1
|
Berger SE, Baria AT. Assessing Pain Research: A Narrative Review of Emerging Pain Methods, Their Technosocial Implications, and Opportunities for Multidisciplinary Approaches. FRONTIERS IN PAIN RESEARCH 2022; 3:896276. [PMID: 35721658 PMCID: PMC9201034 DOI: 10.3389/fpain.2022.896276] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/12/2022] [Indexed: 11/13/2022] Open
Abstract
Pain research traverses many disciplines and methodologies. Yet, despite our understanding and field-wide acceptance of the multifactorial essence of pain as a sensory perception, emotional experience, and biopsychosocial condition, pain scientists and practitioners often remain siloed within their domain expertise and associated techniques. The context in which the field finds itself today-with increasing reliance on digital technologies, an on-going pandemic, and continued disparities in pain care-requires new collaborations and different approaches to measuring pain. Here, we review the state-of-the-art in human pain research, summarizing emerging practices and cutting-edge techniques across multiple methods and technologies. For each, we outline foreseeable technosocial considerations, reflecting on implications for standards of care, pain management, research, and societal impact. Through overviewing alternative data sources and varied ways of measuring pain and by reflecting on the concerns, limitations, and challenges facing the field, we hope to create critical dialogues, inspire more collaborations, and foster new ideas for future pain research methods.
Collapse
Affiliation(s)
- Sara E. Berger
- Responsible and Inclusive Technologies Research, Exploratory Sciences Division, IBM Thomas J. Watson Research Center, Yorktown Heights, NY, United States
| | | |
Collapse
|
2
|
Ashtari S, Taylor AD. The Internet Knows More Than My Doctor: A Qualitative Study of People with Rare Diseases and How They Use Online Support Groups (Preprint). J Med Internet Res 2022; 24:e39172. [PMID: 36006679 PMCID: PMC9459833 DOI: 10.2196/39172] [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: 05/02/2022] [Revised: 05/31/2022] [Accepted: 07/19/2022] [Indexed: 12/01/2022] Open
Abstract
Background Patients struggling with rare diseases may face challenges caused by care providers being unfamiliar with their condition. The life span of people with rare diseases may be the same as that of healthy people, but their quality of life is different. Patients with chronic pain are constantly looking for ways to mitigate their pain. Pain killers are not a permanent solution. In addition to the medical and nonmedical costs of rare diseases for both patients and health care providers, there is a need for sustainable sources of information that are available to help with pain and improve their quality of life, with the goal of reducing physician visits and hospital admissions. Objective This study investigated the challenges that patients with genetic disorders face in managing their health conditions and finding disease-related information as well as the effect of online peer support groups on pain mitigation and care management. Methods Interviews were conducted via Zoom between July 2021 and December 2021. Eligible participants were those who were aged >18 years, had a medical diagnosis of any type of Ehlers-Danlos syndrome (EDS) with chronic pain, and were members of any support group. Participants were recruited through an announcement in the research and survey section of The Ehlers-Danlos Syndrome Society web page. Interviews were analyzed using the framework approach. Data were systematically searched to identify patterns, analyze them, and identify themes. Interview audio files were transcribed and independently coded by two researchers (SA and AT). Through an iterative process, a final coding table was agreed upon by the researchers and used to thematically analyze the data. Results We interviewed 30 participants (mean age 37.7, SD 15 years; n=28, 93% were women; n=23, 77% were residing in the United States). Thematic analysis revealed that participants (patients with EDS) were constantly in pain and most of them have not received accurate and timely diagnoses for many years. They expressed their challenges with health care providers regarding diagnosis and treatment, and complained about their providers’ lack of support and knowledge. Participants’ main sources of information were web-based searches, academic journals, The Ehlers-Danlos Syndrome Society web page, and online peer support groups on Facebook, Reddit, Twitter, and Instagram. Although pain killers, cannabis, and opioids are providing some pain relief, most patients (28/30, 93%) focused on nonmedical approaches, such as hot or ice packs, physical therapy, exercises, massage, mindfulness, and meditation. Conclusions This study highlights the information gap between health care providers and patients with genetic disorders. Patients with EDS seek access to information from different web-based sources. To meet the needs of patients with genetic disorders, future interventions via web-based resources for improving the quality of care must be considered by health care professionals and government agencies.
Collapse
Affiliation(s)
- Sadaf Ashtari
- California State University, Sacramento, Sacramento, CA, United States
| | | |
Collapse
|
3
|
Stokes DC, Kishton R, McCalpin HJ, Pelullo AP, Meisel ZF, Beidas RS, Merchant RM. Online Reviews of Mental Health Treatment Facilities: Narrative Themes Associated With Positive and Negative Ratings. Psychiatr Serv 2021; 72:776-783. [PMID: 34015944 PMCID: PMC9116241 DOI: 10.1176/appi.ps.202000267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Previous studies indicate that patients' satisfaction with mental health care is correlated with both treatment outcomes and quality of life. The aims of this study were to describe online reviews of mental health treatment facilities, including key themes in review content, and to evaluate the correlation between narrative review themes, facility characteristics, and review ratings. METHODS United States National Mental Health Services Survey (N-MHSS) facilities were linked to corresponding Yelp pages, created between March 2007 and September 2019. Correlations between review ratings and both machine learning-generated latent Dirichlet allocation topics and N-MHSS-reported facility characteristics were measured by using Spearman's rank-order correlation coefficient. Significance was defined by a Bonferroni-adjusted p<0.001. RESULTS Of 10,191 unique mental health treatment facilities, 1,383 (13.6%) had relevant Yelp pages with 8,133 corresponding reviews. The number of newly reviewed facilities and the number of new reviews increased throughout the study period. Narrative topics positively correlated with review ratings included caring staff (Spearman's ρ=0.39) and nonpharmacologic treatment (ρ=0.16). Topics negatively correlated with review ratings included rude staff (ρ=-0.14) and safety and abuse (ρ=-0.14). Of 126 N-MHSS survey items, 11 were positively correlated with review rating, including "outpatient mental health facility" (ρ=0.13), and 33 were negatively correlated with review rating, including accepting Medicare (ρ=-0.21). CONCLUSIONS Narrative topics provide information beyond what is currently collected through the N-MHSS. Topics associated with positive and negative reviews, such as staff attitude toward patients, can guide improvement in patients' satisfaction and engagement with mental health care.
Collapse
Affiliation(s)
- Daniel C Stokes
- Penn Medicine Center for Digital Health (Stokes, McCalpin, Pelullo, Merchant), Center for Emergency Care Policy and Research, Department of Emergency Medicine (Stokes, Meisel, Merchant), Department of Psychiatry (Beidas), and Penn Medical Ethics and Health Policy (Beidas), Perelman School of Medicine, University of Pennsylvania, Philadelphia; National Clinician Scholars Program (Kishton), Leonard Davis Institute of Health Economics (Meisel, Merchant), and Penn Implementation Science Center at the Leonard Davis Institute (Beidas), University of Pennsylvania, Philadelphia
| | - Rachel Kishton
- Penn Medicine Center for Digital Health (Stokes, McCalpin, Pelullo, Merchant), Center for Emergency Care Policy and Research, Department of Emergency Medicine (Stokes, Meisel, Merchant), Department of Psychiatry (Beidas), and Penn Medical Ethics and Health Policy (Beidas), Perelman School of Medicine, University of Pennsylvania, Philadelphia; National Clinician Scholars Program (Kishton), Leonard Davis Institute of Health Economics (Meisel, Merchant), and Penn Implementation Science Center at the Leonard Davis Institute (Beidas), University of Pennsylvania, Philadelphia
| | - Haley J McCalpin
- Penn Medicine Center for Digital Health (Stokes, McCalpin, Pelullo, Merchant), Center for Emergency Care Policy and Research, Department of Emergency Medicine (Stokes, Meisel, Merchant), Department of Psychiatry (Beidas), and Penn Medical Ethics and Health Policy (Beidas), Perelman School of Medicine, University of Pennsylvania, Philadelphia; National Clinician Scholars Program (Kishton), Leonard Davis Institute of Health Economics (Meisel, Merchant), and Penn Implementation Science Center at the Leonard Davis Institute (Beidas), University of Pennsylvania, Philadelphia
| | - Arthur P Pelullo
- Penn Medicine Center for Digital Health (Stokes, McCalpin, Pelullo, Merchant), Center for Emergency Care Policy and Research, Department of Emergency Medicine (Stokes, Meisel, Merchant), Department of Psychiatry (Beidas), and Penn Medical Ethics and Health Policy (Beidas), Perelman School of Medicine, University of Pennsylvania, Philadelphia; National Clinician Scholars Program (Kishton), Leonard Davis Institute of Health Economics (Meisel, Merchant), and Penn Implementation Science Center at the Leonard Davis Institute (Beidas), University of Pennsylvania, Philadelphia
| | - Zachary F Meisel
- Penn Medicine Center for Digital Health (Stokes, McCalpin, Pelullo, Merchant), Center for Emergency Care Policy and Research, Department of Emergency Medicine (Stokes, Meisel, Merchant), Department of Psychiatry (Beidas), and Penn Medical Ethics and Health Policy (Beidas), Perelman School of Medicine, University of Pennsylvania, Philadelphia; National Clinician Scholars Program (Kishton), Leonard Davis Institute of Health Economics (Meisel, Merchant), and Penn Implementation Science Center at the Leonard Davis Institute (Beidas), University of Pennsylvania, Philadelphia
| | - Rinad S Beidas
- Penn Medicine Center for Digital Health (Stokes, McCalpin, Pelullo, Merchant), Center for Emergency Care Policy and Research, Department of Emergency Medicine (Stokes, Meisel, Merchant), Department of Psychiatry (Beidas), and Penn Medical Ethics and Health Policy (Beidas), Perelman School of Medicine, University of Pennsylvania, Philadelphia; National Clinician Scholars Program (Kishton), Leonard Davis Institute of Health Economics (Meisel, Merchant), and Penn Implementation Science Center at the Leonard Davis Institute (Beidas), University of Pennsylvania, Philadelphia
| | - Raina M Merchant
- Penn Medicine Center for Digital Health (Stokes, McCalpin, Pelullo, Merchant), Center for Emergency Care Policy and Research, Department of Emergency Medicine (Stokes, Meisel, Merchant), Department of Psychiatry (Beidas), and Penn Medical Ethics and Health Policy (Beidas), Perelman School of Medicine, University of Pennsylvania, Philadelphia; National Clinician Scholars Program (Kishton), Leonard Davis Institute of Health Economics (Meisel, Merchant), and Penn Implementation Science Center at the Leonard Davis Institute (Beidas), University of Pennsylvania, Philadelphia
| |
Collapse
|
4
|
Pruvis TE, Holzman S, Hess DK, Levin SC, Maher DP. Online Ratings of Pain Physicians in a Regional Population: What Matters? PAIN MEDICINE 2021; 21:1743-1748. [PMID: 32626891 DOI: 10.1093/pm/pnaa173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Samuel Holzman
- Division of Infectious Diseases, Department of Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Demere Kasper Hess
- Division of Chronic Pain Management, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Steven C Levin
- Division of Chronic Pain Management, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Dermot P Maher
- Division of Chronic Pain Management, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
5
|
Damiescu R, Banerjee M, Lee DYW, Paul NW, Efferth T. Health(care) in the Crisis: Reflections in Science and Society on Opioid Addiction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E341. [PMID: 33466370 PMCID: PMC7795923 DOI: 10.3390/ijerph18010341] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/28/2020] [Accepted: 12/30/2020] [Indexed: 12/21/2022]
Abstract
Opioid abuse and misuse have led to an epidemic which is currently spreading worldwide. Since the number of opioid overdoses is still increasing, it is becoming obvious that current rather unsystematic approaches to tackle this health problem are not effective. This review suggests that fighting the opioid epidemic requires a structured public health approach. Therefore, it is important to consider not only scientific and biomedical perspectives, but societal implications and the lived experience of groups at risk as well. Hence, this review evaluates the risk factors associated with opioid overdoses and investigates the rates of chronic opioid misuse, particularly in the context of chronic pain as well as post-surgery treatments, as the entrance of opioids in people's lives. Linking pharmaceutical biology to narrative analysis is essential to understand the modulations of the usual themes of addiction and abuse present in the opioid crisis. This paper shows that patient narratives can be an important resource in understanding the complexity of opioid abuse and addiction. In particular, the relationship between chronic pain and social inequality must be considered. The main goal of this review is to demonstrate how a deeper transdisciplinary-enriched understanding can lead to more precise strategies of prevention or treatment of opioid abuse.
Collapse
Affiliation(s)
- Roxana Damiescu
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University, 55128 Mainz, Germany;
| | - Mita Banerjee
- Department of English and Linguistics, Obama Institute for Transnational American Studies, Johannes Gutenberg University, 55128 Mainz, Germany;
| | - David Y. W. Lee
- McLean Hospital, Harvard Medical School, Boston, MA 02478, USA;
| | - Norbert W. Paul
- Institute for History, Philosophy and Ethics of Medicine, Johannes Gutenberg University Medical Center, 55128 Mainz, Germany;
| | - Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University, 55128 Mainz, Germany;
| |
Collapse
|
6
|
Van Wilder A, Vanhaecht K, De Ridder D, Cox B, Brouwers J, Claessens F, De Wachter D, Deneckere S, Ramaekers D, Tambuyzer E, Weeghmans I, Bruyneel L. Six years of measuring patient experiences in Belgium: Limited improvement and lack of association with improvement strategies. PLoS One 2020; 15:e0241408. [PMID: 33141857 PMCID: PMC7608918 DOI: 10.1371/journal.pone.0241408] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 10/14/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To examine trends in patient experiences in the period 2014-2019, describe improvement strategies implemented by hospitals in the same period, and study associations between patient experiences and implemented strategies. DESIGN Multi-center retrospective region-wide observational design. SETTING Flanders, Belgium. PARTICIPANTS 44 out of 46 Flemish acute-care hospitals publicly reporting patient experiences via the Flemish Patient Survey (FPS). MAIN OUTCOME MEASURE(S) Primary outcomes were the two global FPS ratings: percentage of patients rating the hospital 9 or 10 and percentage of patients definitely recommending the hospital. Secondary outcomes were the average top-box score percentages for each of the 8 remaining dimensions of the FPS. RESULTS Between 2014 and 2019, there was a significant improvement in patients scoring the hospital 9 or 10 (56% to 61%) and patients definitely recommending (67% to 70%) the hospital. Significant increases in patient experiences over time were also observed in other dimensions, except for the dimension discharge. Hospital key informants reported various improvement strategies related to patient experiences with care and the FPS. Feedback to nursing wards (n = 44, 100%) and clinicians (n = 39, 89%) were most common. Overall, most improvement strategies were not or only weakly associated with patient experience ratings in 2019 and changes in ratings over time. Still, positive associations were discovered between the strategies 'nursing ward interventions' and 'hospital wide education' and recommendation of the hospital. CONCLUSIONS Patient experiences have improved modestly in Flemish acute-care hospitals. Hospitals report to have invested in patient experience improvement strategies but positive associations between such strategies and FPS scores are weak, although there is potential in further exploring nursing ward interventions and hospital wide education. Hospitals should continue their efforts to improve the patient's experience, but with a more targeted approach, taking the lessons learned on the efficacy of strategies into consideration.
Collapse
Affiliation(s)
- Astrid Van Wilder
- Leuven Institute for Healthcare Policy, KU Leuven—University of Leuven, Leuven, Flanders, Belgium
| | - Kris Vanhaecht
- Leuven Institute for Healthcare Policy, KU Leuven—University of Leuven, Leuven, Flanders, Belgium
- Department of Quality Improvement, University Hospitals Leuven, Leuven, Flanders, Belgium
| | - Dirk De Ridder
- Leuven Institute for Healthcare Policy, KU Leuven—University of Leuven, Leuven, Flanders, Belgium
- Department of Urology, University Hospitals Leuven, Leuven, Flanders, Belgium
| | - Bianca Cox
- Leuven Institute for Healthcare Policy, KU Leuven—University of Leuven, Leuven, Flanders, Belgium
| | - Jonas Brouwers
- Leuven Institute for Healthcare Policy, KU Leuven—University of Leuven, Leuven, Flanders, Belgium
| | - Fien Claessens
- Leuven Institute for Healthcare Policy, KU Leuven—University of Leuven, Leuven, Flanders, Belgium
| | | | - Svin Deneckere
- Leuven Institute for Healthcare Policy, KU Leuven—University of Leuven, Leuven, Flanders, Belgium
- Flemish Institute for Quality of Care, Brussels, Belgium
| | - Dirk Ramaekers
- Leuven Institute for Healthcare Policy, KU Leuven—University of Leuven, Leuven, Flanders, Belgium
- Flemish Hospital Indicator Initiative, Brussels, Belgium
| | | | | | - Luk Bruyneel
- Leuven Institute for Healthcare Policy, KU Leuven—University of Leuven, Leuven, Flanders, Belgium
- Department of Quality Improvement, University Hospitals Leuven, Leuven, Flanders, Belgium
| |
Collapse
|
7
|
Ryskina KL, Wang H, Foley KA, Merchant RM. Patient and Caregiver Perceptions of Nursing Home Physicians: Insight from Yelp Reviews, 2009-2018. J Am Geriatr Soc 2020; 68:2101-2105. [PMID: 32544277 DOI: 10.1111/jgs.16634] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/06/2020] [Accepted: 05/08/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To describe the content of reviews submitted on Yelp that pertain to nursing home (NH) physicians. DESIGN Retrospective qualitative study. SETTING NHs in the United States reviewed on Yelp from 2009 to 2018 with reviews that discussed NH physicians. PARTICIPANTS Physicians in 375 NHs in 31 states. MEASUREMENTS Content analysis was performed to detect recurrent themes and divergent ideas about NH physicians perceived by reviewers. RESULTS Average rating among NHs with physician reviews was 2.0 (standard deviation = 1.5; range = 1-5). The major themes from content analysis of reviews that discussed physicians were perceived attitudes of clinicians toward patients and caregivers, physician communication with patients or caregivers, and perceived clinical expertise of the physicians. CONCLUSION Unsolicited online reviews of NHs that comment on patient and caregiver perceptions of physician care represent a small but growing number of online comments about NHs. These reviews contain important information about aspects of physician care valued by NH patients and caregivers. However, the sample of comments about physicians represents a small proportion of online reviews and is not representative of all NHs. As online reviews grow in number and become more representative, these data could be used by physicians to improve perceptions of their care by NH patients and their families, and by NHs to inform expectations of their medical director and attending physicians.
Collapse
Affiliation(s)
- Kira L Ryskina
- Division of General Internal Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Hannah Wang
- Jerome Fisher Program in Management and Technology, Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kierra A Foley
- Hillman Scholar in Nursing Innovation at the University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Raina M Merchant
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Center for Digital Health, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA.,Department of Emergency Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
8
|
Agarwal AK, Wong V, Pelullo AM, Guntuku S, Polsky D, Asch DA, Muruako J, Merchant RM. Online Reviews of Specialized Drug Treatment Facilities-Identifying Potential Drivers of High and Low Patient Satisfaction. J Gen Intern Med 2020; 35:1647-1653. [PMID: 31755009 PMCID: PMC7280415 DOI: 10.1007/s11606-019-05548-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Despite the importance of high-quality and patient-centered substance use disorder treatment, there are no standardized ratings of specialized drug treatment facilities and their services. Online platforms offer insights into potential drivers of high and low patient experience. OBJECTIVE We sought to analyze publicly available online review content of specialized drug treatment facilities and identify themes within high and low ratings. DESIGN This was a retrospective analysis of online ratings and reviews of specialized drug treatment facilities in Pennsylvania listed within the 2016 National Directory of Drug and Alcohol Abuse Treatment Facilities. Latent Dirichlet Allocation, a machine learning approach to narrative text, was used to identify themes within reviews. Differential Language Analysis was then used to measure correlations between themes and star ratings. SETTING Online reviews of Pennsylvania's specialized drug treatment facilities posted to Google and Yelp (July 2010-August 2018). RESULTS A total of 7823 online ratings were posted over 8 years. The distribution was bimodal (43% 5-star and 34% 1-star). The average weighted rating of a facility was 3.3 stars. Online themes correlated with 5-star ratings were the following: focus on recovery (r = 0.53), helpfulness of staff (r = 0.43), compassionate care (r = 0.37), experienced a life-changing moment (r = 0.32), and staff professionalism (r = 0.29). Themes correlated with a 1-star rating were waiting time (r = 0.41), poor accommodations (0.26), poor phone communication (r = 0.24), medications given (0.24), and appointment availability (r = 0.23). Themes derived from review content were similar to 9 of the 14 facility-level services highlighted by the Substance Abuse and Mental Health Services Administration's National Survey of Substance Abuse Treatment Services. CONCLUSIONS Individuals are sharing their ratings and reviews of specialized drug treatment facilities on online platforms. Organically derived reviews of the patient experience, captured by online platforms, reveal potential drivers of high and low ratings. These represent additional areas of focus which can inform patient-centered quality metrics for specialized drug treatment facilities.
Collapse
Affiliation(s)
- Anish K Agarwal
- Department of Emergency Medicine at the Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Penn Medicine Center for Digital Health, University of Pennsylvania, Philadelphia, PA, USA.
- Penn Medicine Center for Healthcare Innovation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
| | - Vivien Wong
- Penn Medicine Center for Digital Health, University of Pennsylvania, Philadelphia, PA, USA
- Penn Medicine Center for Healthcare Innovation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Arthur M Pelullo
- Penn Medicine Center for Digital Health, University of Pennsylvania, Philadelphia, PA, USA
- Penn Medicine Center for Healthcare Innovation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sharath Guntuku
- Penn Medicine Center for Digital Health, University of Pennsylvania, Philadelphia, PA, USA
- Penn Medicine Center for Healthcare Innovation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Daniel Polsky
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
| | - David A Asch
- Penn Medicine Center for Digital Health, University of Pennsylvania, Philadelphia, PA, USA
- Penn Medicine Center for Healthcare Innovation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
- Division of General Internal Medicine at the Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA
| | - Jonathan Muruako
- Penn Medicine Center for Digital Health, University of Pennsylvania, Philadelphia, PA, USA
- Penn Medicine Center for Healthcare Innovation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Raina M Merchant
- Department of Emergency Medicine at the Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Penn Medicine Center for Digital Health, University of Pennsylvania, Philadelphia, PA, USA
- Penn Medicine Center for Healthcare Innovation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
9
|
Lester CA, Wang M, Vydiswaran VV. Describing the patient experience from Yelp reviews of community pharmacies. J Am Pharm Assoc (2003) 2019; 59:349-355. [DOI: 10.1016/j.japh.2019.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 01/10/2019] [Accepted: 02/09/2019] [Indexed: 02/01/2023]
|
10
|
Yan E, Kuo DJ. 'I just need an opiate refill to get me through the weekend'. JOURNAL OF MEDICAL ETHICS 2019; 45:219-224. [PMID: 30796090 DOI: 10.1136/medethics-2018-105099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 10/24/2018] [Accepted: 02/03/2019] [Indexed: 06/09/2023]
Abstract
In this article, we discuss the ethical dimensions for the prescribing behaviours of opioids for a chronic pain patient, a scenario commonly witnessed by many physicians. The opioid epidemic in the USA and Canada is well known, existing since the late 1990s, and individuals are suffering and dying as a result of the easy availability of prescription opioids. More recently, this problem has been seen outside of North America affecting individuals at similar rates in Australia and Europe. We argue that physicians are also confronted with an ethical crisis where a capitalist-consumerist society is contributing to this opioid crisis in which societal, legal and business interests push physicians to overprescribe opioids. Individual physicians often find themselves unequipped and unsupported in attempts to curb the prescribing of opioid medications and balance competing goals of alleviating pain against the judicious use of pain medications. Physicians, individually and as a community, must reclaim the ethical mantle of our profession, through a more nuanced understanding of autonomy and beneficence. Furthermore, physicians and the medical community at large have a fiduciary duty to patients and society to play a more active role in curbing the widespread distribution of opioids in our communities.
Collapse
Affiliation(s)
| | - Dennis John Kuo
- Pediatric Hematology-Oncology, University of California, San Diego, California, USA
| |
Collapse
|