How to obtain the biopsychosocial record in multidisciplinary pain clinic? An action research study

How to obtain the biopsychosocial record in multidisciplinary pain clinic? An action research study 182Scientific presentations at the 2017 Annual Meeting / Scandinavian Journal of Pain 16 (2017) 165–188Results: There was no significant deference in PDT for neitherCS1 nor CS2. A median split subanalysis on CPM-responders versusCPM-nonresponders to the TS + CS1 combination. Using this grouping, there was significant increase in PDT when comparing TS toTS + CS1 or TS + CS2 (4.0 mA vs 5.6 mA; P < 0.05, 4.0 mA vs 5.1 mA;P < 0.05).Conclusions: The study indicates that CPM can be evoked in asubgroup of subjects by applying the electrical test stimulus andcuff pressure conditioning stimuli to the same experimental site.http://dx.doi.org/10.1016/j.sjpain.2017.04.049The effect of facilitated temporal summation ofpain, widespread pressure hyperalgesia andpain intensity in patients with kneeosteoarthritis on the responds to Non-SteroidalAnti-Inflammatory Drugs – A preliminaryanalysisK.K. Petersen a,b,∗ , O. Simonsen d , M.M. Andersen c ,A.E. Olesen d , L. Arendt-Nielsen a,baSMI, Department of Health Science and Technology,Faculty of Medicine, Aalborg University, Aalborg,Denmarkb Department of Orthopedic Surgery, AalborgUniversity Hospital, Farsø, Denmarkc Department of Mathematical Sciences, AalborgUniversity, Aalborg, Denmarkd Mech-Sense, Department of Clinical Medicine,Aalborg University Hospital, Aalborg, DenmarkE-mail address: kkp@hst.aau.dk (K.K. Petersen).Background: Non-Steroidal Anti-Inflammatory Drug (NSAID)treatment is recommended as the first step in the treatment of kneeosteoarthritis (KOA). Due to the risk of side-effects of NSIADs andlow responds rate, methods for selection of NSAID responders arehighly warranted. Recent studies suggest that pain sensitization inKOA might be predictive for the effect of surgical treatment, whythe purpose of the present study was to evaluated whether quantitative sensory testing (QST) could be predictive for the effect ofNSAID treatment in KOA.Material and methods: 100 patients were enrolled and assessedusing temporal summation of pain (TSP), pressure pain thresholds (PPT) and pain intensity (visual analog scale, VAS; 0: no painand 10: worst imaginable pain) before and 8 weeks after dailytreatment of Ibuprofen 400 mg × 3, Paracetamol 1 g × 3 and Pantoprazole 20 mg × 1. TSP was assessed by the difference in painscores to one PinPrick stimulus followed by 10 PinPrick stimuli. PPTwas assessed at the extensor carpi radialis longus muscle. Responders were categorized as decrease in pain intensity of at least threeVAS-points.Results: 80 patients had complete data at follow-up. 28 patientswere categorized as responders and 52 patients as non-responders.Pre-treatment pain intensity (responders: 7.5 (SD: 1.6) vs. nonresponders: 6.5 (SD: 2.3), P < 0.03) and TSP (responders: 1.9(SD: 2.5) vs. non-responders: 1.0 (SD: 1.5), P < 0.05) were significantly higher in responders compared with non-responders.Pre-treatment PPT at the arm trended towards significantly lowerin responders (293 kPa (SD: 85)) compared with no responders(339 kPa (SD: 124), P < 0.06).Conclusions: This preliminary analysis indicate that KOApatients with high pain intensities, facilitated TSP and widespreadpressure hyperalgesia respond to NSAIDs.http://dx.doi.org/10.1016/j.sjpain.2017.04.050How to obtain the biopsychosocial record inmultidisciplinary pain clinic? An actionresearch studyL.B. Sejling ∗ , L. Svensson, P.F. Jensen, W.Z. PawlakMultidisciplinary Pain Centre, Department ofAnaesthesia, Næstved Hospital, DenmarkE-mail address: wzp@regionsjaelland.dk (W.Z. Pawlak).Background: Patients with complicated chronic non-malignantpain (CCNMP) should be referred to the multidisciplinary treatment based on the biopsychosocial pain model. This is not a trivialtask to obtain the biopsychosocial record (BPSR) during the firstvisit in multidisciplinary pain center – some important data can bemissing, but it is difficult to choose the right questions.Purpose: To find the optimal method for obtaining of BPSR inpatients with CCNMP.Methods: The action research methodology is used. First, the literature search was done. Second, the meetings between therapistswere hold. Third, the patients are asked about their experienceswith obtaining of BPSR.Results: The following area of interest were identified: (1)patient’s demographic data, (2) lifestyle factors, (3) previous diseases, (4) concurrent diseases, (5) previous pain treatments, (6)pain intensity and effect of the actual pain treatment, (7) generalactivity, (8) mood, (9) walking activity, (10) work ability, (11) homeactivities, (12) relations with other people, (13) sleep, (14) enjoyment of life, (15) patients expectations from treatment, and (16)treatment goals. Patients are asked about those variables. EitherVisual Analogue Scale or Numeric Rating Scale is used for assessment of pain intensity and pain influence on variables (7) to (14).First, data about variables (1) to (6) are collected by the physician.Next, data about variables (7) to (15) are gathered under interviewwith the nurse. Last, the physician and the nurse keep the meeting on treatment goals and treatment course. Up to date (February2017), 8 patients were asked about their experience with obtainingof BPSR. All but one patient were very satisfied.Conclusions: The method presented above seems to be promising approach to obtaining of BPSJ in patients with CCNMP. The studyis ongoing and updated results will be presented at the conference.http://dx.doi.org/10.1016/j.sjpain.2017.04.051Experimental neck muscle pain increasepressure pain threshold over cervical facetjointsNing Qu b,∗ , René Lindstrøm b , Rogerio PessotoHirata b , Thomas Graven-Nielsen aaCenter for Neuroplasticity and Pain (CNAP), SMI,Department of Health and Science Technology,Faculty of Medicine, Aalborg University, Aalborg,Denmarkb SMI, Department of Health and Science Technology,Faculty of Medicine, Aalborg University, Aalborg,DenmarkE-mail address: tgn@hst.aau.dk (T. Graven-Nielsen).Aims: Evaluate pressure pain threshold (PPT) over cervical facetjoints before and after injection of experimental pain in the trapezius and multifidus muscles.Methods: Fourteen healthy subjects (6 women) received randomized ultrasound-guided injections of hypertonic saline (5.8%),in the right multifidus muscle medial to C4/C5 facet joint and in theright trapezius muscle at the midpoint between C7 spinous process and acromion. The saline-induced pain intensity was assessedon a VAS scale. Before and during saline-induced pain PPTs were http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Scandinavian Journal of Pain de Gruyter

How to obtain the biopsychosocial record in multidisciplinary pain clinic? An action research study

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© 2017 Scandinavian Association for the Study of Pain
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Abstract

182Scientific presentations at the 2017 Annual Meeting / Scandinavian Journal of Pain 16 (2017) 165–188Results: There was no significant deference in PDT for neitherCS1 nor CS2. A median split subanalysis on CPM-responders versusCPM-nonresponders to the TS + CS1 combination. Using this grouping, there was significant increase in PDT when comparing TS toTS + CS1 or TS + CS2 (4.0 mA vs 5.6 mA; P < 0.05, 4.0 mA vs 5.1 mA;P < 0.05).Conclusions: The study indicates that CPM can be evoked in asubgroup of subjects by applying the electrical test stimulus andcuff pressure conditioning stimuli to the same experimental site.http://dx.doi.org/10.1016/j.sjpain.2017.04.049The effect of facilitated temporal summation ofpain, widespread pressure hyperalgesia andpain intensity in patients with kneeosteoarthritis on the responds to Non-SteroidalAnti-Inflammatory Drugs – A preliminaryanalysisK.K. Petersen a,b,∗ , O. Simonsen d , M.M. Andersen c ,A.E. Olesen d , L. Arendt-Nielsen a,baSMI, Department of Health Science and Technology,Faculty of Medicine, Aalborg University, Aalborg,Denmarkb Department of Orthopedic Surgery, AalborgUniversity Hospital, Farsø, Denmarkc Department of Mathematical Sciences, AalborgUniversity, Aalborg, Denmarkd Mech-Sense, Department of Clinical Medicine,Aalborg University Hospital, Aalborg, DenmarkE-mail address: kkp@hst.aau.dk (K.K. Petersen).Background: Non-Steroidal Anti-Inflammatory Drug (NSAID)treatment is recommended as the first step in the treatment of kneeosteoarthritis (KOA). Due to the risk of side-effects of NSIADs andlow responds rate, methods for selection of NSAID responders arehighly warranted. Recent studies suggest that pain sensitization inKOA might be predictive for the effect of surgical treatment, whythe purpose of the present study was to evaluated whether quantitative sensory testing (QST) could be predictive for the effect ofNSAID treatment in KOA.Material and methods: 100 patients were enrolled and assessedusing temporal summation of pain (TSP), pressure pain thresholds (PPT) and pain intensity (visual analog scale, VAS; 0: no painand 10: worst imaginable pain) before and 8 weeks after dailytreatment of Ibuprofen 400 mg × 3, Paracetamol 1 g × 3 and Pantoprazole 20 mg × 1. TSP was assessed by the difference in painscores to one PinPrick stimulus followed by 10 PinPrick stimuli. PPTwas assessed at the extensor carpi radialis longus muscle. Responders were categorized as decrease in pain intensity of at least threeVAS-points.Results: 80 patients had complete data at follow-up. 28 patientswere categorized as responders and 52 patients as non-responders.Pre-treatment pain intensity (responders: 7.5 (SD: 1.6) vs. nonresponders: 6.5 (SD: 2.3), P < 0.03) and TSP (responders: 1.9(SD: 2.5) vs. non-responders: 1.0 (SD: 1.5), P < 0.05) were significantly higher in responders compared with non-responders.Pre-treatment PPT at the arm trended towards significantly lowerin responders (293 kPa (SD: 85)) compared with no responders(339 kPa (SD: 124), P < 0.06).Conclusions: This preliminary analysis indicate that KOApatients with high pain intensities, facilitated TSP and widespreadpressure hyperalgesia respond to NSAIDs.http://dx.doi.org/10.1016/j.sjpain.2017.04.050How to obtain the biopsychosocial record inmultidisciplinary pain clinic? An actionresearch studyL.B. Sejling ∗ , L. Svensson, P.F. Jensen, W.Z. PawlakMultidisciplinary Pain Centre, Department ofAnaesthesia, Næstved Hospital, DenmarkE-mail address: wzp@regionsjaelland.dk (W.Z. Pawlak).Background: Patients with complicated chronic non-malignantpain (CCNMP) should be referred to the multidisciplinary treatment based on the biopsychosocial pain model. This is not a trivialtask to obtain the biopsychosocial record (BPSR) during the firstvisit in multidisciplinary pain center – some important data can bemissing, but it is difficult to choose the right questions.Purpose: To find the optimal method for obtaining of BPSR inpatients with CCNMP.Methods: The action research methodology is used. First, the literature search was done. Second, the meetings between therapistswere hold. Third, the patients are asked about their experienceswith obtaining of BPSR.Results: The following area of interest were identified: (1)patient’s demographic data, (2) lifestyle factors, (3) previous diseases, (4) concurrent diseases, (5) previous pain treatments, (6)pain intensity and effect of the actual pain treatment, (7) generalactivity, (8) mood, (9) walking activity, (10) work ability, (11) homeactivities, (12) relations with other people, (13) sleep, (14) enjoyment of life, (15) patients expectations from treatment, and (16)treatment goals. Patients are asked about those variables. EitherVisual Analogue Scale or Numeric Rating Scale is used for assessment of pain intensity and pain influence on variables (7) to (14).First, data about variables (1) to (6) are collected by the physician.Next, data about variables (7) to (15) are gathered under interviewwith the nurse. Last, the physician and the nurse keep the meeting on treatment goals and treatment course. Up to date (February2017), 8 patients were asked about their experience with obtainingof BPSR. All but one patient were very satisfied.Conclusions: The method presented above seems to be promising approach to obtaining of BPSJ in patients with CCNMP. The studyis ongoing and updated results will be presented at the conference.http://dx.doi.org/10.1016/j.sjpain.2017.04.051Experimental neck muscle pain increasepressure pain threshold over cervical facetjointsNing Qu b,∗ , René Lindstrøm b , Rogerio PessotoHirata b , Thomas Graven-Nielsen aaCenter for Neuroplasticity and Pain (CNAP), SMI,Department of Health and Science Technology,Faculty of Medicine, Aalborg University, Aalborg,Denmarkb SMI, Department of Health and Science Technology,Faculty of Medicine, Aalborg University, Aalborg,DenmarkE-mail address: tgn@hst.aau.dk (T. Graven-Nielsen).Aims: Evaluate pressure pain threshold (PPT) over cervical facetjoints before and after injection of experimental pain in the trapezius and multifidus muscles.Methods: Fourteen healthy subjects (6 women) received randomized ultrasound-guided injections of hypertonic saline (5.8%),in the right multifidus muscle medial to C4/C5 facet joint and in theright trapezius muscle at the midpoint between C7 spinous process and acromion. The saline-induced pain intensity was assessedon a VAS scale. Before and during saline-induced pain PPTs were

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Scandinavian Journal of Painde Gruyter

Published: Jul 1, 2017

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