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Freeman EE, Strahan AG, Smith LR, Judd AD, Samarakoon U, Chen G, King AJ, Blumenthal KG. The impact of COVID-19 vaccine reactions on secondary vaccine hesitancy. Ann Allergy Asthma Immunol 2024; 132:630-636.e1. [PMID: 38232816 DOI: 10.1016/j.anai.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/05/2023] [Accepted: 01/08/2024] [Indexed: 01/19/2024]
Abstract
BACKGROUND Primary and booster vaccinations are critical for mitigating COVID-19 transmission, morbidity, and mortality. Future booster vaccine campaigns rely on an increased understanding of vaccine hesitancy. OBJECTIVE To evaluate self-reported allergic and skin vaccine reactions as factors potentially associated with vaccine hesitancy in a nationwide vaccine allergy registry. METHODS Responses to survey questions concerning COVID-19 vaccine perceptions, coded from free text by 2 independent reviewers. Multivariable logistic regression models were used to determine the association between changed negative perception and respondent demographics, vaccination history, and reaction characteristics. RESULTS A total of 993 individuals (median of 46 years [IQR, 36-59], 88% female, 82% White) self-reported reactions to COVID-19 vaccination. Reactions included the following: delayed large local skin reaction (40%), hives/urticaria (32%), immediate large local skin reaction (3%), swelling (3%), anaphylaxis (2%), and other or unspecified (20%). Most respondents were initially unconcerned about the safety of COVID-19 vaccines (56%). After reactions, 401 of 993 (40%) report negative change in perception of vaccination, with more than half of these respondents (n = 211, 53%) citing their reasoning as a negative experience with adverse effects. Of 102 individuals asked about future vaccination, 79 (77%) indicated that they were unlikely or very unlikely to receive future COVID-19 vaccinations. Increased negative perception after reaction was associated with younger age, later COVID-19 vaccination dose number, and reaction type. CONCLUSION Our findings reveal that an individual's experience with allergic or cutaneous adverse effects after COVID-19 vaccination affects attitudes and decision-making regarding future vaccination, even in initially non-hesitant individuals. Further investigation of secondary vaccine hesitancy is necessary for adapting public health messaging to this important population.
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Affiliation(s)
- Esther E Freeman
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; The Mongan Institute, Boston, Massachusetts
| | - Alexis G Strahan
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Liam R Smith
- The Mongan Institute, Boston, Massachusetts; Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Allen D Judd
- The Mongan Institute, Boston, Massachusetts; Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Upeka Samarakoon
- The Mongan Institute, Boston, Massachusetts; Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Andrew J King
- Harvard Medical School, Boston, Massachusetts; The Mongan Institute, Boston, Massachusetts; Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Kimberly G Blumenthal
- Harvard Medical School, Boston, Massachusetts; The Mongan Institute, Boston, Massachusetts; Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts.
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Page-Wilson G, Oak B, Silber A, Meyer J, O'Hara M, Geer EB. A medical chart audit to assess endocrinologist perceptions of the burden of endogenous Cushing's syndrome. Pituitary 2024; 27:129-140. [PMID: 38189862 PMCID: PMC11009763 DOI: 10.1007/s11102-023-01371-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/27/2023] [Indexed: 01/09/2024]
Abstract
PURPOSE This study was undertaken to assess the unmet needs within the endogenous Cushing's syndrome (CS) care paradigm from the endocrinologist's perspective, including data abstracted from patient charts. The study evaluated endocrinologists' perceptions on burden of illness and treatment rationale along with the long-term clinical burden of CS, tolerability of CS treatments, and healthcare resource utilization for CS. METHODS Retrospective medical chart data from treated patients with a confirmed diagnosis of CS was abstracted using a cross-sectional survey to collect data from qualified endocrinologists. The survey included a case report form to capture patient medical chart data and a web-enabled questionnaire to capture practitioner-level data pertaining to endocrinologists' perceptions of disease burden, CS treatments, and treatment attributes. RESULTS Sixty-nine endocrinologists abstracted data from 273 unique medical charts of patients with CS. Mean patient age was 46.5 ± 13.4 years, with a 60:40 (female:male) gender split. The mean duration of endogenous CS amongst patients was 4.1 years. Chart data indicated that patients experienced a high burden of comorbidities and symptoms, including fatigue, weight gain, and muscle weakness despite multi-modal treatment. When evaluating treatments for CS, endocrinologists rated improvement in health-related quality of life (HRQoL) as the most important treatment attribute (mean score = 7.8; on a scale of 1 = Not at all important to 9 = Extremely important). Surgical intervention was the modality endocrinologists were most satisfied with, but they agreed that there was a significant unmet treatment need for patients with CS. CONCLUSION Endocrinologists recognized that patients with CS suffered from a debilitating condition with a high symptomatic and HRQoL burden and reported that improvement in HRQoL was the key treatment attribute influencing their treatment choices. This study highlights unmet needs for patients with CS. Patients with CS have a high rate of morbidity and comorbidity, even after treatment.
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Affiliation(s)
- Gabrielle Page-Wilson
- Division of Endocrinology, Columbia University Irving Medical Center, New York, NY, USA
| | | | | | - James Meyer
- Xeris Pharmaceuticals, Inc, Chicago, IL, USA
| | | | - Eliza B Geer
- Multidisciplinary Pituitary and Skull Base Tumor Center, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
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3
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Gochman GE, Young VN, Schneider SL. Prospective Determination of Normative Value of the Singing Voice Handicap Index-10 (SVHI-10). J Voice 2023:S0892-1997(23)00068-1. [PMID: 36931984 DOI: 10.1016/j.jvoice.2023.02.013] [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: 11/29/2022] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVES/HYPOTHESIS To prospectively establish a normative value for the validated Singing Voice Handicap Index-10 (SVHI-10) patient reported outcome measure (PROM). STUDY DESIGN Prospective cross-sectional study. METHODS Adult singers without voice complaints were prospectively invited to complete a demographics questionnaire followed by the SVHI-10. Participants were excluded if they had sought medical care for voice changes within the last year or currently had throat problems. Statistical analysis was completed to establish a normative value and the distribution of demographics by singing experience, primary genre, and gender. RESULTS One hundred forty-nine healthy participants from diverse backgrounds (including singing, financial, educational, and geographic location) successfully completed the SVHI-10. The mean (SD) score of this cohort was 9.13 (5.15). We defined a normative value as two standard deviations above the mean: 19.43 There was no difference in SVHI-10 score in different age groups. CONCLUSIONS A normative value for the SVHI-10 questionnaire has been missing from the current literature and will be of great utility both in clinical practice and research. In previous research, singers have been shown to be more perceptive to quality change in their singing voices, which may be why the normative score is higher than one may expect. A SVHI-10 score ≥20 should be considered abnormal.
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Affiliation(s)
- Grant E Gochman
- Department of Otolaryngology-Head and Neck Surgery, Voice and Swallowing Center, University of California, San Francisco, California
| | - VyVy N Young
- Department of Otolaryngology-Head and Neck Surgery, Voice and Swallowing Center, University of California, San Francisco, California
| | - Sarah L Schneider
- Department of Otolaryngology-Head and Neck Surgery, Voice and Swallowing Center, University of California, San Francisco, California.
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Boring BL, Walsh KT, Nanavaty N, Mathur VA. Shame Mediates the Relationship Between Pain Invalidation and Depression. Front Psychol 2021; 12:743584. [PMID: 34925146 PMCID: PMC8677820 DOI: 10.3389/fpsyg.2021.743584] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 11/11/2021] [Indexed: 11/13/2022] Open
Abstract
The experience of pain is subjective, yet many people have their pain invalidated or not believed. Pain invalidation is associated with poor mental health, including depression and lower well-being. Qualitative investigations of invalidating experiences identify themes of depression, but also social withdrawal, self-criticism, and lower self-worth, all of which are core components of shame. Despite this, no studies have quantitatively assessed the interrelationship between pain invalidation, shame, and depression. To explore this relationship, participants recounted the frequency of experienced pain invalidation from family, friends, and medical professionals, as well as their feelings of internalized shame and depressive symptoms. As shame has been shown to be a precursor for depression, we further explored the role of shame as a mediator between pain invalidation and depressive symptoms. All sources of pain invalidation were positively associated with shame and depressive symptoms, and shame fully mediated the relationship between each source of pain invalidation and depression. Relative to other sources, pain invalidation from family was most closely tied to shame and depression. Overall, findings indicate that one mechanism by which pain invalidation may facilitate depression is via the experience of shame. Future research may explore shame as a potential upstream precursor to depression in the context of pain. Findings provide more insight into the harmful influence of pain invalidation on mental health and highlight the impact of interpersonal treatment on the experiences of people in pain.
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Affiliation(s)
- Brandon L Boring
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - Kaitlyn T Walsh
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - Namrata Nanavaty
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - Vani A Mathur
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States.,Texas A&M Institute for Neuroscience, College Station, TX, United States
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5
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Boring BL, Walsh KT, Nanavaty N, Ng BW, Mathur VA. How and Why Patient Concerns Influence Pain Reporting: A Qualitative Analysis of Personal Accounts and Perceptions of Others' Use of Numerical Pain Scales. Front Psychol 2021; 12:663890. [PMID: 34282355 PMCID: PMC8285731 DOI: 10.3389/fpsyg.2021.663890] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/17/2021] [Indexed: 11/13/2022] Open
Abstract
Complex factors influence how people report and interpret numerical pain ratings. Such variability can introduce noise and systematic bias into clinical pain assessment. Identification of factors that influence self-rated pain and its interpretation by others may bolster utility of these scales. In this qualitative study, 338 participants described motivations for modulating their own pain reports relative to a numerical pain scale (0–10), as well as perceptions of others’ pain reporting modulation. Responses indicated that people over-report pain to enhance provider belief/responsiveness or the likelihood of pain relief, and out of fear of future pain or potential illness. Concerns of how one’s pain affects and is perceived by others, and financial concerns motivated pain under-reporting. Unprompted, many participants reported never modulating their pain ratings, citing trust in providers and personal ethics. Similar reasons were assumed to motivate others’ pain ratings. However, participants often attributed others’ over-reporting to internal causes, and their own to external. This bias may underlie common assumptions that patients over-report pain for nefarious reasons, distort interpretation of pain reports, and contribute to pain invalidation. Recognition of patient concerns and one’s own personal biases toward others’ pain reporting may improve patient-provider trust and support precision of numerical pain ratings.
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Affiliation(s)
- Brandon L Boring
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - Kaitlyn T Walsh
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - Namrata Nanavaty
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - Brandon W Ng
- Department of Psychology, University of Richmond, Richmond, VA, United States
| | - Vani A Mathur
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States.,Texas A&M Institute for Neuroscience, College Station, TX, United States
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Kimber J, Sullivan N, Anastasides N, Slotkin S, McAndrew LM. Understanding Veterans' Causal Attributions of Physical Symptoms. Int J Behav Med 2021; 28:299-307. [PMID: 32691396 PMCID: PMC7855405 DOI: 10.1007/s12529-020-09918-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Illness beliefs are significant contributors to health outcomes. Beliefs about the cause of physical symptoms are considered particularly important among those with medically unexplained symptoms and illnesses (MUS); yet little is known about causal beliefs among those with the most severe MUS (i.e., Veterans). The goal of the current study was to examine Veteran's causal attributions of their physical symptoms. METHOD A total of 91 combat Veterans with MUS were surveyed using a mixed-methods design about the cause of their physical symptoms, physical symptom severity, and PTSD symptoms. Causal attributions of physical symptoms were analyzed through thematic response analysis and grouped into categories. Chi-square analysis was used to assess the distribution of causal attribution types across Veterans with varying physical symptom severity and PTSD symptom severity. RESULTS Veterans with MUS reported an average of 7.9 physical symptoms, and attributed the cause of their symptoms to seven different categories ("Do not Know," "Stress/Mental Health," "Deployment/Environment," "Functional/Symptom," "Medically Explained," "Medically Unexplained Syndrome," and "Lifestyle"). Exploratory chi-square analysis revealed significant differences in causal attributions across physical symptom severity and severity of PTSD symptoms. Veterans with more severe PTSD and Veterans with more severe physical symptoms were more likely to attribute their MUS to stress/mental health or to a medically unexplained syndrome compared with those with low/no PTSD symptoms and physical symptom severity. Veterans with minimal PTSD and Veterans with minimal physical symptom severity were more likely to attribute the cause of their MUS to lifestyle choices (e.g., exercise/diet) compared with those with high PTSD and physical symptom severity. CONCLUSION Veterans with MUS endorse multiple, varied causal attributions for their physical symptoms, suggesting more complex causal beliefs than typically assumed. This has important implications for patient-provider communication and development of concordance around MUS treatment.
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Affiliation(s)
- Justin Kimber
- Department of Educational and Counseling Psychology, University at Albany, State University of New York, 1400 Washington Ave Ext, Albany, 12222, NY, USA.
| | - Nicole Sullivan
- War Related Illness and Injury Study Center, Veterans Affairs New Jersey Health Care System, 385 Tremont Avenue, East Orange, 07018, NJ, USA
| | - Nicole Anastasides
- War Related Illness and Injury Study Center, Veterans Affairs New Jersey Health Care System, 385 Tremont Avenue, East Orange, 07018, NJ, USA
| | - Sarah Slotkin
- Department of Educational and Counseling Psychology, University at Albany, State University of New York, 1400 Washington Ave Ext, Albany, 12222, NY, USA
| | - Lisa M McAndrew
- Department of Educational and Counseling Psychology, University at Albany, State University of New York, 1400 Washington Ave Ext, Albany, 12222, NY, USA
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Geer EB, Sisco J, Adelman DT, Ludlam WH, Haviv A, Gelbaum D, Liu S, Mathias SD, Shi L. Observed discordance between outcomes reported by acromegaly patients and their treating endocrinology medical provider. Pituitary 2020; 23:140-148. [PMID: 31808101 PMCID: PMC7066283 DOI: 10.1007/s11102-019-01013-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Acromegaly patients, even those with IGF-1 values within the normal range receiving somatostatin receptor ligands (SRLs), often suffer from significant symptoms. It is not known to what extent patients' medical providers are aware of the frequency and severity of acromegaly symptoms or level of treatment satisfaction with SRLs. This study sought to examine the concordance between outcomes reported by acromegaly patients treated with long-acting SRLs and those perceived by their medical provider. METHODS US acromegaly patients on a stable dose of SRL and seen by their medical provider in the past year completed an online survey which included the Acro-TSQ. Their medical providers were interviewed about the perception of their patient's symptoms, level of control, and general health, and completed relevant portions of the Acro-TSQ. Concordance between patient and medical provider reported data was examined. RESULTS Medical providers reported that their patients experienced acromegaly symptoms on a regular basis, however, there was poor agreement between patients and medical providers on the frequency, severity, and pattern of symptoms, as well as on the severity of injection site reactions and multiple domains of the Acro-TSQ, with patients generally reporting symptoms and injection site reactions more often and with higher severity than medical providers. CONCLUSIONS Medical providers were aware that their patients who were receiving a stable dose of SRL regularly experienced acromegaly symptoms. Addressing discordance in patient- and medical provider-reported frequency and severity of acromegaly symptoms and injection site reactions by facilitating better communication may improve care of acromegaly patients.
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Affiliation(s)
- Eliza B Geer
- Memorial Sloan Kettering Cancer Center, 1275 York Ave, Box 419, New York, NY, 10065, USA.
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8
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Stefan MS, Priya A, Martin B, Pekow PS, Rothberg MB, Goldberg RJ, DiNino E, Lindenauer PK. How well do patients and providers agree on the severity of dyspnea? J Hosp Med 2016; 11:701-707. [PMID: 27130579 PMCID: PMC6423510 DOI: 10.1002/jhm.2600] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 03/28/2016] [Accepted: 04/05/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Understanding the severity of patients' dyspnea is critical to avoid under- or overtreatment of patients with acute cardiopulmonary conditions. OBJECTIVE To evaluate the agreement between dyspnea assessment by patients and healthcare providers and to explore which factors contribute to discordance in assessment. DESIGN, SETTINGS AND PARTICIPANTS Prospective study of patients hospitalized for acute cardiopulmonary diseases at an urban teaching hospital. INTERVENTION AND MEASUREMENTS A numerical rating scale (0-10) was used to assess dyspnea severity as perceived by patients and assessed by providers. Agreement was defined as a score within ±1 between patient and healthcare provider; differences of ≥2 points were considered over- or underestimations. The relationship between patient self-perceived dyspnea severity and provider rating was assessed using a weighted kappa coefficient. RESULTS Of the 138 patients enrolled, 33% had a diagnosis of heart failure, 30% chronic obstructive pulmonary disease, and 13% pneumonia; median age was 72 years, and 57% were women. In all, 96 patient-physician and 138 patient-nurses pairs were included in the study. The kappa coefficient for agreement was 0.11 (95% confidence interval [CI]: 0.01 to 0.21) between patients and physicians and 0.18 (95% CI: 0.12 to 0.24) between patients and nurses. Physicians underestimated patients' dyspnea 37.9% of the time and overestimated it 25.8% of the time, whereas nurses underestimated it 43.5% of the time and overestimated it 12.4% of the time. Admitting diagnosis was the only patient factor associated with discordance. CONCLUSIONS Agreement between patient perception of dyspnea and healthcare providers' assessment is low. Future studies should prospectively test whether routine assessment of dyspnea results in better patient outcomes. Journal of Hospital Medicine 2016;11:701-707. © 2016 Society of Hospital Medicine.
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Affiliation(s)
- Mihaela S Stefan
- Center for Quality of Care Research, Baystate Medical Center, Springfield, Massachusetts.
- Division of General Internal Medicine, Baystate Medical Center, Springfield, Massachusetts.
- Tufts Clinical and Translational Science Institute, Boston, Massachusetts.
- Tufts University School of Medicine, Boston, Massachusetts.
| | - Aruna Priya
- Center for Quality of Care Research, Baystate Medical Center, Springfield, Massachusetts
| | | | - Penelope S Pekow
- Center for Quality of Care Research, Baystate Medical Center, Springfield, Massachusetts
- School of Public Health & Health Sciences, University of Massachusetts-Amherst, Amherst, Massachusetts
| | | | - Robert J Goldberg
- Division of Epidemiology of Chronic Diseases & Vulnerable Populations and Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Ernest DiNino
- Division of Pulmonary and Critical Care Medicine, Baystate Medical Center, Springfield, Massachusetts
| | - Peter K Lindenauer
- Center for Quality of Care Research, Baystate Medical Center, Springfield, Massachusetts
- Division of General Internal Medicine, Baystate Medical Center, Springfield, Massachusetts
- Tufts Clinical and Translational Science Institute, Boston, Massachusetts
- Tufts University School of Medicine, Boston, Massachusetts
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Hoffelt C, Zwack A. Assessment and management of chronic pain in patients with depression and anxiety. Ment Health Clin 2014. [DOI: 10.9740/mhc.n198935] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This article will review the role of the pharmacist in the management of chronic pain in patients with comorbid mood disorders.
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Park J, Cho B, Paek Y, Kwon H, Yoo S. Development of a pain assessment tool for the older adults in Korea: The validity and reliability of a Korean version of the geriatric pain measure (GPM-K). Arch Gerontol Geriatr 2009; 49:199-203. [DOI: 10.1016/j.archger.2008.07.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2008] [Revised: 07/23/2008] [Accepted: 07/24/2008] [Indexed: 11/30/2022]
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11
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Winstead NS, Wilcox CM. Clinical trials of pancreatic enzyme replacement for painful chronic pancreatitis--a review. Pancreatology 2009; 9:344-50. [PMID: 19451744 DOI: 10.1159/000212086] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Painful chronic pancreatitis is a challenging problem for clinicians and patients. Many patients receive a therapeutic trial of pancreatic enzyme supplementation at some point in the course of their disease, but it is unclear what the expected outcome of such a trial should be and whether or not all patients should receive a trial of pancreatic enzymes. We searched PubMed for all studies of pancreatic enzyme supplementation for painful chronic pancreatitis from 1980 to the present. We also searched the references of identified manuscripts and requested additional information from study authors when necessary. Manuscripts were assessed for study design, bias, pain assessment, and pain management protocol. The results are described in full.
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Affiliation(s)
- Nathaniel S Winstead
- Ochsner Clinic Foundation and Tulane University Health Sciences Center, New Orleans, La, USA.
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Rosenberg EI, Genao I, Chen I, Mechaber AJ, Wood JA, Faselis CJ, Kurz J, Menon M, O'Rorke J, Panda M, Pasanen M, Staton L, Calleson D, Cykert S. Complementary and Alternative Medicine Use by Primary Care Patients with Chronic Pain. PAIN MEDICINE 2008; 9:1065-72. [PMID: 18564996 DOI: 10.1111/j.1526-4637.2008.00477.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Eric I Rosenberg
- Division of Internal Medicine, Department of Medicine, University of Florida, Gainesville, Florida 32610-0277, USA.
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Garcia-Monco JC, Foncea N, Bilbao A, Ruiz de Velasco I, Gomez-Beldarrain M. Impact of preventive therapy with nadolol and topiramate on the quality of life of migraine patients. Cephalalgia 2007; 27:920-8. [PMID: 17645757 DOI: 10.1111/j.1468-2982.2007.01367.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Preventive therapy is aimed at reducing migraine frequency, but should also improve the much deteriorated quality of life of the migraneur. We aimed to evaluate the impact of preventive therapy with two widely employed drugs (topiramate and nadolol) on the quality of life of migraine patients. A population of consecutive migraineurs aged > or = 16 years, with frequent migraines, was selected prospectively for evaluation at baseline and after 16 weeks of therapy with nadolol or topiramate (40 mg and 100 mg daily, respectively) by generic and specific quality of life questionnaires (SF-36 and MSQOL) and by an anxiety and depression scale (HADS). Preventive therapy resulted in a statistically significant improvement in physical domains of the SF-36, whereas mental domains remained almost unchanged. Despite this improvement, all domains remained below the population norms. The HADS revealed a moderate depressive state at baseline that did not change with therapy. The MSQOL global score also revealed statistically significant improvement. Both drugs were similarly effective, although topiramate was superior on the role physical domain compared with nadolol. Preventive therapy with nadolol and topiramate significantly improves the quality of life of migraineurs, although additional efforts are needed to place them in a nearer-to-normal situation compared with the general population.
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