AI Article Synopsis
- - Patients with COPD often suffer from pain as both a symptom and a related health issue, but there hasn't been a comprehensive evaluation of current guidelines for managing this pain.
- - Researchers reviewed 32 clinical practice guidelines and found that while most acknowledged pain, only a subset provided specific pain management recommendations, with common strategies including medication, medical assessments, and surgical options.
- - The study concludes that pain management practices for COPD are inconsistent and not adequately supported by evidence, highlighting the need for improved strategies and referrals to specialists for better patient outcomes.
Article Abstract
Context: Patients with chronic obstructive pulmonary disease (COPD) experience pain as both symptom and comorbidity. There has been no evaluation of the recommendations for pain management in updated clinical practice guidelines (CPGs).
Objectives: Update the evidence on pain management, determine alignment of pain management recommendations with best-practice, and advocate for optimal pain management in patients with COPD.
Methods: PubMed, Guideline International Network, Guideline Portal, Agency for Healthcare Research and Quality, National Institute for Healthcare Excellence, Scottish International Guidelines Network, Institute of Medicine, grey literature, national websites, and bibliographies were searched. CPGs available online for stable COPD produced by organizations representing reputable knowledge of COPD management were included. CPGs unavailable online, not translatable into English, or not including techniques within the defined scope were excluded. Researchers performed frequency counts for the verbatim terms "pain," "physical activity," "exercise," "rehabilitation," "physical therap(ist)/(y), "physiotherap(ist)/(y)," recorded context, and collected recommendations for pain management/treatment when present.
Results: Of 32 CPGs, 24 included "pain" verbatim. Of these, 13 included recommendations for pain treatment/management. Common recommendations included opioids, pharmacological management, further medical assessment, and surgical intervention. Two CPGs referred to palliative care, one CPG discussed treating cough, and one discussed massage, relaxation, and breathing.
Conclusions: Pain management recommendations vary and are not aligned with evidence. Pain should be addressed in patients with COPD, whether directly or indirectly related to the disease. Reduction of variability in pain management and the disease burden is necessary. Pain management should include referrals to providers who can maximize benefit of their services.
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| http://dx.doi.org/10.1016/j.rmed.2024.107553 | DOI Listing |
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