Primary Care: Clinics in Office Practice This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Systems-Based Practice in Chronic Pain Management
Chronic pain is a significant public health concern. Care for patients with chronic pain is complex and involves many intersecting systems, policies, and procedures. Applying systems engineering concepts to chronic pain management opens the door to addressing a wide range of performance gaps through a structured, evidence-based approach. Successful implementation of systems-based practice includes effectively incorporating interprofessional teamwork, community resources, team-based care, patient safety, hospital readmissions, use of evidence-based medicine, transitions of care, and care for the underserved, including socia...
Source: Primary Care: Clinics in Office Practice - September 1, 2022 Category: Primary Care Authors: Margot Latrese Savoy Source Type: research

Chronic Pain Across the Ages
This article examines the occurrence of chronic pain across the human lifespan from pediatrics and adolescents through adulthood and concludes with geriatrics (>65). As a subset of the adolescent and adult age group, the article also explores the impact of chronic pain involving the obstetric population. Within the age groups and populations, we explore available information regarding prevalence, epidemiology, and impact of chronic pain surrounding each group as well as some of the common pain conditions and syndromes unique to a given group. While not focusing on treatment, the article reviews physiologic and other factor...
Source: Primary Care: Clinics in Office Practice - September 1, 2022 Category: Primary Care Authors: Robert L. “Chuck” Rich, Robert N. Agnello, Garett Franklin Source Type: research

Chronic Pain Management
PRIMARY CARE: CLINICS IN OFFICE PRACTICE (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - September 1, 2022 Category: Primary Care Authors: David T. O ’Gurek Source Type: research

Copyright
ELSEVIER (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - September 1, 2022 Category: Primary Care Source Type: research

Contributors
JOEL J. HEIDELBAUGH, MD, FAAFP, FACG (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - September 1, 2022 Category: Primary Care Source Type: research

Contents
Joel J. Heidelbaugh (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - September 1, 2022 Category: Primary Care Source Type: research

Forthcoming Issues
Telehealth (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - September 1, 2022 Category: Primary Care Source Type: research

Management of Chronic Pain in Patients with Substance Use Disorders
Understanding the risks for substance use disorders (SUDs) and how to diagnose and treat is essential to the safe and effective treatment of patients with chronic noncancer pain (CNCP). Because of the common neurologic pathways underlying addiction and chronic pain and common comorbid mental health and psychosocial challenges, these conditions should be treated concurrently. Depending on setting and comfort level of the provider, primary care clinicians may have the resources to provide office-based treatment or may consider referral to specialty treatment. An awareness of the stigma facing patients with both CNCP and SUD ...
Source: Primary Care: Clinics in Office Practice - August 29, 2022 Category: Primary Care Authors: Kellene Eagen, Laurel Rabson, Rebecca Kellum Source Type: research

Comprehensive Evaluation for Chronic Pain
Chronic pain is a common presenting problem in primary care offices. Primary pain disorders and chronic pain secondary to another underlying medical problem can significantly impact a patient ’s function and quality of life. Chronic pain is a complex diagnosis requiring individualized biomedical, psychosocial, and behavioral evaluations for each patient. Through thorough patient interview, physical examination, diagnostics, and standardized assessment tools, primary care clinicians can create a robust care plan for patients with chronic pain. Given the multifaceted nature of chronic pain, it is a diagnosis that fits into...
Source: Primary Care: Clinics in Office Practice - August 29, 2022 Category: Primary Care Authors: Susan Kuchera Fidler Source Type: research

Primary Care-Based Interventional Procedures for Chronic Pain
Chronic pain interventions in the primary care setting can provide temporal relief and are best used as part of a comprehensive treatment plan. Interventional therapies may use steroids, local anesthetic, saline, prolotherapy, no medication at all (dry needling), acupuncture, or transcutaneous electrical nerve stimulation. These interventions may include adjuvant modalities, such as ultrasound, to improve precision and accuracy of injection. Choice of interventional therapy for chronic pain in the primary care setting is highly dependent on the clinician, location, and cause of the pain as well as a multitude of patient fa...
Source: Primary Care: Clinics in Office Practice - August 29, 2022 Category: Primary Care Authors: Alex McDonald Source Type: research

“Suffer Not”
Recently, I was explaining to one of my residents that when I was a medical student in the 1990s, I really don ’t remember learning about or seeing many patients who were treated for chronic pain management. During my family medicine residency, I remember when the Joint Commission on Accreditation of Healthcare Organizations mandated that clinicians must consider pain as the “fifth vital sign.” At that point, pain assessments became ubiquitous, and not only did we recognize pain to a greater degree, but also we began to write many more prescriptions for pain medications, specifically opiates. (Source: Primary Care: C...
Source: Primary Care: Clinics in Office Practice - August 29, 2022 Category: Primary Care Authors: Joel J. Heidelbaugh Tags: Foreword Source Type: research

Trauma and Behavioral Health Care for Patients with Chronic Pain
Chronic pain is a public health problem that affects millions of people; however, those with comorbid behavioral health issues are overrepresented in that number. Although pain can be caused by a variety of factors, it has traditionally been associated directly with physical pathology. We know there is variation in how patients report pain whether in the presence or absence of physical pathology; therefore, pain must be viewed as a complex issue. In this article, the authors review the relationship between pain and mental illness and discuss strategies and various modalities for addressing pain in the primary care setting....
Source: Primary Care: Clinics in Office Practice - August 28, 2022 Category: Primary Care Authors: Daniel Salahuddin, Tracey Conti Source Type: research

Integrative Health Strategies to Manage Chronic Pain
Chronic pain syndromes include chronic low back pain, tension type and migraine headaches, fibromyalgia, and osteoarthritis. Adjunctive therapies may provide real benefit by themselves, as well as when combined with one another and more traditional treatments such as medication and physical therapy. High-quality evidence, including systematic reviews, and/or clinical practice guidelines support the use of acupuncture, acupressure, massage, and/or mindfulness-based stress reduction (MBSR) in patients with one or more of these chronic pain syndromes. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - August 27, 2022 Category: Primary Care Authors: Corey Fogleman, Kathryn McKenna Source Type: research

Ethical Challenges in Chronic Pain
Health care providers are ethically obligated to provide effective management for patients suffering from chronic pain. Many patients have not had access to such management, and current bioethical principles are not sufficient to create the roadmap needed on how to improve current standard of care. Principles described in the emerging field of urban bioethics greatly enhance the toolbox available to providers regarding chronic pain management. Redefining the principles of autonomy, beneficence/nonmaleficence, and justice to agency, social justice, and solidarity is essential to having the framework needed to provide more e...
Source: Primary Care: Clinics in Office Practice - August 27, 2022 Category: Primary Care Authors: Kathleen Reeves, Nora Jones Source Type: research

Pharmacologic Management of Chronic Pain
Pharmacologic management of chronic pain is one component of a patient-centered care plan. Multiple classes of medications are available and can be used individually or in combination. Choice of medication is determined by the type and cause of pain, safety profile of the medication, patient values and preferences, comorbid conditions, cost, and availability. Incorporating shared decision making is critical when implementing a pharmacologic pain management regimen. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - August 27, 2022 Category: Primary Care Authors: Sarah Coles, William Dabbs, Susanne Wild Source Type: research