The Clinical journal of pain
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We created an operational definition of possible opioid shopping in US commercial health insurance data and examined its correlates. ⋯ The use of ≥3 prescribing practices and ≥3 dispensing pharmacies over 18 months sharply discriminated courses of opioid treatment from courses of diuretics. This pattern of fills was additionally associated with the numbers of nonspecialist and self-paid fills, the total morphine milligram equivalents dispensed, and heavier use of drugs for anxiety, sleep, attention, and psychosis.
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Observational Study
The Associated Factors and Clinical Features of Neuropathic Pain after Brachial Plexus Injuries: A Cross-sectional Study.
Neuropathic pain in patients with brachial plexus injuries brings complicated obstacles to the treatment and recovery for both surgeons and patients. ⋯ Though the pain type and time phase manifested differently across patients, paresthesia/dysesthesia occurred most commonly. Patients were more likely to develop neuropathic pain if they had total brachial plexus injuries, avulsion and bad life habits. Moreover, the function of the upper limbs was affected by pain.
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Assess patient-physician agreement on management goals for chronic musculoskeletal pain and its associations with patient and physician visit experiences. ⋯ Patients and physicians prioritize substantially different goals for chronic pain management, but there is no evidence that agreement predicts patient experience or physician-reported visit difficulty. Primary care physicians may have adapted to new recommendations that emphasize functional goals and avoidance of long-term opioid therapy, whereas patients continue to focus on reducing pain intensity.
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Fibromyalgia (FM) patients may present psychopathology and some characteristic personality traits that may affect their adaptation to the disease. The aim of this paper was to study the relationship between personality dimensions according to the psychobiological model of Cloninger and the presence of psychopathology. ⋯ Patients with FM have a high probability of anxious-depressive-type psychopathologic alterations. Their vulnerability to these conditions may be determined by personality traits. The SD character dimension may have implications for therapy, as low SD is associated with the presence of psychopathology and with a low capacity to cope with the disease.
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Pain beliefs have been hypothesized to play an important role in pediatric pain. However, research examining the associations between pain-related beliefs and measures of function in youths with disabilities is limited. ⋯ The findings provide new information regarding the role that pain beliefs have in predicting function and have important clinical implications regarding how youth with physical disabilities and pain might be most effectively treated.