Implementing a chronic pain ambulatory care: preliminary results

Castro, Silvana de; Cavalcanti, Ismar Lima; Barrucand, Louis; Pinto, Cecília Izidoro; Assad, Alexandra Rezende; Verçosa, Núbia

doi:10.1016/j.bjane.2019.01.003

Cited by 5 publications

(6 citation statements)

References 24 publications

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“…In the present study, it was observed that 13.8% of the patients were already using opioids, similarly to other results 22 , in which 20% of the patients had been prescribed opioids. Moreover, it was also noted that the use of opioid analgesics was related to an increased risk profile for opioid abuse (p=0.004).…”

Section: Discussionsupporting

confidence: 91%

Risk of opioid abuse in non-oncologic chronic pain outpatient clinic

Costa¹,

Rates²,

Azevedo³

2021

Brazilian Journal of Pain

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BACKGROUND AND OBJECTIVES: Chronic pain has become an extremely prevalent disease and an ever more recurrent reason for seeking medical attention. It has been treated with opioids, opening the possibility for abuse. This study's objective was to analyze the risk profile for opioid abuse in chronic pain outpatients. METHODS: Cross-sectional study with 72 patients seen in an outpatient clinic of a public hospital in the period of July and August 2019. The variables analyzed were age, gender, comorbidities, drugs in use, and aspects related to pain such as intensity, anatomical location, etiology, and need to be absent from work. In addition, a questionnaire was applied to assess the risk of opioid abuse. RESULTS:The study analyzed 72 patients with chronic pain, most of whom were women (84.7%). The mean age was 52.8 years. Patients were classified into three groups according to the risk of opioid abuse: high (21%), moderate (29%) and low (50%). There was an association of increased risk with opioid use (p=0.004) and presence of depression (p=0.003). CONCLUSION: Half of the patients presented low risk for opioid abuse. Increased risk for opioid abuse is related to the presence of depression or depressive symptoms. No relationship was observed between benzodiazepines use and increased risk for opioid abuse. Patients considered at high risk for opioid abuse are more likely to develop aberrant behaviors. Knowing the patient's risk profile is necessary to increase the safety and effectiveness of chronic pain treatment.

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Section: Discussionsupporting

confidence: 91%

Risk of opioid abuse in non-oncologic chronic pain outpatient clinic

Costa¹,

Rates²,

Azevedo³

2021

Brazilian Journal of Pain

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“…Agostinho et al 14 , encontrou que a dor no ombro acometeu 73,98% das mulheres e 26,02% dos homens. Também foi observado por Castro et al 15 , em atendimento ambulatorial para dor crônica que a prevalência de dor em mulheres em 83%.…”

Section: Discussionunclassified

Impacto da dor na qualidade de vida do paciente com dor crônica

Kanematsu

Atanazio

Cunha

et al. 2022

Rev. Med. (São Paulo)

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Introdução: A dor crônica é uma experiência sensitiva e emocional desagradável, que persiste ou se repete por mais de 3 meses. Por ser uma condição multidimensional, que afeta aspectos biopsicossociais, impacta na qualidade de vida dos indivíduos que convivem com ela, assim o objetivo do estudo foi avaliar este impacto em pacientes de unidades básicas de saúde no noroeste paulista. Metodologia: Foi realizado um inquérito investigativo, em que os 379 voluntários, maiores de 18 anos, de ambos os sexos, com dor crônica, que responderam sobre a relação da qualidade de vida e dor crônica. Resultados: dos participantes 82 eram homens (22%) e 297 mulheres (78%), sendo a maioria maiores de 50 anos (58%), casados (54%), com escolaridade do ensino fundamental (48%) e ensino médio (41%). Constatou-se correlação positiva entre prejuízos na qualidade de vida e baixa escolaridade, sexo feminino e estado civil casados. Conclusões: A prevalência de dor crônica na população geral é maior em mulheres do que em homens, casados, maiores de 50 anos, com baixa escolaridade em consonância com a literatura. Estes resultados são importantes para o planejamento de políticas públicas e a capacitação dos profissionais, de modo a realizarmos uma abordagem multidimensional no acolhimento do paciente com dor.

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“…Castro et al reinforced that most of the patients assisted in the ambulatory pain have already been treated by several different medical specialties without success. They refer this to a lack of training of health professionals that has no specialization on pain purposes (Castro et al, 2019). Finally, although one in four Brazilians have access to private insurance, in 13% of the time they seek medical assistance in the public services (Fontenelle et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

“…Even though chronic pain is an important public health problem, there is little data related to chronic pain patients' characteristics among the Brazilian population. Most recent data showed that patients who seek ambulatory care specialized in pain usually experience severe pain, with a predominance of mixed pain (a combination of nociceptive and neuropathic mechanisms) (Castro et al, 2019). Lower limbs and lumbar region are the main sites of pain complaint leading to a diagnosis of low back pain in most cases.…”

Section: Introductionmentioning

confidence: 99%

Chronic pain patients in the Brazilian private healthcare system: a claim database study with the experts’ perspective

Henriques¹,

Ogata²,

Gondo³

et al. 2022

JBES

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Objective: This study aimed to describe the demands and costs from chronic pain patients over the private Brazilian healthcare system. Methods: This was a retrospective claim database study to assess the resource utilization of pain patients in the private setting. We used a four-year follow-up period to assess inpatient, outpatient, and procedures reported. Further, we promoted a forum of discussion with five pain experts and healthcare managers to address the management of chronic pain and assistance models.Results: We identified 79,689 patients with chronic pain. The orthopedist was the main medical specialist consulted with a total number of 38,879 visits performed. The ophthalmologist, cardiologist, gynecologist, and general practitioner were also frequently consulted (rheumatologist was seldom consulted). Among non-medical specialists, the physical therapist was consulted 87,574 times by 12,342 patients (15% of the entire cohort), Among chronic pain patients, 96% performed at least one exam and 86% of the patients presented at least one ER visit during the follow-up period. In 4 years, we estimate that pain patients costed more than 3 billion reais to the private health care system. According to the experts’ opinions, a fragmented healthcare system and the lack of patient centered interdisciplinary approaches contributes to a high ineffective pain management leading to a high use of resources. Conclusion: There is an urgent need to change the chronic pain care model in the Brazilian private setting. Qualification in pain management, a multidisciplinary patient centered care, integrated approaches, pain centers, and patients’ education may help changing this scenario.

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Implementing a chronic pain ambulatory care: preliminary results

Cited by 5 publications

References 24 publications

Risk of opioid abuse in non-oncologic chronic pain outpatient clinic

Risk of opioid abuse in non-oncologic chronic pain outpatient clinic

Impacto da dor na qualidade de vida do paciente com dor crônica

Chronic pain patients in the Brazilian private healthcare system: a claim database study with the experts’ perspective

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