Pain Management Commons^™

Biopsychosocial Management Of Long Covid Fibromyalgia: Lessons From The Penn Medicine Lancaster General Health Fibromyalgia Program, Joseph Harrison, Dennis Given Psy.D.

The Journal of Integrated Primary Care

The COVID-19 pandemic has increased the prevalence of chronic health concerns worldwide, leading to a new population of patients suffering from Long Covid. Patients with Long Covid often experience persistent symptoms impacting multiple organ systems, including neuroimmune and neurological manifestations. Recently, attention has grown toward Long Covid patients developing chronic widespread pain similar to fibromyalgia. Fibromyalgia is a nociplastic pain disorder characterized by widespread pain and central sensitization with fatigue, sleep disturbances, and impairments in cognitive functioning. Given the nascent and limited research exploring new treatment options, patients need support now from biopsychosocial multi-modal pain management strategies. The Fibromyalgia Program …

Development And Validation Of The Pain Resilience And Optimism Scale (Pros), Wonjin Seo

Electronic Thesis and Dissertation Repository

Numerous self-report questionnaires have been used in pain research to explore patients' experiences. However, these questionnaires often employ negatively worded items that can potentially worsen patients' distress. In response to the emergence of positive psychology, this thesis aimed to develop a new questionnaire that adopts a positive and strengths-focused approach, incorporating resilience, to replace the negative items found in existing tools such as the Pain Catastrophizing Scale (PCS). First, the effectiveness of the Connor-Davidson Resilience Scale (CD-RISC) in measuring resilience following trauma was assessed through a systematic review using the COnsensus-based Standards for the selection of health status Measurement INstruments …

Drug-Free Noninvasive Thermal Nerve Block: Validation Of Sham Devices, Michael Fishman, Ahish Chitneni, Alaa Abd-Elsayed, Samuel Grodofsky, Ashley Scherer, Brendan Schetzner, Malvina Klusek, Stephen Popielarski, Stephen Meloni, Steven Falowski, Philip Kim, Konstantin Slavin, Stephen Silberstein

Department of Jefferson Headache Center papers and presentations

Headache is a leading cause of disability and suffering. One major challenge in developing device treatments is demonstrating their efficacy given devices' often-high placebo rate. This paper reviews the importance of validating sham devices as part of finalizing the design for larger-scale prospective randomized controlled trials in patients with chronic headache as well as the results of a prospective, single-blind trial to validate two potential sham noninvasive thermal nerve block devices. Study participants were trained to self-administer thermal nerve block treatment using sham devices in an office visit. Two different sham systems with different temperature profiles were assessed. Devices were …

Utilizing Primary Care To Engage Patients On Opioids In A Psychological Intervention For Chronic Pain, Sikander Chohan, Lyuba Gavrilova Bs, Leah Hect, Kristi Autio, Erin Tobin, Brian K. Ahmedani, Lisa R. Miller-Matero

Medical Student Research Symposium

Introduction: Chronic pain is commonly encountered in primary care. It is often treated with opioids, which can cause overdose and death. Psychological interventions are an effective alternative, yet difficulty engaging patients with opioid prescriptions has led to their underutilization. Offering these interventions in primary care settings may alleviate this barrier.

Objective: Determine whether opioid prescriptions are related to patients engaging in a brief psychological intervention for chronic pain management in primary care.

Study Design: Secondary analysis of a pilot randomized clinical trial (RCT) of a 5-session psychological intervention for chronic pain. Patients with chronic pain (N= 220) were approached to …

Mindfulness And Pain Regulation: The Role Of Acceptance And Commitment Therapy For Individuals With Chronic Pain, Ariana C. White

Honors Theses and Capstones

Chronic pain is a significant and widely prevalent health condition which requires comprehensive care to address the many facets contributing to symptomatology. In 2016, 20% of American adults (about 50 million) reported experiencing chronic pain, of which 7.4% indicated that chronic pain frequently limited their life and participation in activities within the past 3 months (CDC, 2018). As a result, many individuals with chronic pain turn to opioid-based medication for pain relief, but long-term use of opioids actually increases pain sensation (Tobin, 2019). Moreover, opioid medication is unable to target underlying mental health components which emerge as part of chronic …

Attitudes Toward Mindfulness And Adherence In Chronic Pain Management, Sarah Johnson

Global Honors Theses

Chronic pain is a global public health problem, affecting 10-25% of the population. Mindfulness is an effective treatment but requires consistency. Because of its benefit, it is important to examine obstacles to mindfulness practice. In order to determine if negative attitudes toward mindfulness are related to non-adherence, 748 adults with chronic pain were recruited to fill out a series of questionnaires assessing treatment adherence and attitudes toward mindfulness. We found that positive attitudes toward mindfulness predicted reduced adherence. However, those who had more positive feelings toward mindfulness made more attempts at the therapy. Upper and middle-class participants had more positive …

Knowing What We Know: Leveraging Community Knowledge Through Automated Text-Mining, Justin Gardner, Jonathan Tory Toole, Hemant Kalia, Garry Spink Jr., Gordon Broderick

Advances in Clinical Medical Research and Healthcare Delivery

No abstract provided.

Doctor Recommendations Are Related To Patient Interest And Use Of Behavioral Treatment For Chronic Pain And Addiction, Lisa M. Mcandrew, Alexandria Brunkow, Margeaux Cannon, Fiona S. Graff, Jessica L. Martin, Leslie R.M. Hausmann

Educational & Counseling Psychology Faculty Scholarship

The opioid crisis has highlighted the importance of improving patients’ access to behavioral treatments for chronic pain and addiction. What is not known is if patients are interested in receiving these treatments. In this cross-sectional study, over 1000 participants with chronic pain were surveyed using an anonymous online questionnaire on Amazon Mechanical Turk (Mturk) to investigate participants’ use of and interest in pharmacological and behavioral treatments for chronic pain and addiction. Participants also indicated whether their doctor had recommended these treatments. The majority of participants reported using medication for their pain (83.19%) and that their doctor recommended medication (85.05%), whereas …

The Impact Of Virtual Reality On Chronic Pain, Alexis Whitehead

Honors Undergraduate Theses

Chronic pain remains a prevalent problem across the United States. Chronic pain does not seem to have a function and relief of this symptom remains elusive for many sufferers. Virtual reality has been used as an adjunct therapy to decrease acute pain with promising results, but there is little research on whether virtual reality could be used as a successful intervention for those with chronic pain. Virtual reality has few side effects, so it warrants consideration for the treatment of chronic pain. There is growing evidence that there is potential for virtual reality to produce desired results with patients having …

Do Medical Students' Assessments Of A Patient's Pain Vary Significantly With Gender And Year Of Medical Training?, Catherine Phamduy

Scholarship in Medicine - All Papers

Chronic pain is a common ailment among US adults and can lead to high cost of healthcare when not treated effectively. Unfortunately, studies show that characteristics of the patient population and physician may also influence their treatment of patient pain. Increased years of medical training is associated with a decline in empathy, which may be measurable by a decline in physician’s assessment of patient’s pain. Doctors with the least experience tend to underestimate their patient’s pain. However, very little is known about medical students’ assessment of patient-reported pain. The objective is to determine the significant differences in medical students’ perceptions …

The Effect Of The Implementation Of A Quarterly Triad Tool In The Pain Clinic Setting On The Assessment And Mitigation Of Risks In Patients On Chronic Opioid Therapy, Caroline Asava

Evidence-Based Practice Project Reports

The concurrent use of opioids and benzodiazepines (BZDs poses a formidable challenge for clinicians who manage chronic pain. While the escalating use of opioid analgesics for the treatment of chronic pain and the concomitant rise in opioid-related abuse and misuse are widely recognized trends, the contribution of combination use of BZDs, alcohol, and/or other sedative agents to opioid-related morbidity and mortality is underappreciated, even when these agents are used appropriately. Patients with chronic pain who use opioid analgesics along with BZDs have a defined increase in rates of adverse events, overdose, and death, warranting close monitoring. To improve patient outcomes, …

Evaluating The Relationship Between Phq9 And Global Pain Scale (Gps) Scores In Opioid Dependent Adults: A Retrospective Correlational Study, Lori Nolan

DNP Projects

Background: Depression, chronic pain and opioid dependence are conditions commonly encountered in primary care settings. These comorbidities create treatment challenges while negatively influencing outcomes of care. The Patient Health Questionnaire (PHQ9) and Global Pain Scale (GPS) are valid screening tools used to score depression and pain symptoms. The purpose of this study was to determine the relationship between the PHQ9 and Global Pain Scale (GPS) scores in opioid dependent adults with chronic pain to determine whether both tools are necessary.

Methods: This was a descriptive study using a retrospective correlational research design. Data was obtained from the electronic medical records …

Provider Based Interventions To Mitigate Risk For Opioid Pain Medication Abuse Among Adult Patients In A Primary Care Setting, Sheree Lamara Conley-Donaldson

Doctoral Projects

Mental and substance use disorders are predicted to exceed all physical disease processes causing major disability by 2020. Misuse and overdose of opioid pain medications is a significant public health concern in the United States. Approximately 1 in 4 patients receiving prescription opioids in primary care settings struggle with misuse. Half of all opioid prescriptions are written by primary care providers, including nurse practitioners. The purpose of this DNP project was to determine if nurse practitioner providers are implementing evidence-based practice guidelines including screening, brief intervention, and referral to treatment (SBIRT) to mitigate risk of prescription opioid pain medication misuse …

Healthcare Providers’ Perceptions Of Socioeconomically Disadvantaged Patients With Chronic Pain: A Qualitative Investigation, Nicole A. Hollingshead, Marianne S. Matthias, Matthew Bair, Adam T. Hirsh

Journal of Health Disparities Research and Practice

Socioeconomically disadvantaged individuals are at-risk for chronic pain and disparate care. In this qualitative study, we explored providers’ experiences with socioeconomically disadvantaged patients, with a particular focus on providers’: (1) perceptions of socioeconomically disadvantaged patients’ barriers to pain care, (2) attitudes towards this patient population, and (3) chronic pain decisions for these patients. Individual interviews were conducted with twenty-four healthcare providers. Providers discussed several patient-level access barriers, such as not having health insurance, financial constraints, and scheduling difficulties. Providers believed socioeconomically disadvantaged patients were at-risk to misuse prescription opioids and were less comfortable prescribing opioids to these patients. This investigation …

Treating Chronic Pain At A Federally Qualified Health Center: Staff Perspectives, Nathan K. Goins

Doctor of Psychology (PsyD)

Although half of all patients with chronic pain seek treatment with their primary care practitioner, many physicians report being overburdened, with limited confidence in their training in the treatment of chronic pain. Opiate monotherapy remains the most common treatment utilized, despite strong correlations with addiction issues and increased distrust between patients and providers. In response to these issues, multidisciplinary stepped-care approaches utilizing psychoeducation, cognitive therapies, movement-based therapy, pharmaceutical treatment, yoga, and acupuncture have been developed. However, treatment within Federally Qualified Health Centers (FQHC) are complicated by financial constraints and high complexity in patient populations. This study examined the perspectives of …

Chronic Pain Causal Attributions In An Interdisciplinary Primary Care Clinic: Patient-Provider And Provider-Provider Discrepancies, Bryan Jensen

Theses and Dissertations

The purpose of the present study was to investigate the influence of pain causal attributions on patient pain-related functioning, treatment engagement, and clinical outcomes. Additionally, the impact of discordant pain causal attributions between patients and their providers as well as between interdisciplinary providers was examined. Patients rated their pain functioning and causal pain attributions during a regular clinic visit. Following the patient’s visit both the behavioral medicine provider and internal medicine resident provided ratings of similar pain-related functioning domains and causal attributions. Follow-up data were collected from the electronic medical record three months following that clinic visit. Overall, results revealed …