IntroductionThe first consultation at a specialist pain clinic is potentially a pivotal event in a patient’s pain history, affecting treatment adherence and engagement with longer term self-management. What doctors communicate to patients about their chronic pain and how patients interpret doctors’ messages and explanations in pain consultations are under-investigated, particularly in specialist care. Yet, patients value personalized information about their pain problem.Patients and methodsSixteen patients in their first specialist pain clinic consultation and the doctors they consulted were interviewed shortly after the consultation. Framework analysis, using patient themes, was used to identify full match, partial match, or mismatch of patient–doctor dyads’ understandings of the consultation messages.ResultsPatients and doctors agreed, mainly implicitly, that medical treatment aiming at pain relief was primary and little time was devoted to discussion of self-management. Clinically relevant areas of mismatch included the explanation of pain, the likelihood of medical treatments providing relief, the long-term treatment plan, and the extent to which patients were expected to be active in achieving treatment goals.DiscussionOverall, there appears to be reasonable concordance between doctors and patients, and patients were generally satisfied with their first consultation with a specialist. Two topics showed substantial mismatch, the estimated likely outcome of the next planned intervention and, assuming (as doctors but not patients did) that this was unsuccessful, the long-term treatment plan. It appeared that more complex issues often generate divergence of understanding or agreement. Despite the widespread recommendations to medical practitioners to check patients’ understanding directly, it does not appear to be routine practice.ConclusionIt is hoped that this research encourages more detailed examination of shared and divergent experiences of pain consultations and also their influence on the subsequent course of intervention and adherence to treatment (not addressed here).
INTRODUCTION. This is the 2019 Annual Report of the Kansas Poison Control Center at The University of Kansas Health System (KSPCC). The KSPCC is one of 55 certified poison control centers in the United States and serves the state of Kansas 24-hours a day, 365 days a year with certified specialists in poison information and clinical and medical toxicologists. The KSPCC receives calls from the public, law enforcement, health care professionals, and public health agencies. All calls to the KSPCC are recorded electronically in the Toxicall® data management system and uploaded in near real-time to the National Poison Data System (NPDS) which is the data repository for all poison control centers in the United States. METHODS. All encounters reported to the KSPCC from 01/01/2019 through 12/31/2019 were analyzed. Data recorded for each exposure includes caller location, age, weight, gender, exposure substance, nature of exposure, route of exposure, interventions, medical outcome, disposition and location of care. Encounters were further classified as human exposure, animal exposure, confirmed non-exposure or information call (no exposure reported). RESULTS. The KSPCC logged 20,589 total encounters in 2019, including 19,406 human exposure cases. The KSPCC received calls from every county in Kansas. A slim majority of human exposure cases (50.5%, n=9,790) were female. Approximately 61% (n=11,876) of human exposures involved a child (defined as 19 years of age or less). Most encounters occurred at a residence (91.6%, n=17,780) and most cases (64.9%, n=12,599) originated from a residence. The majority of human exposures (85.5%, n=16,589) were acute cases (exposures occurring over 8 hours or less). Ingestion was the most common route of exposure documented (85.3%, n=16,548). The most common reported substance in pediatric (children ≤5) encounters was cosmetics/personal care products (n=959) followed closely by household cleaning product (n=943). For adult encounters, analgesics (n=1,296) and sedative/hypnotics/antipsychotics (n=1,084) were the most frequently involved substances. Unintentional exposures were the most common reason for exposures (75.4%, n=14,634). Most encounters (65.9%, n=12,780) were managed in a non-healthcare facility (i.e. a residence). Among human exposures, 14,591 involved exposures to pharmaceutical agents while 9,439 involved exposure to non-pharmaceuticals. Medical outcomes were 26.4% (n=5,116) no effect, 18.8% (n=3,652) minor effect, 9.3% (n=1,813) moderate effect, and 3.1% (n=603) major effects. There were 14 deaths in 2019 reported to the KSPCC. Cases from healthcare facilities, and cases with moderate or major medical outcomes and increased in 2019 compared to 2018. The number of deaths reported to the KSPCC increased in 2019 to 14 from 7 in 2018. CONCLUSIONS. The results of the 2019 Kansas Poison Control Center’s annual report demonstrate that cases are received from the entire state of Kansas totaling over 19,400 human exposures per year. While pediatric exposures remain the most common encounter, there continues an trend of increasing number of cases from healthcare facilities and for cases with serious outcomes. The experience of the KSPCC is comparable to national data. This report supports the continued value of the KSPCC to both public and acute health care in the state of Kansas.
Introduction. This is the 2020 Annual Report of the Kansas Poison Control Center (KSPCC) at The University of Kansas Health System. The KSPCC receives calls from the public, law enforcement, health care professionals, and public health agencies.Methods. Encounters reported to the KSPCC from 01/01/2020 through 12/31/2020 were analyzed for caller location, demographics, exposure substance, nature of exposure, route of exposure, interventions, medical outcome, and location of care. Encounters were classified as human or animal exposure, confirmed non-exposure, or information call (no exposure).Results. There were 19,780 total encounters, including 18,492 human exposure cases. These cases were primarily female (53.6%, n = 9,911) and pediatric (19 years of age or less). (59.5%, n = 10,995). Acute cases (82.7%, n = 15,294), unintentional exposures (73.8%, n = 13,643) and ingestions (85.9%, n = 15,901) were most common. The most common reported substance was household cleaning products (n = 937) in pediatric (children ≤ 5) and analgesics (n = 1,335) in adults. An increase in exposures to disinfectants and household cleaning products was seen. Moderate (n = 1,812) or major (n=482) clinical outcomes were seen in 12.4% of cases. There were 18 deaths in 2020 reported to the KSPCC.Conclusions. Over 18,400 exposures were managed by the KSPCC in 2020. Pediatric exposures remained the most common encounter. An increase in exposures to disinfectants and other household cleaning products was seen. This report supports the continued value of the KSPCC to both public and acute health care in the state of Kansas.
Introduction. This is the 2021 Annual Report of the Kansas Poison Control Center (KSPCC) at The University of Kansas Health System. The KSPCC serves the state of Kansas 24-hours a day, 365 days a year with certified specialists in poison information and clinical and medical toxicologists. Methods. Encounters reported to the KSPCC from 01/01/2021 through 12/31/2021 were analyzed. Data recorded includes caller demographics, exposure substance, nature and route of exposure, interventions, medical outcome, disposition, and location of care. Results. The KSPCC logged 18,253 total encounters in 2021, including calls from every county in Kansas. A majority of human exposure cases (53.6%) were female. Approximately 59.8% were pediatric exposures (defined as 19 years of age or less). Most encounters occurred at a residence (91.7%) and most were managed there (70.5%). Unintentional exposures were the most common reason for exposures (70.5%). The most common reported substance in pediatric encounters was household cleaning products (n = 815) and cosmetics/personal care products (n = 735). For adult encounters, analgesics (n = 1,241) and sedative/hypnotics/antipsychotics (n = 1,013) were the most frequently reported. Medical outcomes were 26.0% no effect, 22.4% minor effect, 10.7% moderate effect, and 2.7% major effects. There were 22 deaths. Conclusions. The 2021 KSPCC annual report demonstrated that cases were received from the entire state of Kansas. Pediatric exposures remained most common but cases with serious outcomes continue to increase. This report supports the continued value of the KSPCC to both public and health care providers in the state of Kansas.
IntroductionIncreasing demand for sexual problems services plus reductions in commissioning have led to a need for high quality services delivered in a low-cost model within sexual health settings. A service redesign utilised a stepped-care model included the use of group therapy interventions as a first line treatment for erectile difficulties and painful sex. These interventions continued alongside existing MDT service provision.MethodsAll patients accessing the service in the first 12 months were given self-report outcome measures at key points of the intervention including quantitative and qualitative aspects of change. Results are compared between those accessing an erection difficulties group, a painful sex group and individual psychosexual therapy sessions.ResultsAbstract P136 Table 1Psychosexual intervention resultsInterventionIndividual(n=32)Erection Group(n=23)Pain Group (n=9)% significant change50%30%22%% change38%70%67%% reporting no change12%0%0%DiscussionFurther efforts to utilise group interventions for sexual problems may support the continued provision of psychosexual services in sexual health settings. Groups were evaluated favourably by service users and demonstrated considerable change. Qualitative feedback suggested distinct benefits of a group intervention over individual care. Those receiving a higher stepped intervention (individual sessions) may have been more complex and for others change in the problem in a traditional sense may not have been possible, however change was reported in other ways (i.e. affect in relation to the problem, relationship satisfaction).
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