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A 6-year follow-up study of 122 patients attending a multiprofessional rehabilitation programme for persistent musculoskeletal-related pain.

https://arctichealth.org/en/permalink/ahliterature78830
Source
Int J Rehabil Res. 2007 Mar;30(1):9-18
Publication Type
Article
Date
Mar-2007
Author
Norrefalk Jan-Rickard
Linder Jürgen
Ekholm Jan
Borg Kristian
Author Affiliation
Department of Public Health Sciences, Division of Rehabilitation Medicine, Karolinska University Hospital, Stockholm, Sweden. norrefalk@hotmail.com
Source
Int J Rehabil Res. 2007 Mar;30(1):9-18
Date
Mar-2007
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Age Factors
Analgesics - therapeutic use
Case-Control Studies
Employment - statistics & numerical data
Female
Follow-Up Studies
Humans
Interviews
Male
Middle Aged
Musculoskeletal Diseases - rehabilitation
Pain - rehabilitation
Pain Measurement
Sick Leave
Sweden
Abstract
The aim of the study was to evaluate the outcome 6 years after completing a multiprofessional 8-week rehabilitation programme regarding the following objectives: (1) return to work, (2) level of activity and (3) pain intensity. Of 149 patients attending a rehabilitation programme, 122 were followed up after 6 years, through a structured telephone interview, and their present work situation, level of activity, sleeping habits, their estimated pain intensity and consumption of analgesics were recorded. The questions presented were the same as they had answered before entering the programme. The return-to-work rate was compared to 79 patients in a control group. At the 6-year follow-up, compared to before entering the programme, 52% had returned to work (P
PubMed ID
17293715 View in PubMed
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Source
Neuromodulation. 2013 Nov-Dec;16(6):506-13; discussion 513
Publication Type
Article
Author
Kaare Meier
Lone Nikolajsen
Morten Flink
Ronnie Simonsen
Ioanna Milidou
Troels Staehelin Jensen
Jens Christian Sørensen
Author Affiliation
Danish Pain Research Center, Aarhus University Hospital, Aarhus, Denmark; Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark; Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark; ITmedico, Aarhus, Denmark; Perinatal Epidemiology Research Unit, Aarhus University Hospital, Aarhus, Denmark; and Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.
Source
Neuromodulation. 2013 Nov-Dec;16(6):506-13; discussion 513
Language
English
Publication Type
Article
Keywords
Analgesics - therapeutic use
Chronic Pain - therapy
Computer Security
Databases, Factual
Denmark
Employment
Humans
Internet
Neuralgia - drug therapy - therapy
Neurosurgical Procedures - adverse effects
Pain Measurement
Quality of Life
Questionnaires
Software
Spinal Cord Stimulation - adverse effects
Treatment Outcome
Abstract
?? Spinal cord stimulation (SCS) is increasingly gaining widespread use as a treatment for chronic pain. A widely used electronic registry could play a pivotal role in improving this complex and cost-?intensive treatment. We aimed to construct a comprehensive, universally available data base for SCS.
?? The design considerations behind a new online data base for SCS are presented; basic structure, technical issues, research applications, and future perspectives are described.
?? The Aarhus Neuromodulation Database covers core SCS treatment parameters, including procedure-?related details and complications, and features recording of key success parameters such as pain intensity, work status, and quality of life. It combines easy access to patient information with exhaustive data extraction options, and it can readily be adapted and expanded to suit different needs, including other neuromodulation treatment modalities.
?? We believe that the data base described in this article offers a powerful and versatile data collection tool suited for both clinicians and researchers in the field. The basic data base structure is immediately available on a no?-cost basis, and we invite our colleagues to make use of the data base as part of the efforts to further the field of neuromodulation.
PubMed ID
22882331 View in PubMed
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The abuse potential of the synthetic cannabinoid nabilone.

https://arctichealth.org/en/permalink/ahliterature144124
Source
Addiction. 2010 Mar;105(3):494-503
Publication Type
Article
Date
Mar-2010
Author
Mark A Ware
Emmanuelle St Arnaud-Trempe
Author Affiliation
Pain Clinic, McGill University Health Centre, Montreal, Quebec H3G 1A4, Canada. mark.ware@muhc.mcgill.ca
Source
Addiction. 2010 Mar;105(3):494-503
Date
Mar-2010
Language
English
Publication Type
Article
Keywords
Analgesics - therapeutic use
Antiemetics - therapeutic use
Canada
Cannabinoids - therapeutic use
Dronabinol - adverse effects - analogs & derivatives - therapeutic use
Humans
Off-Label Use
Pain, Intractable - drug therapy - physiopathology
Substance-Related Disorders
Abstract
Nabilone is a synthetic cannabinoid prescription drug approved in Canada since 1981 to treat chemotherapy-induced nausea and vomiting. In recent years, off-label use of nabilone for chronic pain management has increased, and physicians have begun to express concerns about nabilone becoming a drug of abuse. This study evaluates the evidence for abuse of nabilone, which is currently ill-defined.
Scientific literature, popular press and internet databases were searched extensively for evidence of nabilone abuse. Focused interviews with medical professionals and law enforcement agencies across Canada were also conducted.
The scientific literature and popular press reviews found very little reference to nabilone abuse. Nabilone is perceived to produce more undesirable side effects, to have a longer onset of action and to be more expensive than smoked cannabis. The internet review revealed rare and isolated instances of recreational use of nabilone. The database review yielded little evidence of nabilone abuse, although nabilone seizures and thefts have occurred in Canada in the past few years, especially in Ontario. Most law enforcement officers reported no instances of nabilone abuse or diversion, and the drug has no known street value. Medical professionals reported that nabilone is not perceived to be a matter of concern with respect to its abuse potential.
Reports of nabilone abuse are extremely rare. However, follow-up of patients using nabilone for therapeutic purposes is prudent and should include assessment of tolerance and dependence. Prospective studies are also needed to definitively address the issue of nabilone abuse.
Notes
Comment In: Addiction. 2010 Mar;105(3):504-520402994
PubMed ID
20402993 View in PubMed
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Acute pain management in burn patients: appraisal and thematic analysis of four clinical guidelines.

https://arctichealth.org/en/permalink/ahliterature265210
Source
Burns. 2014 Dec;40(8):1463-9
Publication Type
Article
Date
Dec-2014
Author
Hejdi Gamst-Jensen
Pernille Nygaard Vedel
Viktoria Oline Lindberg-Larsen
Ingrid Egerod
Source
Burns. 2014 Dec;40(8):1463-9
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Acute Pain - etiology - psychology - therapy
Adaptation, Psychological
Adult
Analgesics - therapeutic use
Anti-Anxiety Agents - therapeutic use
Anxiety - drug therapy - psychology
Burn Units
Burns - complications - psychology - therapy
Child
Denmark
Evidence-Based Medicine
Humans
Hypnosis, Anesthetic
New Zealand
Pain Management - psychology - standards
Pain Measurement
Pain, Postoperative - psychology - therapy
Practice Guidelines as Topic - standards
Retrospective Studies
Sweden
United States
Abstract
Burn patients suffer excruciating pain due to their injuries and procedures related to surgery, wound care, and mobilization. Acute Stress Disorder, Post-Traumatic Stress Disorder, chronic pain and depression are highly prevalent among survivors of severe burns. Evidence-based pain management addresses and alleviates these complications. The aim of our study was to compare clinical guidelines for pain management in burn patients in selected European and non-European countries. We included pediatric guidelines due to the high rate of children in burn units.
The study had a comparative retrospective design using combined methodology of instrument appraisal and thematic analysis. Three investigators appraised guidelines from burn units in Denmark (DK), Sweden (SE), New Zealand (NZ), and USA using the AGREE Instrument (Appraisal of Guidelines for Research & Evaluation), version II, and identified core themes in the guidelines.
The overall scores expressing quality in six domains of the AGREE instrument were variable at 22% (DK), 44% (SE), 100% (NZ), and 78% (USA). The guidelines from NZ and USA were highly recommended, the Swedish was recommended, whereas the Danish was not recommended. The identified core themes were: continuous pain, procedural pain, postoperative pain, pain assessment, anxiety, and non-pharmacological interventions.
The study demonstrated variability in quality, transparency, and core content in clinical guidelines on pain management in burn patients. The most highly recommended guidelines provided clear and accurate recommendations for the nursing and medical staff on pain management in burn patients. We recommend the use of a validated appraisal tool such as the AGREE instrument to provide more consistent and evidence-based care to burn patients in the clinic, to unify guideline construction, and to enable interdepartmental comparison of treatment and outcomes.
PubMed ID
25277698 View in PubMed
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Adherence to Swedish guidelines for pain treatment in relation to pediatric tonsil surgery: A survey of the multidisciplinary team.

https://arctichealth.org/en/permalink/ahliterature286661
Source
Int J Pediatr Otorhinolaryngol. 2017 Oct;101:123-131
Publication Type
Article
Date
Oct-2017
Author
F. Alm
M. Jaensson
S. Lundeberg
E. Ericsson
Source
Int J Pediatr Otorhinolaryngol. 2017 Oct;101:123-131
Date
Oct-2017
Language
English
Publication Type
Article
Keywords
Analgesics - therapeutic use
Anesthesia
Child
Child, Preschool
Cross-Sectional Studies
Female
Follow-Up Studies
Guideline Adherence
Humans
Male
Pain Management - methods
Pain, Postoperative - drug therapy
Palatine Tonsil - surgery
Patient care team
Surveys and Questionnaires
Sweden
Tonsillectomy - adverse effects
Abstract
Pain management in children after tonsil surgery is essential, and optimal pain treatment has been discussed for many years. Data from the National Tonsil Register in Sweden (NTRS) and a national mapping have demonstrated the need for national pain treatment guidelines for pediatric tonsil surgery. As a result, Swedish national guidelines, together with updated patient information on the website tonsilloperation.se, were developed and implemented in 2013.
The objective of this study was to evaluate the professionals' opinions of and adherence to pain treatment guidelines for pediatric tonsil surgery patients in a two-year follow-up.
This descriptive cross-sectional study was based on data from an inter-professional questionnaire, which was validated by an expert group using a content validity index (S-CVI 0.93). The questionnaire was sent to all Swedish ear, nose and throat (ENT) departments (n = 49) that the NTRS identified as performing tonsil surgery on children younger than 18 years of age. In each clinic, we asked for responses from staff in each of the following professions: ENT physicians, anesthesia physicians, registered nurse anesthetists, and registered nurses in the ENT departments.
Respondents from 48 ENT departments participated, and 139/163 (85%) completed questionnaires were returned. The guidelines were reported as being clear, ensuring patient safety and providing optimal pharmacological treatment. Treatment was given according to the guidelines: Half of the departments gave pre- or intraoperative treatment with clonidine, betamethasone and high-dose paracetamol (acetaminophen). A multimodal pain approach (paracetamol and COX-inhibitors) after hospital discharge was prescribed by all departments after tonsillectomy and, extensively, after tonsillotomy. One-third of the departments prescribed paracetamol with a higher normal dose for the first three postoperative days. Half of the departments prescribed rescue analgesics, clonidine or opioids after tonsillectomy. None of the departments prescribed codeine or tramadol, drugs that are discouraged in the guidelines. The majority of the departments used the website tonsilloperation.se to provide information to the patients and their caregivers.
The respondents' opinions of and the ENT departments adherence to the Swedish national guidelines were considered to be good. The national implementation process in Sweden has impacted the manner in which ENT departments treat pain after tonsil surgery.
PubMed ID
28964282 View in PubMed
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Adrenal response after trauma is affected by time after trauma and sedative/analgesic drugs.

https://arctichealth.org/en/permalink/ahliterature262760
Source
Injury. 2014 Aug;45(8):1149-55
Publication Type
Article
Date
Aug-2014
Author
Camilla Brorsson
Per Dahlqvist
Leif Nilsson
Johan Thunberg
Anders Sylvan
Silvana Naredi
Source
Injury. 2014 Aug;45(8):1149-55
Date
Aug-2014
Language
English
Publication Type
Article
Keywords
Adrenal Cortex Hormones - therapeutic use
Adult
Aged
Aged, 80 and over
Analgesics - therapeutic use
Dehydroepiandrosterone - metabolism
Dehydroepiandrosterone Sulfate - metabolism
Female
Humans
Hydrocortisone - metabolism
Hypnotics and Sedatives - therapeutic use
Logistic Models
Male
Middle Aged
Pituitary-Adrenal Function Tests - methods
Pituitary-Adrenal System - drug effects - metabolism - physiopathology
Practice Guidelines as Topic
Prospective Studies
Sweden
Time Factors
Trauma Severity Indices
Treatment Outcome
Wounds and Injuries - drug therapy - metabolism - physiopathology
Abstract
The adrenal response in critically ill patients, including trauma victims, has been debated over the last decade. The aim of this study was to assess the early adrenal response after trauma.
Prospective, observational study of 50 trauma patients admitted to a level-1-trauma centre. Serum and saliva cortisol were followed from the accident site up to five days after trauma. Corticosteroid binding globulin (CBG), dehydroepiandrosterone (DHEA) and sulphated dehydroepiandrosterone (DHEAS) were obtained twice during the first five days after trauma. The effect of time and associations between cortisol levels and; severity of trauma, infusion of sedative/analgesic drugs, cardiovascular dysfunction and other adrenocorticotropic hormone (ACTH) dependent hormones (DHEA/DHEAS) were studied.
There was a significant decrease over time in serum cortisol both during the initial 24 h, and from the 2nd to the 5th morning after trauma. A significant decrease over time was also observed in calculated free cortisol, DHEA, and DHEAS. No significant association was found between an injury severity score = 16 (severe injury) and a low (
PubMed ID
24975481 View in PubMed
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Source
Int J Behav Med. 2003;10(2):181-90
Publication Type
Article
Date
2003
Author
Joaquim J F Soares
Orjan Sundin
Giorgio Grossi
Author Affiliation
Unit of Mental Health and Karolinska Institute, Stockholm, Sweden. joaquim.soares@smd.sll.se
Source
Int J Behav Med. 2003;10(2):181-90
Date
2003
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Analgesics - therapeutic use
Female
Humans
Male
Middle Aged
Multivariate Analysis
Pain - drug therapy - psychology
Pain Measurement
Poverty Areas
Questionnaires
Socioeconomic Factors
Stress, Psychological - psychology
Sweden
Unemployment
Abstract
Using questionnaires, we analyzed associations between different pain variables (e.g., pain intensity) and age (20-65+ years) among 949 primary pain patients. Older patients (a) were more often divorced, were blue-collar workers, were less educated, and had greater difficulties with living expenses; (b) had pain of longer duration, more frequently and of more complexity, and felt more disabled; (c) consumed more painkillers, analgesics, sedatives, and other medications, and had received more pain treatments; and (d) had more health problems. Younger patients had more severe pain, were financially strained, and were more often unemployed. A multivariate regression analysis showed that high disability was more determined by older than young age. However, other factors (e.g., pain complexity) were also important. Thus, older and younger patients experienced their pain differently
PubMed ID
12763710 View in PubMed
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Analgesic prescribing patterns in Norwegian nursing homes from 2000 to 2011: trend analyses of four data samples.

https://arctichealth.org/en/permalink/ahliterature276993
Source
Age Ageing. 2016 Jan;45(1):54-60
Publication Type
Article
Date
Jan-2016
Author
Reidun Sandvik
Geir Selbaek
Oyvind Kirkevold
Dag Aarsland
Bettina Sandgathe Husebo
Source
Age Ageing. 2016 Jan;45(1):54-60
Date
Jan-2016
Language
English
Publication Type
Article
Keywords
Acetaminophen - therapeutic use
Age Factors
Aged
Aged, 80 and over
Aging - psychology
Analgesics - therapeutic use
Analgesics, Non-Narcotic - therapeutic use
Analgesics, Opioid - therapeutic use
Chi-Square Distribution
Cognition
Dementia - psychology
Drug Prescriptions
Drug Utilization Review
Female
Homes for the Aged - trends
Humans
Logistic Models
Male
Multivariate Analysis
Norway
Nursing Homes - trends
Observational Studies as Topic
Odds Ratio
Practice Patterns, Physicians' - trends
Randomized Controlled Trials as Topic
Time Factors
Abstract
the analgesic drug use has been reported to increase in general in nursing home patients. However, there is insufficient evidence in terms of what agents are used, variations of use over time and to whom these drugs are prescribed.
we investigated the prescribing patterns of scheduled analgesic drugs in Norwegian nursing home patients from 2000 to 2011, with the association to age, gender, cognitive function and type of nursing home unit.
secondary analyses of four study samples (three observational studies and one randomised controlled trial).
nursing home patients included in study samples from 2000 (n = 1,926), 2004 (n = 1,163), 2009 (n = 850) and 2011 (n = 1,858) located in 14 Norwegian counties.
trend analyses of analgesic drug prescriptions. Percentages were described using t-test, ?(2) and Mann-Whitney U test and multivariate logistic regression.
the odds ratio for receiving any pain medication in 2011 compared with 2000 was 2.6 (95% CI 2.23-2.91), this is corresponding to a 65% increase from 34.9 to 57.6%. The paracetamol prescription increased by 113%, from 22.7% in 2000 to 48.4% in 2011. Strong opioids (fentanyl, buprenorphine, morphine, oxycodone) increased from 1.9% in 2000 to 17.9% in 2011 (P
Notes
Comment In: Age Ageing. 2016 Jan;45(1):7-826764389
Erratum In: Age Ageing. 2016 Mar;45(2):32326941355
PubMed ID
26764395 View in PubMed
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Analgesic use among community-dwelling people aged 75 years and older: A population-based interview study.

https://arctichealth.org/en/permalink/ahliterature142226
Source
Am J Geriatr Pharmacother. 2010 Jun;8(3):233-44
Publication Type
Article
Date
Jun-2010
Author
Niina Pokela
J Simon Bell
Katri Lihavainen
Raimo Sulkava
Sirpa Hartikainen
Author Affiliation
Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland.
Source
Am J Geriatr Pharmacother. 2010 Jun;8(3):233-44
Date
Jun-2010
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Analgesics - therapeutic use
Analgesics, Opioid - therapeutic use
Cross-Sectional Studies
Data Collection
Depression - complications
Female
Finland
Health status
Humans
Male
Multivariate Analysis
Pain - drug therapy
Polypharmacy
Residence Characteristics - statistics & numerical data
Sex Factors
Abstract
Pain is often underrecognized and undertreated among older people. However, older people may be particularly susceptible to adverse drug reactions linked to prescription and nonprescription analgesics.
The aims of this study were to assess the prevalence of analgesic use among a random sample of community-dwelling people aged >or=75 years, and to investigate factors associated with daily and as-needed analgesic use.
A random sample of people aged >or=75 years was drawn from the population register in Kuopio, Finland, in November 2003. Data on prescription and nonprescription analgesic use were elicited during nurse interviews conducted once for each participant in 2004. Self-reported drug utilization data were verified against medical records. The interview included items pertaining to sociodemographic factors, living conditions, social contacts, health behavior, and state of health. Physical function was assessed using the Instrumental Activities of Daily Living Scale, and the 10-item Barthel Index. Self-rated mobility was assessed by asking whether respondents could walk 400 meters (yes, yes with difficulty but without help, not without help, or no). Cognitive function was assessed using the Mini-Mental State Examination. The presence of depressive symptoms was assessed using the 15-item Geriatric Depression Scale. Respondents' self-rated health was determined using a 5-point scale (very poor, poor, moderate, good, or very good).
Of the initial random sample of participants (N = 1000), 700 provided consent to participate and were community dwelling. Among the participants, 318 (45.4%) were users of >or=1 analgesic on a daily or as-needed basis. Only 23.3% of analgesic users took an analgesic on a daily basis. Factors associated with any analgesic use included female sex (odds ratio [OR], 1.78 [95 degrees % CI, 1.17-2.71]), living alone (OR, 1.46 [95 degrees % CI, 1.02-2.11]), poor self-rated health (OR, 2.6 [95% CI, 1.22-3.84]), and use of >or=10 nonanalgesic drugs (OR, 2.21 [95% CI, 1.26-3.87]). Among users of >or=1 oral analgesic, factors associated with opioid use included moderate (OR, 2.46 [95% CI, 1.175.14]) and poor (OR, 2.57 [95% CI, 1.03-6.42]) self-rated health. Opioid use (OR, 0.19 [95% CI, 0.04-0.86]) and daily analgesic use (OR, 0.16 [95% CI, 0.34-0.74]) were inversely associated with depressive symptoms. Pain in the previous month was reported by 71.4% of analgesic users and 26.4% of nonusers of analgesics.
Analgesics were used by approximately 50% of community-dwelling people aged >or=75 years. However, age was not significantly associated with increased use of analgesics in multivariate analysis. The majority of analgesic drugs were used on an as-needed rather than a daily basis (76.7% vs 23.3%, respectively). Factors most significantly associated with analgesic use were female sex, living alone, poor self-rated health, and use of >or=10 nonanalgesic drugs.
PubMed ID
20624613 View in PubMed
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Analgesic use and frailty among community-dwelling older people: a population-based study.

https://arctichealth.org/en/permalink/ahliterature117548
Source
Drugs Aging. 2013 Feb;30(2):129-36
Publication Type
Article
Date
Feb-2013
Author
Marjaana P H Koponen
J Simon Bell
Niina M Karttunen
Irma A Nykänen
Franciska A M Desplenter
Sirpa A Hartikainen
Author Affiliation
Kuopio Research Centre of Geriatric Care, School of Pharmacy, University of Eastern Finland, 70211 Kuopio, Finland. marjaana.koponen@uef.fi
Source
Drugs Aging. 2013 Feb;30(2):129-36
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Aged
Analgesics - therapeutic use
Drug Utilization - statistics & numerical data
Female
Finland - epidemiology
Frail Elderly - statistics & numerical data
Humans
Male
Pain - drug therapy - epidemiology
Pain Measurement
Residence Characteristics
Abstract
Frail older people have a decreased ability to respond to stressors and may therefore be more susceptible to adverse events related to inadequately treated pain. Conversely, aging- and frailty-related changes in pharmacokinetics and pharmacodynamics may predispose frail older people to adverse events of analgesics.
The aim of this study was to explore whether analgesic use is associated with frailty status and whether there are differences in the types of analgesics used between frailty groups among community-dwelling older people.
The study population consisted of 605 community-dwelling people aged >75 years. Demographic, diagnostic and drug use data were collected during standardized nurse interviews. Participants were classified as frail, pre-frail or robust using the Cardiovascular Health Study frailty criteria (weight loss, weakness, exhaustion, slowness and low physical activity).
Overall, 11.4 % (n = 69) of the study participants were frail and 49.4 % (n = 299) were pre-frail. The prevalence of prescription and non-prescription analgesic use was higher among frail (68.1 %) than among pre-frail (54.5 %) and robust (40.5 %) older people (p
PubMed ID
23288603 View in PubMed
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229 records – page 1 of 23.