American Pain Society Recommendations for Improving the Quality of Acute and Cancer Pain Management

Gordon, Debra B.; Dahl, June L.; Miaskowski, Christine; McCarberg, Bill; Todd, Knox H.; Paice, Judith A.; Lipman, Arthur G.; Bookbinder, Marilyn; Sanders, Steve H.; Turk, Dennis C.; Carr, Daniel B.

doi:10.1001/archinte.165.14.1574

Cited by 597 publications

(461 citation statements)

References 72 publications

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“…38 Several organizations, including the AGS, the American Pain Society, the Joint Commission, the IOM, and the Agency for Healthcare Research and Quality (AHRQ), have issued standards regarding timely, tailored, and adequate pain assessment and treatment. 1,4,[39][40][41][42][43][44][45][46] However, pain care remains inconsistent and inadequate in many health care settings including the ED, [47][48][49][50] and there has been minimal decrease in overall pain intensity scores nationally. 48,51 Advanced age is the strongest predictor of receiving no analgesic for painful conditions in EDs.…”

Section: Resultsmentioning

confidence: 99%

“…Several prominent organizations have issued standards regarding pain assessment and treatment. 1,4,[39][40][41][42][43][44][45][46] The standards for pain care include pain assessments in all patients, the documentation of regular reassessments, and attention to pain symptom management during discharge planning. 60,61 If pain is not assessed appropriately, then appropriate treatment cannot be determined.…”

Section: Resultsmentioning

confidence: 99%

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Quality Indicators for Geriatric Emergency Care

Terrell

Hustey²,

Hwang³

et al. 2009

Academic Emergency Medicine

163

120

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Objectives: Emergency departments (EDs), similar to other health care environments, are concerned with improving the quality of patient care. Older patients comprise a large, growing, and particularly vulnerable subset of ED users. The project objective was to develop ED-specific quality indicators for older patients to help practitioners identify quality gaps and focus quality improvement efforts.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Quality Indicators for Geriatric Emergency Care

Terrell

Hustey²,

Hwang³

et al. 2009

Academic Emergency Medicine

163

120

View full text Add to dashboard Cite

show abstract

“…5,36 Physicians, therefore, must balance the fundamental need to adequately treat conditions that require controlled medications while remaining cognizant of the potential misuse and diversion of these medications. Although clinical guidelines are available to support treatment of pain and other conditions, 37,38 physicians often feel ill equipped.…”

Section: Figurementioning

confidence: 99%

Prescribing of Controlled Medications to Adolescents and Young Adults in the United States

et al. 2010

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WHAT'S KNOWN ON THIS SUBJECT:The nonmedical use of prescription drugs by adolescents and young adults has surpassed all illicit drugs except marijuana and has become an increasing public health concern. Adolescents and young adults are in the most likely age groups to abuse prescription medications. WHAT THIS STUDY ADDS: OBJECTIVE:The nonmedical use of prescription drugs by adolescents and young adults has surpassed all illicit drugs except marijuana, yet little is known about prescribing patterns. We examined the prescribing of controlled medications to adolescents aged 15 to 19 and young adults aged 20 to 29. METHODS:We used cross-sectional data from the National Ambulatory Medical Care Survey (N ϭ 4304 physicians) and the National Hospital Ambulatory Medical Care Survey (N ϭ 2805 clinics; N ϭ 1051 emergency departments) between 2005 and 2007. We also used consecutive data from 1994 to describe trends. RESULTS:A controlled medication was prescribed at 2.3 million visits by adolescents and 7.8 million visits by young adults in 2007. Between 1994 and 2007, controlled medications were prescribed at an increasing proportion of visits from adolescents (6.4%-11.2%) and young adults (8.3%-16.1%) (P Ͻ .001 for trend). This increase was seen among males and females, in ambulatory offices and emergency departments, and for injury-related and non-injury-related visits (all P Ͻ .001). A controlled medication was prescribed during 9.6% of all adolescent visits and 13.8% of young-adult visits for non-injury-related indications and at 14.5% of adolescent visits and 27.0% of young-adult visits for injury-related reasons. Controlled medications were prescribed at a substantial proportion of visits for common conditions, such as back pain, to both adolescents (23.4%) and young adults (36.9%). CONCLUSIONS:Controlled medications are prescribed at a considerable proportion of visits from adolescents and young adults, and prescribing rates have nearly doubled since 1994. This trend and its relationship to misuse of medications warrants further study. Pediatrics

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“…Estimates suggest that up to 79% of hospitalized cancer patients experience pain [8][9][10][11]. The primary treatment for cancer-related pain focuses on the use of analgesic and adjuvant medications; and while complementary therapies may be offered in some settings, they are widely considered to be underutilized [9,[12][13].…”

Section: Introductionmentioning

confidence: 99%

Patients’ perceptions of the effectiveness of guided imagery and progressive muscle relaxation interventions used for cancer pain

Kwekkeboom

Hau

Wanta

et al. 2008

Complementary Therapies in Clinical Practice

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Relaxation and guided imagery are useful strategies for cancer pain; however, their effects vary from patient to patient. Patients' perceptions of these treatments and factors that contribute to their effectiveness have not previously been described. Data from interviews conducted after a trial of guided imagery and progressive muscle relaxation (PMR) interventions were analyzed to compare patients' perceptions of treatment effects with observed changes in pain scores, and to explore patients' ideas about factors that contributed to the effectiveness of each intervention. Post-study interviews were conducted with 26 hospitalized patients with cancer-pain who had completed trials of guided imagery and PMR. In most cases, participants' perceptions of treatment effects matched observed changes in pain scores. Participants described treatment and patient characteristics that influenced effectiveness of the interventions such as active involvement in the intervention, guided instructions, providing a source of distraction, stimulating relaxation, individual abilities and preferences, and pain qualities.

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American Pain Society Recommendations for Improving the Quality of Acute and Cancer Pain Management

Abstract: Efforts to improve the quality of pain management must move beyond assessment and communication of pain to implementation and evaluation of improvements in pain treatment that are timely, safe, evidence based, and multimodal.

Cited by 597 publications

References 72 publications

Quality Indicators for Geriatric Emergency Care

Quality Indicators for Geriatric Emergency Care

Prescribing of Controlled Medications to Adolescents and Young Adults in the United States

Patients’ perceptions of the effectiveness of guided imagery and progressive muscle relaxation interventions used for cancer pain

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