Barriers and facilitators to use of non-pharmacological treatments in chronic pain

Becker, William C.; Dorflinger, Lindsey; Edmond, Sara N.; Islam, Leila Z.; Heapy, Alicia; Fraenkel, Liana

doi:10.1186/s12875-017-0608-2

Cited by 202 publications

(189 citation statements)

References 39 publications

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“…Our review also demonstrates that certain non-pharmacological interventions, which were suggested to be less prone to the occurrence of undesirable side effects [53], can be effective in symptom management and enhancing QOL. For example, psychotherapeutic interventions such as yoga could effectively reduce fatigue among breast cancer survivors, while cognitive behavioral therapy could help address sleep disturbance, enhance survivors' QOL, and reduce their perceived burden of hot flashes and night sweats.…”

Section: Discussionmentioning

confidence: 75%

The Effects of Pharmacological and Non-Pharmacological Interventions on Symptom Management and Quality of Life among Breast Cancer Survivors Undergoing Adjuvant Endocrine Therapy: A Systematic Review

Chan

Tai

Kwong

et al. 2020

IJERPH

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Breast cancer survivors need to undergo adjuvant endocrine therapy after completion of curative treatments to prevent disease recurrence. These individuals often experience symptoms which are detrimental to their quality of life (QOL). Implementation of interventions for effective symptom management among these survivors is warranted. This review provides an overview of studies on the effectiveness of the previously developed interventions for breast cancer survivors undergoing adjuvant endocrine therapy on symptom alleviation and enhancement of QOL or health-related QOL (HRQOL). Five electronic databases were employed in the literature search. Study selection, data extraction and critical appraisal of the included studies were conducted by three authors independently. Twenty-four studies were included. Both pharmacological and non-pharmacological interventions are effective in addressing the symptoms associated with adjuvant endocrine therapy among the breast cancer survivors, and in improving their QOL, although discrepancies were noted between the studies in terms of the significance of these effects. Pharmacological and non-pharmacological interventions can be effective for symptom management among breast cancer survivors. Their implementation is recommended for effective survivorship care for these individuals. Further research on intervention development for breast cancer survivors is recommended to provide further evidence for the utility of the explored interventions in survivorship care for these patients.

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Section: Discussionmentioning

confidence: 75%

The Effects of Pharmacological and Non-Pharmacological Interventions on Symptom Management and Quality of Life among Breast Cancer Survivors Undergoing Adjuvant Endocrine Therapy: A Systematic Review

Chan

Tai

Kwong

et al. 2020

IJERPH

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“…Several barriers to implementation of non-pharmacological methods had also been identi ed such as knowledge and experience of the nurse, availability of time, heavy workload, patients' uncooperativeness and local policies and procedures (15,17). In actual situation nurses experience a lot of hurdles to execute and use the non-pharmacological methods, which are in uenced by various factors, such as prolonged course of treatment, time required, and perceived pain or stress that may accompany engagement in nonpharmacological methods were identi ed as a barriers by the nurses (18). Among many others, lack of administrative support, lack of resources, nurses' heavy work load, shortage of nurses, lack of nurse's knowledge and lack of patient's cooperation were some of the few mentioned barriers towards the practice of non-pharmacological methods (18,19).…”

Section: Introductionmentioning

confidence: 99%

Utilization of Non-Pharmacological Methods and the Perceived Barriers for Adult Postoperative Pain Management by the Nurses at Selected National Hospitals in Asmara, Eritrea

Kidanemariam

Elsholz

Simel

et al. 2020

Preprint

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Background Postoperative pain remains a concern to both patients and health care professionals. Non-pharmacological pain relief methods have the potential to complement pharmacological interventions and may offer alternative treatment options. The aim of the study was to assess nurses’ utilization of postoperative nurses’ non-pharmacological pain relief methods and the perceived barriers for their implementation in the National Hospitals. Methods Descriptive cross sectional study was conducted among 154 nurses working at the National Referral Hospitals and Sembel Private Hospital. A standardized five-point Likert-scale questionnaire which assesses nurses' utilization of selected non-pharmacological methods and the perceived barriers for the implementation of those methods were used to collect data. Descriptive statistics for the demographic data, independent samples t-test and one way ANOVA for the nurses’ utilization of the non-pharmacological methods and perceived barriers were used to analyze the data. Statistical significance level was set at P < 0.05. Results The study found that emotional support (45.5%), helping with daily activities (67.5%) and creating a comfortable environment (61%) were reported to be the most frequently used methods, whereas the cognitive-behavioral (5.9%) and physical methods (5.8%) were found with less frequency. The results also show that characteristics, such as the nurses' age (p = 0.013), education (p = 0.012), work experience (p = 0.001) and place of work (p = 0.001), were significantly related to the use of non-pharmacological methods. Among the various perceived barriers, health care system related barriers such as heavy work load (87.7%), shortage of time (84.4%), limited resources (82.5%), deficit in the guidelines for pain management (77.3%), lack of administrative support (76.6%) followed by patient related barriers such as patients uncooperative behavior (57.1%) were identified. Conclusion Only few of the non-pharmacological methods were found to be utilized by the nurses as pain relieving strategies and various perceived barriers are existing among the nurses towards the utilization of these methods. Nurses in these settings need training and education on non-pharmacological pain relief methods, particularly on methods that are utilized less often.

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“…Additionally, there is lack of empirical evidence guiding multiple aspects of opioid prescribing practices for cancer patients (Paice et al, 2016) and a number of inconsistencies among existing national pain management guidelines (Meghani & Vapiwala, 2018), underscoring a need to further expand knowledge on opioid management for cancer pain. Careful pharmacological management of cancer pain continues to be important for optimal pain control and function, especially until there is consistent access to nonopioid and nonpharmacological treatments for chronic pain, which remains limited in the United States (Becker et al, 2017;Meghani & Vapiwala, 2018).…”

Section: Discussionmentioning

confidence: 99%

Both Race and Insurance Type Independently Predict the Selection of Oral Opioids Prescribed to Cancer Outpatients

Meghani

Rosa

Chittams

et al. 2020

Pain Management Nursing

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a b s t r a c tBackground: Previous research suggests that racial disparities in patients' reported analgesic adverse effects are partially mediated by the type of opioid prescribed to African Americans despite the presence of certain comorbidities, such as renal disease. Aims: We aimed to identify independent predictors of the type of opioid prescribed to cancer outpatients and determine if race and chronic kidney disease independently predict prescription type, adjusting for relevant sociodemographic and clinical confounders. Design: We conducted a secondary analysis of a 3-month observational study. Setting: Outpatient oncology clinics of an academic medical center. Participants/Subjects: Patients were older than 18 years of age, self-identified as African American or White, and had an analgesic prescription for cancer pain. Methods: Cancer patients (N ¼ 241) were recruited from outpatient oncology clinics within a large mid-Atlantic healthcare system. Results: Consistent with published literature, most patients (75.5%) were prescribed either morphine or oxycodone preparations as oral opioid therapy for cancer pain. When compared with Whites, African Americans were significantly more likely to be prescribed morphine (33% vs 14%) and less likely to be prescribed oxycodone (38% vs 64%) (p < .001). The estimated odds for African Americans to receive morphine were 2.573 times that for Whites (95% confidence interval 1.077-6.134) after controlling for insurance type, income, and pain levels. In addition, the presence of private health insurance was negatively associated with the prescription of morphine and positively associated with prescription of oxycodone in separate multivariable models. The presence of chronic kidney disease did not predict type of analgesic prescribed. Conclusions: Both race and insurance type independently predict type of opioid selection for cancer outpatients. Larger clinical studies are needed to fully understand the sources and clinical consequences of racial differences in opioid selection for cancer pain.

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Barriers and facilitators to use of non-pharmacological treatments in chronic pain

Cited by 202 publications

References 39 publications

The Effects of Pharmacological and Non-Pharmacological Interventions on Symptom Management and Quality of Life among Breast Cancer Survivors Undergoing Adjuvant Endocrine Therapy: A Systematic Review

The Effects of Pharmacological and Non-Pharmacological Interventions on Symptom Management and Quality of Life among Breast Cancer Survivors Undergoing Adjuvant Endocrine Therapy: A Systematic Review

Utilization of Non-Pharmacological Methods and the Perceived Barriers for Adult Postoperative Pain Management by the Nurses at Selected National Hospitals in Asmara, Eritrea

Both Race and Insurance Type Independently Predict the Selection of Oral Opioids Prescribed to Cancer Outpatients

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