Purpose: Although physicians view failure to assess pain systematically as the most important barrier to outpatient cancer pain management, little is known about pain assessment in this setting. We sought to determine whether pain is routinely assessed and whether routine quantitative pain assessment is feasible in a busy outpatient oncology practice.
Patients And Methods: We conducted a pre- and postintervention chart review of 520 randomly selected medical and radiation oncology patient visits at a community hospital-based private outpatient practice. The intervention consisted of training health assistants (HAs) to measure and document patient pain scores by using a visual analog scale. The main outcome measures included HA documentation of patient pain scores, quantitative and qualitative mention of pain in the physician note, and analgesic treatment before and after the intervention.
Results: After the intervention, HA documentation of pain scores increased from 1% to 75.6% (P < .0001). Physician documentation increased from 0% to 4.8% for quantitative documentation (P < .01), and from 60.0% to 68.3% for qualitative documentation (not significant). Of all the patients, 23.1% reported significant pain. Subgroups with greater pain included patients actively receiving radiation treatments and patients with lung cancer. Of patients with significant pain, 28.2% had no mention of pain in the physician note and 47.9% had no documented analgesic treatment.
Conclusion: Quantitative pain assessment was virtually absent before our intervention but easily implemented and sustained in a busy outpatient oncology practice. Pain score collection identified a high prevalence of pain, patient subgroups at risk for pain, and a significant proportion of patients with pain that was neither evaluated nor treated by their oncologists.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1200/JCO.2001.19.2.501 | DOI Listing |
Am J Drug Alcohol Abuse
January 2025
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Kratom is a plant with alkaloids acting at opioid, serotonergic, adrenergic, and other receptors. Consumers report numerous use motivations. To distinguish subgroups of kratom consumers by kratom-use motivations using latent-class analysis.
View Article and Find Full Text PDFJMIR Form Res
January 2025
Faculty of Medicine, The University of Queensland, Brisbane, Australia.
Background: Opioid medications are important for pain management, but many patients progress to unsafe medication use. With few personalized and accessible behavioral treatment options to reduce potential opioid-related harm, new and innovative patient-centered approaches are urgently needed to fill this gap.
Objective: This study involved the first phase of co-designing a digital brief intervention to reduce the risk of opioid-related harm by investigating the lived experience of chronic noncancer pain (CNCP) in treatment-seeking patients, with a particular focus on opioid therapy experiences.
JMIR Res Protoc
January 2025
Institute for Health Care Management and Research, University of Duisburg-Essen, Essen, Germany.
Background: Artificial intelligence (AI)-based clinical decision support systems (CDSS) have been developed for several diseases. However, despite the potential to improve the quality of care and thereby positively impact patient-relevant outcomes, the majority of AI-based CDSS have not been adopted in standard care. Possible reasons for this include barriers in the implementation and a nonuser-oriented development approach, resulting in reduced user acceptance.
View Article and Find Full Text PDFJBJS Case Connect
January 2025
Cedars Sinai Medical Center, Los Angeles, California.
Case: A 14-year-old male athlete presented with a 9-month history of low back pain, worse with hyperextension. Nonoperative management for bilateral L4 spondylolysis had been unsuccessful. The patient underwent a novel magnetic resonance imaging (MRI) that generated a synthetic computed tomography (sCT).
View Article and Find Full Text PDFJBJS Case Connect
January 2025
Department of Orthopedic Surgery, Texas Tech University Health Sciences, Center; Lubbock, Texas.
Case: We present a 42-year-old man who developed extensive left lower extremity arterial thrombosis following COVID-19 pneumonia. Despite multiple revascularization attempts and a below-knee amputation, he faced wound necrosis and insufficient soft tissue coverage. An innovative approach using a pedicled flap and sequential flow-through free flaps was used for limb salvage.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!