TY - JOUR
T1 - Chronic nonmalignant pain in primary care
AU - Jackman, Robert P.
AU - Purvis, Janey M.
AU - Mallett, Barbara S.
N1 - Funding Information:
The authors acknowledge the contribution of Celia Freeman in the preparation of and Online Figure A; and acknowledge Lisa Poppe, Amber McKeen, Karen Langley, John Shaw, and Angela Ronnander in the preparation of the patient information handout. This work was supported in part by the Title VII Health Resources and Service Administration grant for curriculum development in primary care. Figure 1
PY - 2008/11/15
Y1 - 2008/11/15
N2 - A systematic approach to chronic nonmalignant pain includes a comprehensive evaluation; a treatment plan determined by the diagnosis and mechanisms underlying the pain; patient education; and realistic goal setting. The main goal of treatment is to improve quality of life while decreasing pain. An initial comprehensive pain assessment is essential in developing a treatment plan that addresses the physical, social, functional, and psychological needs of the patient. One obstacle to appropriate pain management is managing the adverse effects of medication. Opioids pose challenges with abuse, addiction, diversion, lack of knowledge, concerns about adverse effects, and fears of regulatory scrutiny. These challenges may be overcome by adherence to the Federation of State Medical Boards guidelines, use of random urine drug screening, monitoring for aberrant behaviors, and anticipating adverse effects. When psychiatric comorbidities are present, risk of substance abuse is high and pain management may require specialized treatment or consultation. Referral to a pain management specialist can be helpful.
AB - A systematic approach to chronic nonmalignant pain includes a comprehensive evaluation; a treatment plan determined by the diagnosis and mechanisms underlying the pain; patient education; and realistic goal setting. The main goal of treatment is to improve quality of life while decreasing pain. An initial comprehensive pain assessment is essential in developing a treatment plan that addresses the physical, social, functional, and psychological needs of the patient. One obstacle to appropriate pain management is managing the adverse effects of medication. Opioids pose challenges with abuse, addiction, diversion, lack of knowledge, concerns about adverse effects, and fears of regulatory scrutiny. These challenges may be overcome by adherence to the Federation of State Medical Boards guidelines, use of random urine drug screening, monitoring for aberrant behaviors, and anticipating adverse effects. When psychiatric comorbidities are present, risk of substance abuse is high and pain management may require specialized treatment or consultation. Referral to a pain management specialist can be helpful.
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M3 - Review article
C2 - 19035063
AN - SCOPUS:58149180643
SN - 0002-838X
VL - 78
SP - 1155-1162+1164
JO - American family physician
JF - American family physician
IS - 10
ER -