Pain Management

Pain Management

Undertreatment of Pain Among the Elderly

(Undertreatment of Pain Among the Elderly) "Factors affecting the severity of pain in the elderly include
"• complex manifestations of pain;
"• underreporting of pain;
"• concurrent problems and multiple diseases (comorbidities), which complicate diagnosis and treatment;
"• higher rates of medication side effects; and
"• higher rates of treatment complications (American Geriatrics Society, 2009).

Populations At Increased Risk For Chronic Pain And For Inadequate Treatment

(Populations At Increased Risk For Chronic Pain And For Inadequate Treatment) "An important message from epidemiologic studies cited by Blyth and colleagues (2010) is 'the universal presence across populations of characteristic subgroups of people with an underlying propensity or increased risk for chronic pain, in the context of a wide range of different precipitating or underlying diseases and injuries' (p. 282).

Barriers to Adequate Pain Care

(Barriers to Adequate Pain Care) "Adequate pain treatment and follow-up may be thwarted by a mix of uncertain diagnosis and the societal stigma that is applied, consciously or unconsciously, to people reporting pain, particularly if they do not respond readily to treatment. Questions and reservations may cloud perceptions of clinicians, family, employers, and others: Is he really in pain? Is she drug seeking? Is he just malingering? Is she just trying to get disability payments?

Regulatory Barriers to Adequate Pain Care

(Regulatory Barriers to Adequate Pain Care) "In the United States, many pain experts agree that physicians should prescribe opioids when necessary regardless of outside pressures as an exercise of their 'moral and ethical obligations to treat pain' (Payne et al., 2010, p. 11). For some time, observers have attributed U.S. patients’ difficulty in obtaining opioids to pressures on physicians from law enforcement and risk-averse state medical boards.

Majority of Pain Patients Use Prescription Drugs Properly

(Majority of Pain Patients Use Prescription Drugs Properly) "The research findings noted above need to be set against the testimony of people with pain, many of whom derive substantial relief from opioid drugs. This tension perhaps reflects the complex nature of pain as a lived experience, as well as the need for biopsychosocial assessments and treatment strategies that can maximize patients’ comfort and minimize risks to them and society.

Development of Pain Management Model Policy

(Development of Pain Management Model Policy) "In the wake of criticism of state medical boards’ actions against physicians who prescribed large amounts of opioids, the Federation of State Medical Boards developed a model policy in 1998—since adopted by many individual state boards—that supports use of opioids for pain management if appropriately documented by the treating physician (Federation of State Medical Boards of the United States, 2004).

Barriers to Effective Pain Care

(Barriers to Effective Pain Care) "A number of barriers to effective pain care involve the attitudes and training of the providers of care. First, health professionals may hold negative attitudes toward people reporting pain and may regard pain as not worth their serious attention. As discussed in detail in Chapter 2, patients can be at a particular disadvantage if they are members of racial or ethnic minorities, female, children, or infirm elderly.

Strategies to Reduce Risk of Abuse

(Strategies to Reduce Risk of Abuse) "Current voluntary strategies to reduce opioid abuse include
"• the clinician’s assessment in a history and physical exam that includes psychosocial factors, family history, and risk of abuse;
"• the clinician’s regular monitoring of the progress of patients on opioids and assessment for aberrant behavior that may indicate abuse;
"• random urine drug screening and pill counts for patients at risk;

Reasons Why Many in the US Receive Inadequate Treatment for Pain

(Reasons Why Many in the US Receive Inadequate Treatment for Pain) "Currently, large numbers of Americans receive inadequate pain prevention, assessment, and treatment, in part because of financial incentives that work against the provision of the best, most individualized care; unrealistic patient expectations; and a lack of valid and objective pain assessment measures.