A nurse‐delivered advice intervention can reduce chronic non‐steroidal anti‐inflammatory drug use in general practice: a randomized controlled trial

Jones, Adrian; Coulson, L; Kr, Muir; Tolley, Keith; Lophatananon, Artitaya; Everitt, Louise; Pringle, Mike; Doherty, Michael

doi:10.1093/rheumatology/41.1.14

Cited by 25 publications

(13 citation statements)

References 17 publications

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“…There is growing evidence to support the role of nurses and pharmacists in chronic pain management [7,8,9]. Pharmacist-led interventions have been shown to reduce pain intensity, improve physical functioning and reduce adverse events among chronic pain patients [7].…”

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confidence: 99%

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Effectiveness of a community based nurse-pharmacist managed pain clinic: A mixed-methods study

Hadi

Alldred

Briggs

et al. 2016

International Journal of Nursing Studies

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Background: Chronic pain is predominantly managed in primary care, although often ineffectively. There is growing evidence to support the potential role of nurses and pharmacists in the effective management of chronic pain.Objective: To evaluate the effectiveness of a pain clinic jointly managed by a nurse and pharmacist.Design: A mixed-methods design consisting of qualitative interviews embedded within a quasi-experimental study. Settings:A community-based nurse-pharmacist led pain clinic in the north of England.Participants: Adult chronic pain (non-malignant) patients referred to the pain clinic. Methods:Pain intensity was the primary outcome. Questionnaires (The Brief Pain Inventory (BPI), the Hospital Anxiety and Depression scale (HADS), the SF-36 and the Chronic Pain Grade (CPG) questionnaire) were administered at the baseline, on discharge and at 3-months post discharge (BPI and HADS only). Patient satisfaction was explored using face-to-face, semi-structured qualitative interviews.Results: Seventy nine patients with a mean age of 46.5 years (SD ±14.4) took part in the quasi-experimental study. Thirty-six and nine patients completed the discharge and 3-month follow-up questionnaires respectively. Compared to baseline, statistically significant reductions were noted for two of the outcome measures: pain intensity (P=0.02), and interference of pain with physical functioning (P=0.02) on discharge from 2 the service. Nineteen patients participated in qualitative interviews. The patients were, in general, satisfied with the quality of service. Four contributing factors to patient satisfaction were identified: ample consultation time; in-depth specialised knowledge; listening and understanding to patients' needs; and a holistic approach. Conclusion:Nurse and pharmacist managed community-based pain clinics can effectively deliver quality pain management services as they offer an interdisciplinary holistic approach to pain management. Such services have the potential not only to reduce the burden on secondary care but also decrease long waiting times for referral to secondary care. Further research is required to support the development of evidence based referral guidelines to such services.

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confidence: 99%

“…Pharmacist-led interventions have been shown to reduce pain intensity, improve physical functioning and reduce adverse events among chronic pain patients [7]. Similarly, nurse-led interventions have been shown to reduce the chronic use of non-steroidal anti-inflammatory drugs (NSAIDs) [8], and improve physical functioning [9] and self-management skills.…”

mentioning

confidence: 99%

Effectiveness of a community based nurse-pharmacist managed pain clinic: A mixed-methods study

Hadi

Alldred

Briggs

et al. 2016

International Journal of Nursing Studies

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“…68 Importantly, this was not detrimental to the patients' symptoms, function, or quality of life. Such an intervention involving advice and, if needed, simple alternative non-drug and over the counter treatments, would be cost effective if continued long term.…”

Section: Safety and Costsmentioning

confidence: 94%

“…Such an intervention involving advice and, if needed, simple alternative non-drug and over the counter treatments, would be cost effective if continued long term. 68 March et al used "n of 1" trials to determine the comparative efficacy of paracetamol and oral NSAIDs within individual patients with OA. 69 As with later studies 7 8 15 they could not demonstrate clear overall superiority for NSAIDs, and at six months OA in almost half their patients was well controlled by paracetamol.…”

Section: Safety and Costsmentioning

confidence: 99%

Key questions concerning paracetamol and NSAIDs for osteoarthritis

Courtney

Doherty²

2002

Annals of the Rheumatic Diseases

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“…The requirement to reduce NSAID usage in older OA patients has led to studies that have shown that nurseled education programmes and use of alternative simple nonpharmacological measures can greatly reduce chronic NSAID usage among OA patients in primary care with no detriment to the patients. 16 …”

Section: Oral Nsaidsmentioning

confidence: 99%

Current drug treatment of osteoarthritis in primary care

Courtney¹,

Doherty²

2006

Prescriber

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O steoarthritis (OA) of the knee is the single most common cause of disability in those aged over 65, and knee and hip OA together affect over 20 per cent of the elderly population. With the increasing proportion of older people, large-joint OA will become an even more important healthcare problem.The traditional pessimistic view of OA as a simple degenerative condition that inevitably accompanies ageing and about which little can be done is outdated. It is now clear that OA is a dynamic, potentially reparative process that can be triggered by a wide variety of insults. OA involves new tissue synthesis, not just tissue damage, and much can be done to improve clinical outcome. There is often discordance between symptoms and the degree of structural OA change: indeed, most OA remains asymptomatic. Rather than the degree of structural change, important factors that influence the extent of pain and disability from OA are poor psychosocial

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A nurse‐delivered advice intervention can reduce chronic non‐steroidal anti‐inflammatory drug use in general practice: a randomized controlled trial

Abstract: Nurse-based intervention can reduce chronic NSAID usage and costs in primary care and would be cost-effective if maintained in the long term. This intervention package would be readily applicable in primary care.

Cited by 25 publications

References 17 publications

Effectiveness of a community based nurse-pharmacist managed pain clinic: A mixed-methods study

Effectiveness of a community based nurse-pharmacist managed pain clinic: A mixed-methods study

Key questions concerning paracetamol and NSAIDs for osteoarthritis

Current drug treatment of osteoarthritis in primary care

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