Browsing by Subject "pain management"

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    Achieving balance in federal and state pain policy: a guide to evaluation (Evaluation guide 2006). [Part 1]
    (2006-09) University of Wisconsin. School of Medicine and Public Health. Pain & Policy Studies Group.
    Assesses federal and state policies regarding the use of controlled substances for pain management, palliative care and end-of-life care. Part 1 contains Sections I - VII of the report, and the federal profile of Section VIII. Part 2 contains state profiles for Alabama - Illinois. Part 3 contains state profiles for Indiana - Michigan. Part 4 contains state profiles for Minnesota - South Dakota. Part 5 contains state profiles for Tennessee - Wyoming, Section IX and the appendices.
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    Achieving balance in federal and state pain policy: a guide to evaluation (Evaluation guide 2006). [Part 2]
    (2006-09) University of Wisconsin. School of Medicine and Public Health. Pain & Policy Studies Group.
    Assesses federal and state policies regarding the use of controlled substances for pain management, palliative care and end-of-life care. Part 1 contains Sections I - VII of the report, and the federal profile of Section VIII. Part 2 contains state profiles for Alabama - Illinois. Part 3 contains state profiles for Indiana - Michigan. Part 4 contains state profiles for Minnesota - South Dakota. Part 5 contains state profiles for Tennessee - Wyoming, Section IX and the appendices.
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    Achieving balance in federal and state pain policy: a guide to evaluation (Evaluation guide 2006). [Part 3]
    (2006-09) University of Wisconsin. School of Medicine and Public Health. Pain & Policy Studies Group.
    Assesses federal and state policies regarding the use of controlled substances for pain management, palliative care and end-of-life care. Part 1 contains Sections I - VII of the report, and the federal profile of Section VIII. Part 2 contains state profiles for Alabama - Illinois. Part 3 contains state profiles for Indiana - Michigan. Part 4 contains state profiles for Minnesota - South Dakota. Part 5 contains state profiles for Tennessee - Wyoming, Section IX and the appendices.
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    Achieving balance in federal and state pain policy: a guide to evaluation (Evaluation guide 2006). [Part 4]
    (2006-09) University of Wisconsin. School of Medicine and Public Health. Pain & Policy Studies Group.
    Assesses federal and state policies regarding the use of controlled substances for pain management, palliative care and end-of-life care. Part 1 contains Sections I - VII of the report, and the federal profile of Section VIII. Part 2 contains state profiles for Alabama - Illinois. Part 3 contains state profiles for Indiana - Michigan. Part 4 contains state profiles for Minnesota - South Dakota. Part 5 contains state profiles for Tennessee - Wyoming, Section IX and the appendices.
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    Achieving balance in federal and state pain policy: a guide to evaluation (Evaluation guide 2006). [Part 5]
    (2006-09) University of Wisconsin. School of Medicine and Public Health. Pain & Policy Studies Group.
    Assesses federal and state policies regarding the use of controlled substances for pain management, palliative care and end-of-life care. Part 1 contains Sections I - VII of the report, and the federal profile of Section VIII. Part 2 contains state profiles for Alabama - Illinois. Part 3 contains state profiles for Indiana - Michigan. Part 4 contains state profiles for Minnesota - South Dakota. Part 5 contains state profiles for Tennessee - Wyoming, Section IX and the appendices.
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    Achieving balance in state pain policy: a progress report card (Second edition)
    (2006-09) University of Wisconsin. School of Medicine and Public Health. Pain & Policy Studies Group.
    A "report card" for state policies regulating pain medications used for pain management and palliative care.
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    Analysis of a Standardized Perioperative Pain Management Order Set in Highly Opioid-Tolerant Patients
    (Lippincott, Williams, and Wilkins, 2015) Isaacs, Alex N.; Knight, Kellie L.; Nisly, Sarah A.; Department of Medicine, IU School of Medicine
    Objective: The aim was to assess a standardized order set for perioperative pain management in highly opioid-tolerant patients undergoing elective orthopedic surgery. Methods: This retrospective chart review evaluated a pain order set in highly opioid-tolerant patients undergoing elective total knee or total hip arthroplasty from January 2010 through August 2012. Based on the date of the surgery, patients were allocated into preimplementation or postimplementation order set groups. The primary outcome assessed whether an adjustment in daily opioid dosage was required within the first 48 hours postoperatively. Secondary outcomes included pain scores, length of hospitalization, and safety outcomes. Results: Sixty patients were included in the analysis. An adjustment to postoperative opioid therapy occurred in 62% of the patients in the preimplementation group and in 56% of postimplementation group patients (P = 0.786). There were no differences in median pain scores 48 hours postoperatively (P = 0.348). Cumulative toxicity was increased after order set implementation compared with previous patients (44% versus 5%, P < 0.005); however, opioid doses held for sedation was the only individual toxicity to reach statistical significance (P = 0.011). Conclusions: This study is the first to evaluate a standardized order set for pain management in highly opioid-tolerant patients undergoing elective orthopedic surgery. The order set demonstrated similar efficacy to previous treatment modalities, but opioid-induced sedation was of concern with the order set. After the initial analysis, the order set was modified to minimize opioid-induced sedation. Continual safety analysis is warranted for quality improvement to enhance perioperative pain management in highly opioidtolerant patients
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    Benefits of Intervention in Managing Chronic Pain
    (Office of the Vice Chancellor for Research, 2014-04-11) Benbow, Kyle L.; Miller, Megan; Scott, Eric; Kroenke, Kurt
    As studies of individuals with chronic pain continue more is being understood about cognitive and behavioral components that drive pain. While the goal of treatment is to reduce or eliminate the locus of pain, another model known as intervention, focuses more on self-management and cognitive change. The presented research is the 12-month results of trails of intervention for chronic pain management. Three hundred participants were recruited from the VA of Indianapolis. All participants were being seen in a primary care setting for severe pain that persisted for more than 3 months. Participants were randomly assigned to two groups: the control group, which would continue receiving the usual care for their pain; and the variable group, which would receive intervention. Intervention methods included automated home-based monitoring, selective care manager calls, weekly case review with MD specialist and escalation of therapy using an evidence-based stepped care analgesic algorithm. Participants pain was measured using the Brief Pain Inventory (BPI), which is a self-report assessing the severity of pain and impact of pain on daily functioning. The trial results showed that a 1-point difference in BPI scores between the intervention and control group. Participants in the intervention group showed a good adherence and satisfaction with automate and nurse components of intervention. These results show pain management through intervention has a positive effect on pain, which in turn has an effect on depression, anxiety, and outlook. Intervention aims to empower patients to become active participants in the management of their illness and feel more in control of their pain in hopes of giving them a better outlook of their situation.
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    A Brief Peer Support Intervention for Veterans with Chronic Musculoskeletal Pain: A Pilot Study of Feasibility and Effectiveness
    (Wiley, 2015-01) Matthias, Marianne S.; McGuire, Alan B.; Kukla, Marina; Daggy, Joanne; Myers, Laura J.; Bair, Matthew J.; Department of Communication Studies, School of Liberal Arts
    Objective The aim of this study was to pilot test a peer support intervention, involving peer delivery of pain self-management strategies, for veterans with chronic musculoskeletal pain. Design Pretest/posttest with 4-month intervention period. Methods Ten peer coaches were each assigned 2 patients (N = 20 patients). All had chronic musculoskeletal pain. Guided by a study manual, peer coach–patient pairs were instructed to talk biweekly for 4 months. Pain was the primary outcome and was assessed with the PEG, a three-item version of the Brief Pain Inventory, and the PROMIS Pain Interference Questionnaire. Several secondary outcomes were also assessed. To assess change in outcomes, a linear mixed model with a random effect for peer coaches was applied. Results Nine peer coaches and 17 patients completed the study. All were male veterans. Patients' pain improved at 4 months compared with baseline but did not reach statistical significance (PEG: P = 0.33, ICC [intra-class correlation] = 0.28, Cohen's d = −0.25; PROMIS: P = 0.17, d = −0.35). Of secondary outcomes, self-efficacy (P = 0.16, ICC = 0.56, d = 0.60) and pain centrality (P = 0.06, ICC = 0.32, d = −0.62) showed greatest improvement, with moderate effect sizes. Conclusions This study suggests that peers can effectively deliver pain self-management strategies to other veterans with pain. Although this was a pilot study with a relatively short intervention period, patients improved on several outcomes.
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    Characterizing the role of haloperidol for analgesia in the Emergency Department
    (Nova Science, 2019) Cowling, Matt; Covington, Stephen; Roehmer, Christian; Musey, Paul; Medicine, School of Medicine
    The purpose of this study was to characterize emergency department (ED) physicians' beliefs and current practices regarding the use of haloperidol for the management of acute and acute on chronic pain. METHODS: A survey regarding haloperidol use was distributed by email to attending physicians, resident physicians, nurse practitioners, and physician assistants at emergency medicine departments in the Indiana University Health System and at St Joseph Mercy Ann Arbor. RESULTS: Of the 129 responses received, the majority (89.1%) of providers had used haloperidol for control of pain in the ED. The most common reason that respondents used haloperidol to treat pain was that they did not want to use an opioid or other agent (91.3%). The majority of providers (73.9%) believed that haloperidol was effective because there is a psychiatric component to pain, while over half of respondents (58.3%) chose haloperidol as they believed it to have analgesic properties. When haloperidol was used as a first line medication, providers felt that it was effective in controlling pain about 69.0% of the time without the need for further medication. The most common presentations for use were for unspecified abdominal pain, headache, and gastroparesis. CONCLUSION: ED providers reported using haloperidol most often as a second line treatment to manage both acute and acute on chronic pain. When haloperidol was used as a first line agent, providers claimed that additional medicines were not usually required. Haloperidol may provide an effective alternative to opioids in treatment of acute pain and acute exacerbations of chronic pain in the ED.