Who is at risk for inadequate pain treatment?
Mar 15, 2016 · Pain might go unrecognized, and patients, particularly members of racial and ethnic minority groups, women, the elderly, persons with cognitive impairment, and those with cancer and at the end of life, can be at risk for inadequate pain treatment (4). Patients can experience persistent pain that is not well controlled.
When should a patient be treated for chronic pain?
Chronic noncancer pain (CNCP) is a major challenge for clinicians as well as for the patients who suffer from it. The complete elimination of pain is rarely obtainable for any substantial period. Therefore, patients and clinicians should discuss treatment goals that include reducing pain, maximizing function, and improving quality of life. The best outcomes can be achieved when …
Why are Hispanics at high risk for pain and pain undertreatment?
A 43 year old medical director of a licensed methadone treatment program for opioid use disorder wants to reduce the overdose risk of the patients at his clinic. Which strategy is unlikely to reduce overdose risk for individuals in the community who could benefit from methadone treatment
What are the treatment goals for chronic pain management?
Infants have the same capacity for pain as adults, but are at high risk for undertreatment of pain because they are nonverbal.
What type of pain are antidepressants and anticonvulsants most beneficial for?
Antidepressants and anticonvulsants have been shown to be efficacious in the treatment of neuropathic pain, chronic headache, and other chronic pain conditions. They may be useful in the treatment of disorders in which central nervous system hypersensitivity con-tributes to pain.
Why is pain management a priority?
Pain interferes with many daily activities, and one of the goals of acute pain management is to reduce the affect of pain on patient function and quality of life. The ability to resume activity, maintain a positive affect or mood, and sleep are relevant functions for patients following surgery.
Which of the following best describes palliative care as opposed to hospice care?
Palliative Care vs Hospice Care Hospice is comfort care without curative intent; the patient no longer has curative options or has chosen not to pursue treatment because the side effects outweigh the benefits. Palliative care is comfort care with or without curative intent.
Which of the following best describe palliative care?
Definition. Palliative care is specialized medical care for people living with a serious illness. This type of care is focused on providing relief from the symptoms and stress of the illness. The goal is to improve quality of life for both the patient and the family.
What is the treatment of pain?
pain medicines. physical therapies (such as heat or cold packs, massage, hydrotherapy and exercise) psychological therapies (such as cognitive behavioural therapy, relaxation techniques and meditation) mind and body techniques (such as acupuncture)
What are barriers to managing pain?
The [Institute of Medicine] committee [has] identified several important barriers to adequate pain care in the United States. These include the magnitude of the problem, provider attitudes and training, insurance coverage, cultural attitudes of patients, geographic barriers, and regulatory barriers.
For which of the following patients would palliative care be most appropriate?
Palliative care is a resource for anyone living with a serious illness, such as heart failure, chronic obstructive pulmonary disease , cancer, dementia, Parkinson's disease, and many others. Palliative care can be helpful at any stage of illness and is best provided soon after a person is diagnosed.Mar 24, 2022
What are the 4 types of palliative care?
Areas where palliative care can help. Palliative treatments vary widely and often include: ... Social. You might find it hard to talk with your loved ones or caregivers about how you feel or what you are going through. ... Emotional. ... Spiritual. ... Mental. ... Financial. ... Physical. ... Palliative care after cancer treatment.More items...
How do you explain palliative care to patients?
Palliative care is specialized medical care for people living with a serious illness. This type of care is focused on providing relief from the symptoms and stress of the illness. The goal is to improve quality of life for both the patient and the family.
What is the role of palliative care?
Palliative care is specialized medical care that focuses on providing patients relief from pain and other symptoms of a serious illness, no matter the diagnosis or stage of disease. Palliative care teams aim to improve the quality of life for both patients and their families.Aug 15, 2017
What is palliative care nursing?
Palliative nursing is the assessment, diagnosis, and treatment of human responses to actual or potentially life-limiting illnesses within the context of a dynamic caring relationship with the patient and family in order to reduce or relieve suffering and optimize health (wholeness, integrity of the person, quality of ...
What are three of the principles of palliative care?
PrinciplesPrinciple 1: Care is patient, family and carer centred. ... Principle 2: Care provided is based on assessed need. ... Principle 3: Patients, families and carers have access to local and networked services to meet their needs. ... Principle 4: Care is evidence-based, clinically and culturally safe and effective.More items...
What are the consequences of chronic pain?
There are clinical, psychological, and social consequences associated with chronic pain including limitations in complex activities, lost work productivity, reduced quality of life, and stigma, emphasizing the importance of appropriate and compassionate patient care ( 4 ).
What is chronic pain?
Chronic pain can be the result of an underlying medical disease or condition, injury, medical treatment, inflammation, or an unknown cause ( 4 ). Estimates of the prevalence of chronic pain vary, but it is clear that the number of persons experiencing chronic pain in the United States is substantial.
Why do we use GAD-7?
Because psychological distress frequently interferes with improvement of pain and function in patients with chronic pain, using validated instruments such as the Generalized Anxiety Disorder (GAD)-7 and the Patient Health Questionnaire (PHQ)-9 or the PHQ-4 to assess for anxiety, post-traumatic stress disorder, and/or depression ( 205 ), might help clinicians improve overall pain treatment outcomes. Experts noted that clinicians should use additional caution and increased monitoring (see Recommendation 7) to lessen the increased risk for opioid use disorder among patients with mental health conditions (including depression, anxiety disorders, and PTSD), as well as increased risk for drug overdose among patients with depression. Previous guidelines have noted that opioid therapy should not be initiated during acute psychiatric instability or uncontrolled suicide risk, and that clinicians should consider behavioral health specialist consultation for any patient with a history of suicide attempt or psychiatric disorder ( 31 ). In addition, patients with anxiety disorders and other mental health conditions are more likely to receive benzodiazepines, which can exacerbate opioid-induced respiratory depression and increase risk for overdose (see Recommendation 11). Clinicians should ensure that treatment for depression and other mental health conditions is optimized, consulting with behavioral health specialists when needed. Treatment for depression can improve pain symptoms as well as depression and might decrease overdose risk (contextual evidence review). For treatment of chronic pain in patients with depression, clinicians should strongly consider using tricyclic or SNRI antidepressants for analgesic as well as antidepressant effects if these medications are not otherwise contraindicated (see Recommendation 1).
What is the CDC guideline for opioids?
This guideline provides recommendations for primary care clinicians who are prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care. The guideline addresses 1) when to initiate or continue opioids for chronic pain; 2) opioid selection, dosage, duration, follow-up, and discontinuation; and 3) assessing risk and addressing harms of opioid use. CDC developed the guideline using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework, and recommendations are made on the basis of a systematic review of the scientific evidence while considering benefits and harms, values and preferences, and resource allocation. CDC obtained input from experts, stakeholders, the public, peer reviewers, and a federally chartered advisory committee. It is important that patients receive appropriate pain treatment with careful consideration of the benefits and risks of treatment options. This guideline is intended to improve communication between clinicians and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder, overdose, and death. CDC has provided a checklist for prescribing opioids for chronic pain ( http://stacks.cdc.gov/view/cdc/38025) as well as a website ( http://www.cdc.gov/drugoverdose/prescribingresources.html) with additional tools to guide clinicians in implementing the recommendations.
How often should you evaluate opioids?
Clinicians should evaluate benefits and harms with patients within 1 to 4 weeks of starting opioid therapy for chronic pain or of dose escalation. Clinicians should evaluate benefits and harms of continued therapy with patients every 3 months or more frequently.
What is the opioid prescribed for?
Background. Opioids are commonly prescribed for pain. An estimated 20% of patients presenting to physician offices with noncancer pain symptoms or pain-related diagnoses (including acute and chronic pain) receive an opioid prescription ( 1 ).
Can opioids cause pregnancy?
Opioids used in pregnancy might be associated with additional risks to both mother and fetus. Some studies have shown an association of opioid use in pregnancy with stillbirth, poor fetal growth, pre-term delivery, and birth defects (contextual evidence review). Importantly, in some cases, opioid use during pregnancy leads to neonatal opioid withdrawal syndrome. Clinicians and patients together should carefully weigh risks and benefits when making decisions about whether to initiate opioid therapy for chronic pain during pregnancy. In addition, before initiating opioid therapy for chronic pain for reproductive-age women, clinicians should discuss family planning and how long-term opioid use might affect any future pregnancy. For pregnant women already receiving opioids, clinicians should access appropriate expertise if considering tapering opioids because of possible risk to the pregnant patient and to the fetus if the patient goes into withdrawal (see Recommendation 7). For pregnant women with opioid use disorder, medication-assisted therapy with buprenorphine or methadone has been associated with improved maternal outcomes and should be offered ( 202) (see Recommendation 12). Clinicians caring for pregnant women receiving opioids for pain or receiving buprenorphine or methadone for opioid use disorder should arrange for delivery at a facility prepared to monitor, evaluate for, and treat neonatal opioid withdrawal syndrome. In instances when travel to such a facility would present an undue burden on the pregnant woman, it is appropriate to deliver locally, monitor and evaluate the newborn for neonatal opioid withdrawal syndrome, and transfer the newborn for additional treatment if needed. Neonatal toxicity and death have been reported in breast-feeding infants whose mothers are taking codeine (contextual evidence review); previous guidelines have recommended that codeine be avoided whenever possible among mothers who are breast feeding and, if used, should be limited to the lowest possible dose and to a 4-day supply ( 203 ).
What is chronic pain?
Chronic pain is a common, complex, and distressing problem, which has a significant impact on society and individuals .1It commonly presents as a result of an injury or a disease; however, it is a separate condition in its own right, ...
How does nutrition help with chronic pain?
Nutrition management plans may be of benefit to patients with chronic pain by improving pain management and reducing cardiovascular risk factors that are related to chronic pain.
What is prevalence in health?
Prevalence is the proportion of the at-risk population affected by a condition. Population estimates for the prevalence of chronic pain vary widely according to case definition and ascertainment methods, and time place and population.
Is chronic pain a disease?
Chronic pain is a common, complex, and distressing problem that has a profound impact on individuals and society. It frequently presents as a result of a disease or an injury; however, it is not merely an accompanying symptom, but rather a separate condition in its own right, with its own medical definition and taxonomy.