Severity of Chronic Pain Affects Health Care Utilization After Kidney Transplantation

Hollisaaz, M.-T.; Noorbala, M.-H.; Irani, Nushafreen; Bahaeloo-Horeh, Saeid; Assari, Shervin; Saadat, Seyed Hassan; Araghizadeh, H; Rezaie, Y.

doi:10.1016/j.transproceed.2007.03.098

Cited by 6 publications

(10 citation statements)

References 21 publications

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“…22 If not managed well, these chronic medical symptoms may lead to considerable social and economic burdens upon patients, caregivers, employers, and society as a whole. 23 Our findings suggest that the MSRP might help promote the healthy behaviors measured by the HPLP-II at a point 12 weeks after commencing the program. Patients rated significant improvement in spiritual growth, health responsibility, physical activity, nutrition, interpersonal relations, and stress management behaviors after the intervention.…”

Section: Discussionmentioning

confidence: 63%

Exploring the Effectiveness of a Comprehensive Mind–Body Intervention for Medical Symptom Relief

Samuelson

Foret

Baim

et al. 2010

The Journal of Alternative and Complementary Medicine

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Objective: The objective of this study was to describe possible changes in physical and psychologic symptoms among outpatients completing a 12-week mind-body medical symptom reduction program related to chronic medical conditions. Design: The cornerstone of the program is elicitation of the relaxation response, and the curriculum also incorporates trainings on mind-body interactions, cognitive restructuring, nutrition, and physical activity. The Medical Symptom Checklist (MSCL), Health Promoting Lifestyle Profile-II (HPLP-II) and Symptom Checklist-90R (SCL-90-R) were used to assess 331 patients' physical and psychologic symptoms before and after the intervention. Results: Significant post-treatment improvements in symptom frequency occurred for 12 individual symptoms on the MSCL, all 6 of the HPLP-II subscales, and 8 of the 9 SCL-90-R subscales from pre-to post-treatment. Conclusions:The results from this uncontrolled study suggest that a comprehensive mind-body intervention program might be useful as a complementary or adjunct therapy for treatment of chronic medical symptoms.

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Section: Discussionmentioning

confidence: 63%

Exploring the Effectiveness of a Comprehensive Mind–Body Intervention for Medical Symptom Relief

Samuelson

Foret

Baim

et al. 2010

The Journal of Alternative and Complementary Medicine

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“…Unterman et al (21) reported that 265 (70%) patients had at least one ED visit among 395 kidney transplant recipients at a single center between 2000 and 2004 with average follow-up of 31 months. A 2007 study of kidney transplant recipients concluded that pain management was a significant contribution to the frequency of ED use (22). Trzeciak et al (23) concluded that infections were the most common indications for admission after discharge from the ED among transplant recipients, including 12% with severe sepsis.…”

Section: Introductionmentioning

confidence: 99%

Emergency Department Visits after Kidney Transplantation

Schold¹,

Elfadawy

Buccini

et al. 2016

Clinical Journal of the American Society of Nephrology

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Background and objectives In 2011, there were approximately 131 million visits to an emergency department in the United States. Emergency department visits have increased over time, far outpacing growth of the general population. There is a paucity of data evaluating emergency department visits among kidney transplant recipients. We sought to evaluate the incidence and risk factors for emergency department visits after initial hospital discharge after transplantation in the United States.Design, setting, participants, & measurements We identified 10,533 kidney transplant recipients from California, New York, and Florida between 2009 and 2012 using the State Inpatient and Emergency Department Databases included in the Healthcare Cost and Utilization Project. We used multivariable Poisson and Cox proportional hazard models to evaluate adjusted incidence rates and time to emergency department visits after transplantation.Results There were 17,575 emergency department visits over 13,845 follow-up years (overall rate =126.9/100 patient-years; 95% confidence interval, 125.1 to 128.8). The cumulative incidences of emergency department visits at 1, 12, and 24 months were 12%, 40%, and 57%, respectively, with median time =19 months; 48% of emergency department visits led to hospital admission. Risk factors for higher emergency department rates included younger age, women, black and Hispanic race/ethnicity, public insurance, depression, diabetes, peripheral vascular disease, and emergency department use before transplant. There was wide variation in emergency department visits by individual transplant center (10th percentile =70.0/100 patient-years; median =124.6/100 patient-years; and 90th percentile =187.4/100 patient-years).Conclusions The majority of kidney transplant recipients will visit an emergency department in the first 2 years post-transplantation, with significant variation by patient characteristics and individual centers. As such, coordination of care through the emergency department is a critical component of post-transplant management, and specific acumen of transplant-related care is needed among emergency department providers. Additional research assessing best processes of care for post-transplant management and health care expenditures and outcomes associated with emergency department visits for transplant recipients are warranted.

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“…The literature suggests that self-reported pain is associated with high utilization of health care services as it can lead to other impairments [28,[59][60][61] and is a key predictor of patient-initiated visits [62].…”

Section: Discussionmentioning

confidence: 99%

Planning for what? Challenging the assumptions of health human resources planning

et al. 2009

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Severity of Chronic Pain Affects Health Care Utilization After Kidney Transplantation

Cited by 6 publications

References 21 publications

Exploring the Effectiveness of a Comprehensive Mind–Body Intervention for Medical Symptom Relief

Exploring the Effectiveness of a Comprehensive Mind–Body Intervention for Medical Symptom Relief

Emergency Department Visits after Kidney Transplantation

Planning for what? Challenging the assumptions of health human resources planning

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