Objectives: Management of patients with chronic musculoskeletal pain (CMP) remains a challenge in general practice. The general practitioner (GP) often experiences diagnostic uncertainty despite frequently referring patients with CMP to specialized departments. Therefore, it remains imperative to gain insights on how to optimize and reframe the current setup for the management of patients with CMP. The objective was to explore GP's perspectives on the challenges, needs, and visions for improving the management of patients with CMP.
Methods: A qualitative study with co-design using the future workshop approach. Eight GPs participated in the future workshop (five females). Insights and visions emerged from the GP's discussions and sharing of their experiences in managing patients with CMP. The audio-recorded data were subjected to thematic text analysis.
Results: The thematic analysis revealed four main themes, including (1) challenges with current pain management, (2) barriers to pain management, (3) the need for a biopsychosocial perspective, and (4) solutions and visions. All challenges are related to the complexity and diagnostic uncertainty for this patient population. GPs experienced that the patients' biomedical understanding of their pain was a barrier for management and underlined the need for a biopsychosocial approach when managing the patients. The GPs described taking on the role of coordinators for their patients with CMP but could feel ill-equipped to handle diagnostic uncertainty. An interdisciplinary unit was recommended as a possible solution to introduce a biopsychosocial approach for the examination, diagnosis, and management of the patient's CMP.
Conclusions: The complexity and diagnostic uncertainty of patients with CMP warrants a revision of the current setup. Establishing an interdisciplinary unit using a biopsychosocial approach was recommended as an option to improve the current management for patients with CMP.
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http://dx.doi.org/10.1515/sjpain-2023-0070 | DOI Listing |
Front Parasitol
July 2023
Facultad de Ciencias Medicas de Cordoba, Universidad Nacional de Cordoba, Cordoba, Argentina.
Introduction: According to estimates by the World Health Organization, the infection and disease caused by the protozoan parasite affects almost 6 million people, and more than 1 million suffer chagasic cardiomyopathy (Ch-CMP). It is estimated that 376,000 of these individuals live in Argentina. This study describes the characteristics and medical management of individuals with Ch-CMP in Argentina.
View Article and Find Full Text PDFSensors (Basel)
December 2024
Mines Saint-Etienne, Centre CMP, Département BEL, F-13541 Gardanne, France.
The primary method of treatment for patients suffering from drug-resistant focal-onset epilepsy is resective surgery, which adversely impacts neurocognitive function. Radio frequency (RF) ablation and laser ablation are the methods with the most promise, achieving seizure-free rates similar to resection but with less negative impact on neurocognitive function. However, there remains a number of concerns and open technical questions about these two methods of thermal ablation, with the primary ones: (1) heating; (2) hemorrhage and bleeding; and (3) poor directionality.
View Article and Find Full Text PDFHealthcare (Basel)
December 2024
School of Engineering, University of Southern Queensland, Springfield, QLD 4300, Australia.
: This article presents analytical techniques and a decision support tool to aid in hospital capacity assessment and case mix planning (CMP). To date, no similar techniques have been provided in the literature. : Initially, an optimization model is proposed to analyze the impact of making a specific change to an existing case mix, identifying how patient types should be adjusted proportionately to varying levels of hospital resource availability.
View Article and Find Full Text PDFAcad Radiol
January 2025
Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (Y.X., B.X., Z.W., C.P., M.X.). Electronic address:
Rationale And Objectives: To develop and externally validate interpretable CT radiomics-based machine learning (ML) models for preoperative Ki-67 expression prediction in clear cell renal cell carcinoma (ccRCC).
Methods: 506 patients were retrospectively enrolled from three independent institutes and divided into the training (n=357) and external test (n=149) sets. Ki67 expression was determined by immunohistochemistry (IHC) and categorized into low (<15%) and high (≥15%) expression groups.
J ISAKOS
January 2025
Laboratory Study of Movement, Instituto de Ortopedia e Traumatologia do Hospital das Clínicas (IOT-HC), Faculdade de Medicina, Universidade de São Paulo (FMSUP), São Paulo, SP; Brazil.
Introduction: Chondromalacia patella (CMP) is characterized by cartilage degeneration, affects young adults, more women (2:1) and is responsible for 75% of knee pain complaints in the active population. The etiology is multifactorial and may be related to extrinsic factors (trauma and burden) and intrinsic factors (patellar malalignment and quadriceps weakness). Isokinetic dynamometry (ID) can aid in the detection of the causal factors of knee pain related to CMP.
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