A 20-Year Study of the Bidirectional Relationship Between Anxious and Depressive Symptomology and Pain Medication Usage

Skadberg, Rebecca M.; Moore, Todd M.; Elledge, L. Christian

doi:10.2217/pmt-2019-0037

Cited by 7 publications

(5 citation statements)

References 48 publications

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“…13,14 Although the first line of treatment is the management and titration of the potent opioid, where there is no evidence of superiority of a particular opioid and considering the high incidence of hyperalgesia in cancer abdominal pain, methadone is a good option. 15 Among the adjuvants, the combination of non-steroidal anti-inflammatory drugs or corticosteroids in short cycles may have better results than monotherapy. There are also medications such as anticholinergics and octreotide that show greater benefits, mainly for malignant intestinal obstructions.…”

Section: Discussionmentioning

confidence: 99%

Using a multimodal approach to manage difficult visceral cancer pain: A case study

Fernández

Cardona

Rey

et al. 2023

SAGE Open Medical Case Reports

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Difficult visceral cancer pain is defined as pain that does not improve with conventional non-pharmacological and pharmacological strategies, including opioids and adjuvants, and occurs in up to 15% of patients with cancer. In oncological practice, we must be prepared to establish strategies for dealing with such complex cases. Different analgesic strategies have been described in the literature, including managing refractory pain through palliative sedation; however, this might become a dilemma from a clinical and bioethical point of view in end-of-life situations. We present the case of a young male patient with moderately differentiated intestinal-type adenocarcinoma of the left colon, with intra-abdominal sepsis, and for whom despite the multimodal treatment for difficult visceral cancer pain, the pain was refractory leading to palliative sedation. Difficult visceral cancer pain is a pathology that affects the quality of life of patients and is a challenge for pain specialists, for both pharmacological and non-pharmacological management.

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Section: Discussionmentioning

confidence: 99%

Using a multimodal approach to manage difficult visceral cancer pain: A case study

Fernández

Cardona

Rey

et al. 2023

SAGE Open Medical Case Reports

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“…The importance of using the appropriate timescale is often underestimated in longitudinal studies. 74 Causes may manifest their effects only within a particular time frame. 28 A large interval between measuring risk factors and its effects is not by definition a feature of a high-quality study.…”

Section: The Cause Precedes the Effect Within Timementioning

confidence: 99%

The effect of psychological factors on pain outcomes: lessons learned for the next generation of research

Crombez,

Veirman,

Van Ryckeghem

et al. 2023

PR9

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Big data and machine learning techniques offer opportunities to investigate the effects of psychological factors on pain outcomes. Nevertheless, these advances can only deliver when the quality of the data is high and the underpinning causal assumptions are considered. We argue that there is room for improvement and identify some challenges in the evidence base concerning the effect of psychological factors on the development and maintenance of chronic pain. As a starting point, 3 basic tenets of causality are taken: (1) cause and effect differ from each other, (2) the cause precedes the effect within reasonable time, and (3) alternative explanations are ruled out. Building on these tenets, potential problems and some lessons learned are provided that the next generation of research should take into account. In particular, there is a need to be more explicit and transparent about causal assumptions in research. This will lead to better research designs, more appropriate statistical analyses, and constructive discussions and productive tensions that improve our science.

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“…Chronic pain is a life-altering condition for service members and veterans that significantly affects patient's quality of life, sleep quality, anxiety, stress, depression (Skadberg et al, 2020;Burrowes et al, 2021) and difficulty working (Katz, 2002). The management of chronic pain in veterans often requires a multidisciplinary approach that includes collaboration between various types of providers (pain, anesthesia, psychiatry, and rehabilitation), patient, and caregiver.…”

Section: Chronic Pain In Veteransmentioning

confidence: 99%

“…Chronic pain is associated with greater levels of stress, and depression, which results in significant reductions in patients' quality of life and leads to substantial direct and indirect healthcare costs (Skadberg, Moore, and Elledge, 2020). Stressful events, depression and other negative psychological influences can exacerbate chronic pain.…”

Section: Vr Mindfulnessmentioning

confidence: 99%

Immersive Virtual Reality: A Safe, Scalable, Non-opioid Analgesic for Military and Veteran Patients

Peterson¹,

Hitching

Howard

et al. 2021

Front. Virtual Real.

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In Iraq and Afghanistan over 75% of the combat casualties suffered by U.S. troops have involved explosive devices. Improvements in body armor and advances in military medicine have significantly reduced the number of combat-related fatalities, but have greatly increased the number of U.S. active component personnel suffering painful trauma injuries. Unfortunately, so far, advances in pharmacologic analgesia pain medications have not kept pace with advances in survivability. For many active component personnel and Veterans, pain is a top health complaint from patients. The opioid epidemic has increased the urgency of developing powerful non-pharmacologic approaches for the management of pain. Immersive VR is proving to be a powerful non-opioid pain management technique for acute pain. However, the cost and usability limitations of pre-2016 VR clinical products resulted in limited treatment adoption rates for clinical use. In recent years, VR technology has become increasingly immersive, portable, and miniaturized, requiring minimal technical expertise to operate, and low-cost, factors that are likely contributing to the recent increase in the clinical use of VR analgesia. VR is greatly benefitting from a growing string of major technological breakthroughs and VR treatment improvements that will likely continue to increase the effectiveness and suitability of VR analgesia for military and VA patients. Regarding acute pain, we propose that the next revision to the current Tactical Combat Casualty Care guidelines consider including VR as an effective and hemodynamically safe approach to the current management of acute trauma pain in military personnel during medical procedures. With recent miniaturization and ruggedization, VR can potentially be used closer to the battlefield in the future. Beyond distraction, innovative VR therapy techniques designed to help reduce chronic pain are discussed. Recent breakthroughs in the mass production of inexpensive, highly immersive lightweight stand alone VR systems and augmented reality systems increase the potential for widespread dissemination of VR analgesia for acute and potentially for chronic pain. For example, the U.S. military recently purchased 22 billion dollar’s worth of Microsoft Hololens mixed reality systems (e.g., for training). Expanded research and development of VR analgesia customized for the unique needs of military and VA patients is recommended.

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A 20-Year Study of the Bidirectional Relationship Between Anxious and Depressive Symptomology and Pain Medication Usage

Cited by 7 publications

References 48 publications

Using a multimodal approach to manage difficult visceral cancer pain: A case study

Using a multimodal approach to manage difficult visceral cancer pain: A case study

The effect of psychological factors on pain outcomes: lessons learned for the next generation of research

Immersive Virtual Reality: A Safe, Scalable, Non-opioid Analgesic for Military and Veteran Patients

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