores. The analysis
includes the following: (1) confirmatory factor analysis of the global pain scores with
4 related dimensions, (2) the stability of the pain scores between 2 clinical visits,
(3) the change trajectories of pain scores in 4 waves of the pain measurement, and (4)
the detection of physician variability in patients’ treatment outcomes measured by the
reduction of total pain scores. Main Findings: The global pain scores were relatively stable between time 1 and time 2 clinical
visits. The analysis indicated that there was a decrease in pain with longitudinal
advancement in treatment. It also indicated that there was no significant change in this
improvement with respect to difference in physicians involved in providing
treatment. Principal Conclusion: While the results indicated a decrease in pain with an alleviation in treatment
provided to the patient, the article delineates a well-thought scientific approach to
the targeted problem.
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Affiliation(s)
- Thomas T H Wan
- Department of Health Management and Informatics, University of Central Florida, Orlando, FL, USA
| | - Varadraj Gurupur
- Department of Health Management and Informatics, University of Central Florida, Orlando, FL, USA
| | - Anand Patel
- Florida Hospital Pain Medicine, Orlando, FL, USA
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