Pivoting to virtual delivery for managing chronic pain with nonpharmacological treatments: implications for pragmatic research.
Pivoting to virtual delivery for managing chronic pain with nonpharmacological treatments: implications for pragmatic research.
复制标题
转向虚拟交付，通过非药物治疗来管理慢性疼痛：对实用研究的影响。
DOI：
10.1097/j.pain.0000000000002139
复制
发表时间：
2021-06-01
期刊：
影响因子：
7.4
通讯作者：
Kerns RD
中科院分区：
文献类型：
--
作者：
Fritz JM;Davis AF;Burgess DJ;Coleman B;Cook C;Farrokhi S;Goertz C;Heapy A;Lisi AJ;McGeary DD;Rhon DI;Taylor SL;Zeliadt S;Kerns RD
2019年冠状病毒病（COVID-19）在整个医疗保健领域造成了快速中断。在大流行之前，慢性疼痛是全球范围内导致残疾的主要原因30，也是就诊的最常见原因之一。17,31,70,71与covid相关的限制中断了面对面护理，并对慢性疼痛患者产生了其他不利影响。同时发生的精神健康状况在慢性疼痛患者中很常见40,64，并可能因COVID-19的社会孤立和心理后果而加剧。35,74慢性疼痛在活动受限的老年人中更为普遍。与大流行相关的干扰给慢性疼痛患者带来了独特的挑战，并可能产生持久的后果。疼痛护理正在经历一种转变，以增加对非药物治疗（NPTs）的关注。推荐的慢性疼痛npt包括运动、针灸、手法、正念、认知行为疗法（CBT）和其他方法。69,75尽管指南推荐了npt，但在常规护理中的实施却滞后。过度使用影像学、介入性疼痛手术和药物，特别是阿片类药物治疗，仍然是慢性疼痛护理的特征。43 .指导方针与实践之间的巨大差距促使了在“现实世界”环境中研究执行情况的实用主义研究。在2019冠状病毒病之前，实施不扩散方案很困难。这一大流行病带来了更多挑战。COVID-19可能导致缩小疼痛管理证据与实践差距的努力失去进展，引发人们对过度依赖阿片类药物和其他低价值护理的担忧。41岁的53
Coronavirus disease 2019 (COVID-19) created rapid disruptions throughout health care. Before the pandemic, chronic pain was the leading cause of disability worldwide30 and one of the most common reasons for health care visits. 17, 31, 70, 71 COVID-related restrictions interrupted in-person care and have had other detrimental effects for individuals with chronic pain. Co-occurring mental health conditions are common among persons with chronic pain40, 64 and may be intensified by the social isolation and psychological consequences of COVID-19. 35, 74 Chronic pain is more prevalent in older adults18 whose activities are most restricted. Pandemic-related disruptions present unique challenges for individuals with chronic pain and may have enduring consequences.Pain care has been undergoing a transformation to increase focus on nonpharmacological treatments (NPTs). 58 Recommended NPTs for chronic pain include exercise, acupuncture, manipulation, mindfulness, cognitive-behavioral therapy (CBT), and other approaches. 69, 75 Although guidelines recommend NPTs, implementation into routine care has lagged. 28 Overuse of imaging, interventional pain procedures, and medications, particularly opioid therapy, continues to characterize chronic pain care. 43 The considerable gap between guidelines and practice has motivated pragmatic research studying implementation in “real-world” settings. Implementation of NPTs was difficult before COVID-19. The pandemic has imposed additional challenges. COVID-19 could result in losing ground on efforts to narrow the pain management evidence-practice gap, raising concerns that overreliance on opioids and other low value care will increase. 41, 53
登录
查看更多内容
影响因子：
2.5
作者：
Fluckiger, Christoph;Del Re, A. C.;Horvath, Adam O.
通讯作者：
Horvath, Adam O.
DOI：
10.1007/978-94-017-7537-3_10
发表时间：
2016-01-01
期刊：
TRANSLATIONAL RESEARCH IN PAIN AND ITCH
影响因子：
--
作者：
Driscoll, Mary A.;Kerns, Robert D.
通讯作者：
Kerns, Robert D.
DOI：
10.1177/1740774515598334
发表时间：
2015-10
期刊：
Clinical trials (London, England)
影响因子：
--
作者：
Califf RM;Sugarman J
通讯作者：
Sugarman J
影响因子：
168.9
作者：
通讯作者：
--
影响因子：
4.7
作者：
Adamse, Corine;Dekker-Van Weering, Marit G. H.;Stuiver, Martijn M.
通讯作者：
Stuiver, Martijn M.