Identifying barriers and facilitators for nurse practitioners' opioid management of chronic pain

Abstract

Supplemental Digital Content is Available in the Text.

Pain management in primary care

“…Along with the wide variety of available nonpharmacologic and pharmacologic therapies for its treatment, pain's complex etiology and subjective, variable nature make evaluating and treating affected patients rather challenging. Other factors, such as stringent regulation and scrutiny of controlled substance prescribing, potential adverse reactions of opioids, and potential for misuse and/or diversion of opioids, increase the intricacy of care 3-5. Lack of adequate clinician pain management knowledge and training has also been identified as a barrier to effective pain treatment 4-6.…”

“…Other factors, such as stringent regulation and scrutiny of controlled substance prescribing, potential adverse reactions of opioids, and potential for misuse and/or diversion of opioids, increase the intricacy of care. [3][4][5] Lack of adequate clinician pain management knowledge and training has also been identifi ed as a barrier to eff ective pain treatment. [4][5][6] Th e result is that pain, both acute and chronic, is oft en undertreated or inappropriately treated.…”

Nursing guidelines and multidisciplinary approach of chronic pain

“…Thus, pharmacologic management of chronic pain may be facilitated by nurse practitioners in conjunction with the medical staff avoiding prescription barriers and emphasizing interprofessional collaboration and patient education. These guidelines to identify facilitators and barriers for chronic pain management by nurse practitioners could improve chronic pain interventions by nursing management in the healthcare system (2) .Chronic pain may be defined as recurrent or persistent soreness for more than 3 months which represented a key healthcare problem affecting up to 19% of the European population and 20% of the American population. This condition implicated not only a temporal extension of acute pain, due to it comprised physiological nociception mechanism as well as pathogenetical and physical alterations, such as central sensitization linked to altered modulation of pain disorders, activation of glial cells and modified processing of neuroimmune signaling.…”

“…Thus, pharmacologic management of chronic pain may be facilitated by nurse practitioners in conjunction with the medical staff avoiding prescription barriers and emphasizing interprofessional collaboration and patient education. These guidelines to identify facilitators and barriers for chronic pain management by nurse practitioners could improve chronic pain interventions by nursing management in the healthcare system (2) .…”

Pautas de Enfermería y enfoque multidisciplinario con respecto al dolor crónico

“…En consecuencia, el manejo farmacológico del dolor crónico puede ser dirigido por enfermeros profesionales junto con el personal médico, evitando así obstáculos relacionados con la prescripción y enfatizando la colaboración interprofesional y la educación de los pacientes. Estas pautas para identificar facilitadores y obstáculos para el manejo del dolor crónico por parte de enfermeros profesionales podrían mejorar las intervenciones relacionadas con el dolor crónico implementadas por las áreas de gestión de Enfermería en los sistemas de salud (2) .El dolor crónico puede definirse como una molestia recurrente o persistente durante más de 3 meses, lo que representa un problema de salud clave que afecta a hasta al 19% de la población europea y al 20% de los habitantes del continente americano. Esta condición no solo implica una extensión temporaria del dolor agudo, puesto que incluye tanto un mecanismo fisiológico de nocicepción como también alteraciones patogenéticas y físicas, como ser sensibilización central vinculada a cambios en la modulación de los trastornos relacionados con el dolor, activación de células gliales y procesamiento modificado de la señalización neuroinmune.…”