Pain medicine : the official journal of the American Academy of Pain Medicine
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Observational Study
Conversion from high-dose full-opioid agonists to sublingual buprenorphine reduces pain scores and improves quality of life for chronic pain patients.
This study aims to determine the effectiveness of converting patients from high doses of full-opioid agonists to sublingual (SL) buprenorphine. ⋯ Average pain scores decreased from 7.2 to 3.5, and quality of life scores increased from 6.1 to 7.1 for 35 patients converted from high-dose full-opioid agonists to SL buprenorphine therapy for more than 60 days. Clinicians should consider buprenorphine SL conversion for all patients on high-dose opioids, particularly patients with severe pain (7-10) unrelieved by their current opioid regimen or patients for whom the clinician does not feel comfortable prescribing high-dose opioids.
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The epidemic of prescription opioid-related morbidity and mortality demonstrates the need for a fresh, open, and balanced approach to managing pain while minimizing adverse personal and public health outcomes. Interventions by pharmacists in situations in which prescriptions are felt to be inappropriate have raised the ire of prescribers who feel their professional judgment is being questioned and their time is being usurped from patient care. ⋯ Pharmacies need to keep a mindful eye toward professional practices of physicians and use noninvasive means, such as database inquiries, prior to directly contacting a prescriber. Collaboration is the most professional approach that can be taken to assure that our joint priority of caring for patients in distress will be accomplished effectively and safely.
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During palpation, the pressure intensity and direction include minor deviations suggesting that standardized variations of the pressure intensity during pressure algometry may optimize the stimulus efficacy. This study examined the perceived pain outcome and reliability of a biaxial (bidirectional) algometer exerting rotational and vibratory stimulation on top of the basic pressure. ⋯ PPT assessment and multidirectional stimulations can be exerted reliably via biaxial algometer. Linear vibrational stimulation effect on pressure pain perception verified the inhibitory interaction between simultaneous pressure stimulation of low-threshold mechanoreceptors and nociceptors, while radial vibration and rotational stimulation showed facilitatory effects.