Publications by authors named "Amy G McNeilage"
Purpose: To evaluate the acceptability and feasibility of a consumer co-designed telehealth intervention which aimed to reduce claimant distress by providing pain management strategies, informational and social support to people who had made a compensation claim following road traffic musculoskeletal injury.
Methods: Eleven claimant participants who were at risk of a poor outcome completed the intervention in a one-on-one setting with the same clinician delivering the program across all sessions.They were interviewed about their experience (acceptability and feasibility including the use of telehealth).
Introduction: In light of the risks of over-reliance on opioid analgesia during recovery from rib fractures, there is increased interest in the efficacy of non-pharmacological approaches to pain management. This paper describes the protocol for a double-blind randomised controlled trial to evaluate the efficacy of an mHealth intervention for reducing pain intensity, pain-related distress and opioid use during early recovery from rib fractures.
Methods And Analysis: Adults (N=120) with isolated rib fractures will be recruited within 24 hours of admission to a large public hospital in Sydney, Australia (single site), and randomised (1:1 allocation) to an intervention or active control group.
Purpose: Recovering from compensable injuries can be influenced by a variety of factors including the claimant's experience of distress during the claims process. In order to develop cross-scheme, nation-wide strategies to improve claimants' interactions with the compensation system, reduce claimant distress, and improve claimant outcomes, it is important to understand sources of claims-related distress from the perspective of both claimants and clinicians.
Methods: An exploratory qualitative design was undertaken using semi-structured interviews with 13 claimants and 26 clinicians from four injury compensation schemes in five Australian states.
Article Synopsis
- Gabapentinoids, widely prescribed for pain, have been linked to misuse and dependence, prompting a systematic review of qualitative research on this issue.* -
- The review analyzed 26 high-quality studies, revealing motives for misuse such as seeking euphoria, self-medicating, and dealing with withdrawal symptoms, along with symptoms of dependence including tolerance and severe withdrawal effects.* -
- Findings indicate significant public health concerns regarding gabapentinoid use, as misuse can lead to harmful effects like overdose and psychiatric issues, highlighting the need for careful prescribing practices.*
Article Synopsis
- The study investigates the experiences of clinicians in Australia who provide care to patients with compensable injuries, highlighting the challenges they face in this stressful environment.* -
- Through interviews with 26 clinicians, it was found that they deal with high patient distress and administrative burdens, leading to feelings of emotional exhaustion in some while others find meaning and purpose in their work.* -
- Positive coping strategies, such as mentoring and continuous education, enhance clinician well-being and improve patient care, stressing the importance of a supportive workplace culture.*
Introduction: Understanding patient motivations and expectations of orthognathic surgery are critical aspects of the perioperative assessment, as these factors have been demonstrated to influence patient satisfaction with surgical outcomes.
Materials And Methods: Consecutive patients undergoing orthognathic surgery by a tertiary oral and maxillofacial surgeon underwent two structured interviews to explore their pre-operative motivations for orthognathic surgery, their post-operative reflections on the surgery and their outcomes. Interviews were transcribed verbatim and analysed using thematic analysis.
Background: Musculoskeletal injuries can cause distress, and distress is associated with delayed recovery. Numerous interventions have been developed to facilitate recovery from injury, and several systematic reviews evaluate the efficacy of these interventions for reducing psychological distress.
Objectives: This scoping review aims to map the synthesised evidence for the relationship between treatment interventions and distress-related outcomes following acute injury.
Introduction: Recent changes in opioid prescribing guidelines have led to an increasing number of patients with chronic pain being recommended to taper. However, opioid tapering can be challenging, and many patients require support.
Objectives: We evaluated the feasibility, acceptability, and potential efficacy of a codesigned digital health intervention to support patients with chronic pain during voluntary prescription opioid tapering.
Introduction: Increases in pain and interference with quality of life is a common concern among people with chronic non-cancer pain (CNCP) who are tapering opioid medications. Research indicates that access to social and psychological support for pain self-management may help people to reduce their opioid dose without increasing pain and interference. This study evaluates the efficacy of a text messaging intervention designed to provide people with CNCP with social and psychological support for pain self-management while tapering long-term opioid therapy (LTOT) under the guidance of their prescriber.
View Article and Find Full Text PDFIntroduction: Gabapentinoids are among the most widely prescribed pain medications. However, there is growing evidence to suggest that gabapentinoids may be associated with dependence and misuse. The aim of this systematic review is to synthesise the qualitative literature on gabapentinoid misuse and symptoms of dependence.
View Article and Find Full Text PDFArticle Synopsis
- The study explored the experiences of 12 adults in Australia using gabapentinoids (pregabalin or gabapentin) for chronic pain management through semi-structured interviews.
- Participants initially turned to gabapentinoids out of desperation for pain relief, influenced by the perception that these medications are a safer alternative to opioids, despite mixed feelings about their effectiveness and safety once they began using them.
- The results highlight the need for better communication between patients and healthcare providers, emphasizing a patient-centered approach in prescribing gabapentinoids and suggesting further research on the factors influencing their increased use.
Introduction: Recent changes in opioid prescribing guidelines have led to an increasing number of patients with chronic pain being recommended to taper. However, opioid tapering can be challenging, and many patients require support.
Objectives: We evaluated the feasibility, acceptability, and potential efficacy of a co-designed psycho-educational video and SMS text messaging intervention to support patients with chronic pain during prescription opioid tapering.
Background: People living with chronic pain report that tapering prescribed opioids is challenging and more support is needed. In our formative research, consumers indicated that mobile health (mHealth) technology could be an acceptable form of support for opioid tapering and may improve tapering self-efficacy.
Objective: We aimed to evaluate and improve the content of an mHealth intervention before pilot-testing, based on consumer and clinician feedback.
Occupational burnout is a critical issue affecting the welfare of veterinary care providers, their patients, and the sustainability of veterinary healthcare organizations. The current research aimed to evaluate the prevalence of and factors contributing to stress, wellbeing, burnout symptoms and job satisfaction among clinical and non-clinical staff at a large specialist small animal hospital in Australia. Participants completed an anonymous online survey including self-report measures of job satisfaction and symptoms of burnout, and open-text response questions probing sources of stress and wellbeing.
View Article and Find Full Text PDFIntroduction: Opioid medications are no longer recommended as long-term therapy for chronic non-cancer pain, and many patients are advised to reduce or discontinue opioid medications. Many patients report difficulties in tapering opioid medications, necessitating supporting interventions. This protocol describes a pilot randomised controlled trial (RCT) to investigate the acceptability, feasibility and potential efficacy of a mobile health intervention to improve the opioid tapering self-efficacy of patients with chronic non-cancer pain.
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- The study aimed to review various interventions aimed at reducing long-term opioid treatment for chronic non-cancer pain, focusing on factors like dose reduction, pain, function, quality of life, and withdrawal symptoms.
- A systematic review was conducted, gathering data from multiple databases, leading to the exclusion of many studies due to high risk of bias, with only 36 studies included for analysis.
- Results showed low to very low certainty in the evidence for most outcomes; however, a moderate certainty indicated that interventions supporting prescribers' adherence to guidelines could improve patient discontinuation of opioids.
Article Synopsis
- Patients tapering off prescription opioids often seek better coping support for pain and withdrawal symptoms, and mobile health technologies could fill this gap by offering educational and motivational resources.
- The study investigates how patients with chronic pain interact with mobile technology for health care, their willingness to use mobile health support, and their preferences regarding the format and content of such support.
- In a sample of 21 patients, all owned mobile phones, with a high percentage using apps, indicating strong potential for engaging with mobile health resources during opioid tapering.
Tapering opioids for chronic pain can be challenging for both patients and prescribers, both of whom may be unsure of what to expect in terms of pain, distress, activity interference, and withdrawal symptoms over the first few weeks and months of the taper. To better prepare clinicians to provide patient-centred tapering support, the current research used prospective longitudinal qualitative methods to capture individual-level variation in patients' experience over the first few months of a voluntary physician-guided taper. The research aimed to identify patterns in individuals' experience of tapering and explore whether patient characteristics, readiness to taper, opioid tapering self-efficacy, or psychosocial context were related to tapering trajectory.
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- Frequent exposure to patient distress leads to higher burnout rates among clinicians, particularly those working with chronic pain patients.
- A study involving 176 clinicians from pain clinics in Australia found that many experienced symptoms of burnout, with significant links to their confidence in managing emotions.
- The qualitative data highlighted the emotional challenges faced by clinicians, while positive workplace relationships and teamwork were key factors for wellbeing.