Health service utilisation by people living with chronic non-cancer pain: findings from the Pain and Opioids IN Treatment (POINT) study

Nielsen, Suzanne; Campbell, Gabrielle; Peacock, Amy; Smith, Kimberly; Bruno, Raimondo; Hall, Wayne; Cohen, Milton; Degenhardt, Louisa

doi:10.1071/ah15047

Cited by 15 publications

(20 citation statements)

References 31 publications

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“…Extant literature documents that opioid users report severe pain [64], and have higher healthcare utilization compared with non-opioid users [38,65,66]. Our findings suggest that similarly to other chronic pain conditions, MFS individuals who use opioids report more intense, frequent, and non-remitting pain.…”

Section: Physical and Psychological Burden In Opioid Userssupporting

confidence: 60%

Survey of Pain Therapies in Marfan Syndrome

Speed¹

2017

J Musculoskelet Disord Treat

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Objective: Pain in Marfan syndrome is common, although frequently under diagnosed and undertreated. Few studies have investigated the treatment of pain symptoms in Marfan syndrome and no study has reported on the use of opioid therapy in this patient population. This study aims to characterize the use of pain treatment interventions, including opioid use in individuals with Marfan syndrome. We hypothesize that opioid use would be associated with worse pain and greater psychological burden and that pain-related disability would moderate opioid use.Methods: Individuals with Marfan syndrome completed an online questionnaire assessing pain severity, psychological burden, and pain management therapies. The sample reporting pain (N = 218) were 74.5% female, average age ranging from 35 to 44 years, predominantly white (91%), and majority are employed (53%).Results: Participants frequently use a combination of pharmacological and non-pharmacological therapies, and the most commonly used treatments are over the counter medications and opioid medications. Use of opioids, and non-opioid medications, but not non-pharmacological treatments, increases with pain severity. Individuals who use opioids (34%) report more severe and frequent pain compared to non-opioid users, perceive greater pain-related disability and psychological burden, and more frequently utilize the emergency department. Conclusion:Pharmacological and non-pharmacological treatment for pain in Marfan syndrome is common, although psychotherapeutic interventions are significantly underutilized. Further studies are needed to address pain management in Marfan syndrome. Pain therapies should be multimodal and include adjunctive interventions that reduce pain and suffering, improve function, and enhance quality of life in this patient population.

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Section: Physical and Psychological Burden In Opioid Userssupporting

confidence: 60%

Survey of Pain Therapies in Marfan Syndrome

Speed¹

2017

J Musculoskelet Disord Treat

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“…For example, 34% of a cohort of CNCP participants reported that there had been no clinically significant change in their activity limitations, symptoms, emotions and overall quality of life since starting opioids 23. Significant proportions of the cohort were using complementary or alternative interventions for their pain which have limited or no evidence of efficacy in chronic pain 23 24. In addition, they often report that attending physiotherapy, specialised exercise classes or psychotherapy was often prohibitively expensive and unfunded whereas medicines and general practitioner (GP) visits are at least partially covered by the Australian Medicare and Pharmaceutical Benefits Schemes.…”

Section: Introductionmentioning

confidence: 99%

A protocol for a discrete choice experiment: understanding patient medicine preferences for managing chronic non-cancer pain

et al. 2019

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IntroductionHigh rates of chronic non-cancer pain (CNCP), concerns about adverse effects including dependence among those prescribed potent pain medicines, the recent evidence supporting active rather than passive management strategies and a lack of funding for holistic programme have resulted in challenges around decision making for treatment among clinicians and their patients. Discrete choice experiments (DCEs) are one way of assessing and valuing treatment preferences. Here, we outline a protocol for a study that assesses patient preferences for CNCP treatment.Methods and analysisA final list of attributes (and their levels) for the DCE was generated using a detailed iterative process. This included a literature review, a focus group and individual interviews with those with CNCP and clinicians who treat people with CNCP. From this process a list of attributes was obtained. Following a review by study investigators including pain and addiction specialists, pharmacists and epidemiologists, the final list of attributes was selected (number of medications, risk of addiction, side effects, pain interference, activity goals, source of information on pain, provider of pain care and out-of-pocket costs). Specialised software was used to construct an experimental design for the survey. The survey will be administered to two groups of participants, those from a longitudinal cohort of patients receiving opioids for CNCP and a convenience sample of patients recruited through Australia’s leading pain advocacy body (Painaustralia) and their social media and website. The data from the two participant groups will be initially analysed separately, as their demographic and clinical characteristics may differ substantially (in terms of age, duration of pain and current treatment modality). Mixed logit and latent class analysis will be used to explore heterogeneity of responses.Ethics and disseminationEthics approval was obtained from the University of New South Wales Sydney Human Ethics committee HC16511 (for the focus group discussions, the one-on-one interviews and online survey) and HC16916 (for the cohort). A lay summary will be made available on the National Drug and Alcohol Research Centre website and Painaustralia’s website. Peer review papers will be submitted, and it is expected the results will be presented at relevant pain management conferences nationally and internationally. These results will also be used to improve understanding of treatment goals between clinicians and those with CNCP.

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“…The mean of pain scores suggested a significant reduction has been significantly increased (Figure 5). The results shed light on CAM potential positive effects on chronic pain management and further limiting analgesic misuse that were found in some research [13,16,27].…”

Section: Resultsmentioning

confidence: 59%

Complementary and Alternative Medicine: Managing Chronic Pain and Preventing Analgesic Misuse in the Community

Feng¹

2021

OJCAM

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Background: Chronic pain is one of the top causes of disability in the US. Repeated use and large dosages of analgesic medications increase the risks of side effects, misuse, and dependency. When the pain control cannot be achieved at a satisfactory level, patients may seek complementary and alternative medicine (CAM). There is a dearth of evidence-based practice research showing the effectiveness of CAM in reducing analgesic use.Objective: This pilot study provides evidence to increase awareness of CAM to improve community health and offers nonpharmacological interventions in pain management along with the prevention of analgesic misuse.Methodology: This quantitative research recruited 16 participants in an underserved community in Omaha for phase I sampling, 15 participants for beginning of phase II sampling. The participants from phase I received an education session and completed a survey. Phase II participants received six sessions of CAM education and treatments. The attitude, knowledge level, pain scores, and analgesics usages were collected and analyzed after six sessions.Results: Most health issues likely to be addressed with CAM were chronic pain. Participants increased communication about CAM practice with their providers after completion of phase II. Participants overall pain score and analgesics usage significantly decreased after six weeks of CAM education and treatment. Conclusion:After six sessions of CAM education and treatments, participant pain level and analgesic usage decreased significantly. This study is a good example of a successful intervention in an underserved community population about the effectiveness of CAM approaches on chronic pain and analgesic misuse management.

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Health service utilisation by people living with chronic non-cancer pain: findings from the Pain and Opioids IN Treatment (POINT) study

Cited by 15 publications

References 31 publications

Survey of Pain Therapies in Marfan Syndrome

Survey of Pain Therapies in Marfan Syndrome

A protocol for a discrete choice experiment: understanding patient medicine preferences for managing chronic non-cancer pain

Complementary and Alternative Medicine: Managing Chronic Pain and Preventing Analgesic Misuse in the Community

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