Background: Emergency department (ED) patients are among the many groups at risk for prescription drug overdose. There is limited research on how best to communicate with ED patients about options for pain management and the risks of opioids. The aim of this study is to pilot test a web-based, patient-centred educational programme that encourages the patient to have an informed discussion about pain medication options with their ED provider.
Methods: This multisite, randomised trial will evaluate an m-health programme designed to aid the patient in making an informed decision about their pain treatment. Patients reporting to the ED with an injury-related or pain- related chief complaint who agree to participate are randomised to receive the intervention programme, , or an attention-matched control. pairs tailored education with a patient decision aid to describe what opioid and non-opioid pain medications are, assess the patient's risk factors for opioid-related adverse effects, and produce a tailored report that patients are encouraged to share with their doctor. Data are collected through surveys at three time points during the ED encounter (baseline, immediately after the intervention and just before discharge), and at a 6-week follow-up survey. The primary outcomes are whether the patient prefers an opioid pain reliever (OPR) and whether the patient takes an OPR.
Discussion: We hope this programme will facilitate patient-provider communication, as well as reduce the number of prescriptions written for OPRs and thus the number of patients exposed to prescription opioids and the associated risks of addiction and overdose.
Trial Registration Number: NCT03012087; Pre-results.
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http://dx.doi.org/10.1136/injuryprev-2017-042319 | DOI Listing |
Cureus
November 2024
Orthopaedics and Trauma, Russells Hall Hospital, Dudley, GBR.
Background/objective: Adequate postoperative analgesics are an essential element in the recovery and rehabilitation of large joint lower-limb arthroplasty patients in their acute postoperative phase. In this study, we will establish that strong opioids like morphine should be included as postoperative analgesics to improve patient satisfaction. Material: This retrospective cross-sectional study was conducted in the Arthroplasty Ward, Trauma, and Orthopaedics Department in a district general hospital of the United Kingdom.
View Article and Find Full Text PDFWorld J Gastrointest Surg
December 2024
Department of Oncology, Suzhou Ninth People's Hospital, Suzhou 215200, Jiangsu Province, China.
Background: Surgical palliative surgery is a common method for treating patients with middle and late stage gastrointestinal tumors. However, these patients generally experience high levels of cancer pain, which can in turn stimulate the body's stress and undermine the effect of external surgery. Although opioid drugs have a significantly positive effect on controlling cancer pain, they can induce adverse drug reactions and potential damage to the body 's immune function.
View Article and Find Full Text PDFUrogynecology (Phila)
October 2024
From the Urology Institute, University Hospitals/ Cleveland Medical Center, Cleveland, OH.
Importance: Evidence regarding the effect of pudendal nerve blockade during vaginal surgery is conflicting. Previous studies compared pudendal nerve blockade to either normal saline placebo injection or no injection, demonstrating small or no difference in pain outcomes. Studies investigating nerve blocks at the time of vaginal surgery have not evaluated the effect of infiltration of the space around the pudendal nerve.
View Article and Find Full Text PDFBMC Anesthesiol
December 2024
Department of Anesthesiology, Nara Medical University, Shijo-cho 840, Kashihara, Nara, 634-8522, Japan.
Background: Modified thoracoabdominal nerves block through perichondrial approach (M-TAPA) is a trunk block that has been gaining attention for managing postoperative pain following abdominal surgeries since its first report in 2019. We conducted a scoping review on M-TAPA, aiming to comprehensively evaluate existing research, identify the gaps in knowledge, and understand the implications of M-TAPA.
Methods: This scoping review was conducted using databases including PubMed, Embase, Cochrane, and CINAHL to evaluate the clinical efficacy of M-TAPA on April 19, 2024.
Psychopharmacology (Berl)
December 2024
Department of Basic Medical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, 47904, USA.
Rationale: The rise in overdose deaths from synthetic opioids, especially fentanyl, necessitates the development of preclinical models to study fentanyl use disorder (FUD). While there has been progress with rodent models, additional translationally relevant models are needed to examine excessive fentanyl intake and withdrawal signs.
Objective: The current study aimed to develop a translationally relevant preclinical mouse model of FUD by employing chronic intravenous fentanyl self-administration (IVSA).
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