National survey of pain clinics in Croatia: Organization and services

Fidahic, Mahir; Dogan, Katarina; Sapunar, Damir; Puljak, Livia

doi:10.5644/ama2006-124.123

Cited by 7 publications

(5 citation statements)

References 32 publications

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“…Another study of chronic pain treatment in the same hospital showed long waiting times for referral to a tertiary pain clinic and for procedures and referrals to specialists 22. Understaffed pain clinics in Croatia and a narrow focus of work may explain their limited involvement in acute pain management 23. ASA guidelines recommend multimodal pain management, but this was not observed in the present study or the previous studies on acute perioperative pain management,14,24 and the treatment of chronic pain25 at the same hospital.…”

Section: Discussioncontrasting

confidence: 65%

Anesthesia and perioperative pain management during cardiac electronic device implantation

Biočić¹,

Vidosevic²,

Borić³

et al. 2017

JPR

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BackgroundThe degree of pain caused by the implantation of cardiac electronic devices (CEDs) and the type of anesthesia or perioperative pain management used with the procedure have been insufficiently studied. The aim of this study was to analyze perioperative pain management, as well as intensity and location of pain among patients undergoing implantation of CED, and to compare the practice with published guidelines.Patients and methodsThis was a combined retrospective and prospective study conducted at the tertiary hospital, University Hospital Split, Croatia. The sample included 372 patients who underwent CED implantation. Perioperative pain management was analyzed retrospectively in 321 patients who underwent CED implantation during 2014. In a prospective study, intensity and location of pain before, during, and after the procedure were measured by using a numerical rating scale (NRS) ranging from 0 to 10 in 51 patients at the same institution from November 2014 to August 2015.ResultsA quarter of patients received analgesia or sedation before surgery. All the patients received local lidocaine anesthesia. After surgery, 31% of patients received pain medication or sedation. The highest pain intensity was observed during CED implantation with the highest NRS pain score being 8. Some patients reported severe pain (NRS >5) also at 1, 3, 6, 8, and 24 hours after surgery. The most common pain locations were surgical site, shoulder, and chest. Adherence to guidelines for acute perioperative pain management was insufficient.ConclusionPatients may experience severe pain during and after CED implantation. Perioperative pain management was suboptimal, and higher doses of sedation and intensive analgesia are required. Guidelines for acute perioperative pain management and anesthesia during CED implantation should be developed.

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Section: Discussioncontrasting

confidence: 65%

Anesthesia and perioperative pain management during cardiac electronic device implantation

Biočić¹,

Vidosevic²,

Borić³

et al. 2017

JPR

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“…Adherence errors were also frequent (18). In Croatia there is a network of pain clinics, that employ pain specialists that could be consulted for adopting interventions to prevent such ADRs (19).…”

Section: Discussionmentioning

confidence: 99%

Adverse drug reactions of non-opioid and opioid analgesics reported to Croatian national authority from 2007 to 2014

Sunara

Krnić

Puljak

2018

ama

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Objective. Adverse drug reactions (ADRs) are commonly observed in the health services because of system weaknesses and individual errors. Analgesics are widely used and it can be expected that with the increased use one can expect increased number of ADRs of analgesics. The aim of this study was to analyze ADRs of non-opioid and opioid analgesics reported to the Croatian Agency for Medicinal Products and Medical Devices (HALMED) from 2007 to 2014. Methods. HALMED provided data on generic drug name, year of the ADR re- port, type of report, institution, reporting person, patient’s age, sex and ADR type. Results. In the analyzed period 796 ADRs of analgesics were reported, of which 367 (46%) were serious ADRs. Number of ADR reports was continuously increasing during the analyzed period. There were 20 analgesics that had ≥5 reports, making 597 (75%) of all ADR reports for analgesics. The most common adverse reaction re- ports of those 20 analgesics referred to individual drugs (n=16; 80%). Most of the ADR reports were filed by physicians (n=257; 43%), fol- lowed by pharmacists (n=252; 42%). Most side effects (n=572; 96%) were reported spontaneously through appropriate forms by patients or health professionals. ADRs were most commonly reported in wom- en (n=352; 59%) and most of them have occurred in adults (n=354; 59%). The most common ADRs of opioid and non-opioid analgesics have been reported on the skin and mucous membranes. Most serious ADRs were result of action of opioid analgesics. Conclusion. Num- ber of ADR reports in Croatia is continuously increasing and a consid- erable number of them refers to serious ADRs. To keep better track of medications and ADRs it is necessary to educate and encourage health professionals and patients in reporting side effects

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“…The sample size was rather small, with 15 PMPs included. However, based on a survey of pain clinics in Croatia, published in 2015, there were 70 anesthesiologists employed in them 35. If this number is still the same, this sample constitutes 21% of the PMPs who work in pain clinics in Croatia.…”

Section: Limitationsmentioning

confidence: 99%

Risks associated with borrowing and sharing of prescription analgesics among patients observed by pain management physicians in Croatia: a qualitative study

Markotić

Puljak

2016

JPR

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BackgroundUnderstanding and improving patient safety is a key issue in medicine. One of the potential threats to patient safety is the sharing of medication among patients, which is a form of self-medication. This study analyzed experiences and attitudes of pain management physicians (PMPs) about sharing prescription analgesics among patients.MethodsThis qualitative study was conducted by semi-structured interviews among PMPs employed in Croatian pain clinics. The study involved two researchers and 15 PMPs.ResultsAmong PMPs, 80% have seen patients who share their prescription analgesics with other patients for whom prescription is not intended. Most PMPs consider prescription analgesics sharing a risky and negative behavior. Some of them, however, found certain positive aspects associated to it, such as being a benevolent behavior, helping patients to get medications when they need them, and helping them cope with pain.ConclusionThe majority of physicians specialized in pain management encountered patients sharing prescription analgesics. Most of them considered this as risky behavior with a number of potential consequences. It has been noted that this problem is neglected and that physicians should inquire about medication sharing. Direct-to-consumers advertising was perceived as a factor contributing to such behavior. Patient education and more involvement of physicians in identifying this behavior were cited as potential remedies for preventing sharing of prescription analgesics.

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National survey of pain clinics in Croatia: Organization and services

Cited by 7 publications

References 32 publications

Anesthesia and perioperative pain management during cardiac electronic device implantation

Anesthesia and perioperative pain management during cardiac electronic device implantation

Adverse drug reactions of non-opioid and opioid analgesics reported to Croatian national authority from 2007 to 2014

Risks associated with borrowing and sharing of prescription analgesics among patients observed by pain management physicians in Croatia: a qualitative study

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