The Experts below are selected from a list of 312 Experts worldwide ranked by ideXlab platform
Michael J. C. Rhodes - One of the best experts on this subject based on the ideXlab platform.
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attendance at a Pain Clinic with severe chronic Pain after open and laparoscopic inguinal hernia repairs
British Journal of Surgery, 2003Co-Authors: A. Hindmarsh, Edward Cheong, Mark Lewis, Michael J. C. RhodesAbstract:Background: The aim was to compare the frequency of severe chronic Pain that required attendance at a Pain Clinic after open and laparoscopic inguinal hernia repairs. Methods: This was a retrospective analysis of 7999 patients who underwent inguinal hernia repair between January 1994 and December 2001. The definition of severe chronic Pain was Pain related to inguinal hernia surgery that was bad enough for the patient to seek further medical help and be referred to the specialist Pain Clinic after exclusion of surgically correctable pathology such as hernia recurrence. Results: During the study there were 7153 open repairs and 846 laparoscopic repairs. Sixty-nine patients (1·0 per cent) were referred to the Pain Clinic a median of 16·9 (range 5·1–69·4) months after open hernia repair. Three patients (0·4 per cent) were referred a median of 16·5 (range 7·3–21·5) months after laparoscopic hernia repair (P = 0·045). Conclusion: Laparoscopic inguinal hernia repair was associated with a significantly lower frequency of attendance at the Pain Clinic with severe chronic Pain. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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Attendance at a Pain Clinic with severe chronic Pain after open and laparoscopic inguinal hernia repairs.
The British journal of surgery, 2003Co-Authors: A. Hindmarsh, Edward Cheong, Mark Lewis, Michael J. C. RhodesAbstract:The aim was to compare the frequency of severe chronic Pain that required attendance at a Pain Clinic after open and laparoscopic inguinal hernia repairs. This was a retrospective analysis of 7999 patients who underwent inguinal hernia repair between January 1994 and December 2001. The definition of severe chronic Pain was Pain related to inguinal hernia surgery that was bad enough for the patient to seek further medical help and be referred to the specialist Pain Clinic after exclusion of surgically correctable pathology such as hernia recurrence. During the study there were 7153 open repairs and 846 laparoscopic repairs. Sixty-nine patients (1.0 per cent) were referred to the Pain Clinic a median of 16.9 (range 5.1-69.4) months after open hernia repair. Three patients (0.4 per cent) were referred a median of 16.5 (range 7.3-21.5) months after laparoscopic hernia repair (P = 0.045). Laparoscopic inguinal hernia repair was associated with a significantly lower frequency of attendance at the Pain Clinic with severe chronic Pain. Copyright 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Eldon Tunks - One of the best experts on this subject based on the ideXlab platform.
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An epidemiological follow-up survey of persistent Pain sufferers in a group family practice and specialty Pain Clinic
Pain, 2003Co-Authors: Joan Crook, Robin Weir, Eldon TunksAbstract:The course and prognosis of persistent Pain are largely unknown. In addition, follow-up studies of chronic Pain sufferers have come from specialized Pain Clinics and have ignored the question of how representative this special group is to the general population who suffer persistent Pain. Because health care planners are assumed to require these data for projection of health care needs, it is important to determine the course of persistent Pain in those persistent Pain sufferers in the general population as well as those referred to a specialty Clinic. An epidemiological study compared 2 groups of self-reported persistent Pain sufferers from a Family Practice Clinic and a Specialty Pain Clinic over a 2 year period. All subjects reporting a persistent problem with Pain at the time of the initial survey were contacted 2 years later to determine whether the initial differences between the 2 groups remained constant over time and whether there were any changes within each group over time. Despite the similarities between the study groups on multiple socioeconomic and demographic variables, the Specialty Pain Clinic group remained distinctly different from the Family Practice Pain sufferers on many Pain behavior and emotional variables. Thirteen percent of the persistent Pain sufferers from the Pain Clinic group and 36% of the persistent Pain sufferers from the Family Practice group no longer reported Pain as a problem at follow-up. Of those Pain sufferers from either group who continued to experience Pain at 2 years follow-up, their Pain became more intermittent, psychological distress factors improved, and the use of health services decreased. The implications are that persistent Pain does not necessarily continue forever and that persistent Pain sufferers in the general population have a better prognosis than those who are referred to a Specialty Pain Clinic. All follow-up studies need to be interpreted in light of these findings.
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A profile of users of specialty Pain Clinic services: predictors of use and cost estimates.
Journal of clinical epidemiology, 1992Co-Authors: Robin Weir, Eldon Tunks, Gina Browne, Amiiram Gafni, Jackie RobertsAbstract:During the past decade, the multidisciplinary Pain Clinic has become a popular alternative to the traditional treatment of persistent Pain. There is, however, little information describing this population of health care users nor the impact this new demand has on utilization of health care services. The objectives of this study were three fold: to develop a profile of the characteristics of patients referred to a specialty Pain Clinic including their psychosocial adjustment to their condition; to identify predictors of the use of the specialty services; and to estimate the cost of health service utilization. This historical cohort analytic survey of 571 patients referred to the Clinic assessed them for exposure to selected referral variables through a chart review and sampled (n = 222) these patients' current adjustment and health service use through mailed questionnaire. There were four types of use of specialty Clinic services. These included: non-users (n = 210); consultation only (n = 180); and the remaining 32% of the referrals were divided between "users-non complete" (n = 98) and "users-complete" (n = 83). "User" groups were similar in characteristics to each other at referral and follow-up on all the major variables with the exception of two factors: non-users lived further from the Clinic than users and users were rated as psychologically more vulnerable than non-users. The best predictors for attending the Clinic were the presence of referral information from the referring physician and the geographic location of the patient's referring physician. The prevalence of poor psychosocial adjustment was 55.7%, high by comparison with other specialty Clinics. Seventy percent of the variance in psychosocial adjustment to chronic Pain was explained by social and cognitive variables. In addition, users of specialty Pain Clinic services generated proportionately less costs in the use of other health services when they were compared to non-users. The importance of social support and meaning of illness variables in predicting psychosocial adjustment to chronic Pain is corroborated in this study as is the relevance of the Pain Clinic cognitive behavioural approach for these problems. In addition, compared to other chronic Pain sufferers with similar characteristics, it appears that the use of the Pain Clinic contains the use of other services and thus has an important economic impact.
A. Hindmarsh - One of the best experts on this subject based on the ideXlab platform.
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attendance at a Pain Clinic with severe chronic Pain after open and laparoscopic inguinal hernia repairs
British Journal of Surgery, 2003Co-Authors: A. Hindmarsh, Edward Cheong, Mark Lewis, Michael J. C. RhodesAbstract:Background: The aim was to compare the frequency of severe chronic Pain that required attendance at a Pain Clinic after open and laparoscopic inguinal hernia repairs. Methods: This was a retrospective analysis of 7999 patients who underwent inguinal hernia repair between January 1994 and December 2001. The definition of severe chronic Pain was Pain related to inguinal hernia surgery that was bad enough for the patient to seek further medical help and be referred to the specialist Pain Clinic after exclusion of surgically correctable pathology such as hernia recurrence. Results: During the study there were 7153 open repairs and 846 laparoscopic repairs. Sixty-nine patients (1·0 per cent) were referred to the Pain Clinic a median of 16·9 (range 5·1–69·4) months after open hernia repair. Three patients (0·4 per cent) were referred a median of 16·5 (range 7·3–21·5) months after laparoscopic hernia repair (P = 0·045). Conclusion: Laparoscopic inguinal hernia repair was associated with a significantly lower frequency of attendance at the Pain Clinic with severe chronic Pain. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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Attendance at a Pain Clinic with severe chronic Pain after open and laparoscopic inguinal hernia repairs.
The British journal of surgery, 2003Co-Authors: A. Hindmarsh, Edward Cheong, Mark Lewis, Michael J. C. RhodesAbstract:The aim was to compare the frequency of severe chronic Pain that required attendance at a Pain Clinic after open and laparoscopic inguinal hernia repairs. This was a retrospective analysis of 7999 patients who underwent inguinal hernia repair between January 1994 and December 2001. The definition of severe chronic Pain was Pain related to inguinal hernia surgery that was bad enough for the patient to seek further medical help and be referred to the specialist Pain Clinic after exclusion of surgically correctable pathology such as hernia recurrence. During the study there were 7153 open repairs and 846 laparoscopic repairs. Sixty-nine patients (1.0 per cent) were referred to the Pain Clinic a median of 16.9 (range 5.1-69.4) months after open hernia repair. Three patients (0.4 per cent) were referred a median of 16.5 (range 7.3-21.5) months after laparoscopic hernia repair (P = 0.045). Laparoscopic inguinal hernia repair was associated with a significantly lower frequency of attendance at the Pain Clinic with severe chronic Pain. Copyright 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Joseph D. Tobias - One of the best experts on this subject based on the ideXlab platform.
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Barriers to Outpatient Pediatric Chronic Pain Clinic Participation Among Referred Patients
Clinical pediatrics, 2020Co-Authors: Sushmitha S. Boppana, Dmitry Tumin, Rebecca Miller, Sharon Wrona, Timothy P. Smith, Tarun Bhalla, Aubrey Wrona, Stephani S Kim, Joseph D. TobiasAbstract:Initial Clinic evaluation among referred patients and factors limiting treatment initiation are not well characterized. We conducted a retrospective review of referrals to our outpatient Pain Clinic to identify intake visits and factors associated with treatment initiation among adolescents with chronic Pain. We identified adolescents aged 13 to 18 years at the time of referral to Clinic (2010-2016). Factors associated with completion of visits were evaluated using logistic regression. Patients who completed visits more frequently had private insurance than public or no insurance (P = .053). The most common reasons for caregiver decision not to attend the Pain Clinic included use of another Pain Clinic, that services were not wanted or no longer needed, and that their child was undergoing further testing. The current study demonstrated that patients with head Pain were more likely to complete an intake visit, while there was a trend showing that lack of private insurance decreased this likelihood.
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predictors of referral to a pediatric outpatient chronic Pain Clinic
The Clinical Journal of Pain, 2019Co-Authors: Dmitry Tumin, Rebecca Miller, Mohammed Hakim, Shabana Z Shafy, David Drees, Sharon Wrona, Timothy P. Smith, Joseph D. TobiasAbstract:Objectives:The main objectives of this study were to retrospectively characterize the rate of referrals to an outpatient chronic Pain Clinic among adolescents with chronic Pain, and to identify factors associated with referral.Materials and Methods:Adolescents, 13 to 18 years of age seen in 2010 to
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Predictors of Referral to a Pediatric Outpatient Chronic Pain Clinic
The Clinical journal of pain, 2019Co-Authors: Dmitry Tumin, Rebecca Miller, Mohammed Hakim, Shabana Z Shafy, David Drees, Sharon Wrona, Timothy P. Smith, Joseph D. Tobias, Tarun BhallaAbstract:The main objectives of this study were to retrospectively characterize the rate of referrals to an outpatient chronic Pain Clinic among adolescents with chronic Pain, and to identify factors associated with referral. Adolescents, 13 to 18 years of age seen in 2010 to 2015 at outpatient Clinics associated with Nationwide Children's Hospital (NCH) and diagnosed with chronic Pain were included if they lived near NCH and had not been previously referred to the NCH outpatient chronic Pain Clinic. Subsequent referrals to the Pain Clinic were tracked through December 2017 using a quality improvement database. Factors predicting referral were assessed at the initial encounter in another outpatient Clinic and analyzed using multivariable logistic regression. The analysis included 778 patients (569 female; median age, 15 y), of whom 96 (12%) were subsequently referred to the chronic Pain Clinic, after a median period of 3 months. Generalized chronic Pain (adjusted odds ratio, 1.8; 95% confidence interval, 1.1-3.1; P=0.023) and regional Pain syndromes (adjusted odds ratio, 3.1; 95% confidence interval, 1.5-6.7; P=0.003) were associated with increased likelihood of referral. The referral was also more likely among female patients and among patients with a mental health comorbidity or recent surgery or hospitalization. Referrals to our chronic Pain Clinic were more likely for adolescents with generalized chronic Pain, regional Pain syndromes, and patients with mental health comorbidities. Recent hospitalization or surgery, but not recent emergency department visits, were associated with Pain Clinic referral. The multivariable analysis did not find disparities in referral by race or socioeconomic status.
Tonya M Palermo - One of the best experts on this subject based on the ideXlab platform.
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waiting for a pediatric chronic Pain Clinic evaluation a prospective study characterizing waiting times and symptom trajectories
The Journal of Pain, 2019Co-Authors: Tonya M Palermo, Margaret Slack, Chuan Zhou, Rachel V Aaron, Emma Fisher, Sade RodriguezAbstract:Abstract Chronic Pain during childhood is prevalent and costly, but the access to interdisciplinary Pain care is limited. Studies investigating adults waiting for Pain Clinic evaluation found that symptoms and quality of life deteriorate over the waiting period, but little is known about the experience of adolescents. Therefore, we aimed to determine wait list times and the longitudinal trends of Pain and physical, mental, and social health over a 12-week period. In total, 97 adolescents, aged 10 to 18 years (M = 14.7 years, 82% female), waiting for evaluation at an interdisciplinary pediatric Pain Clinic completed assessments at enrollment and at 4-, 8-, and 12-week follow-up. We performed a review of the medical record of attendance patterns 12 months later. Twelve adolescents and their parents also completed qualitative interviews, describing their experience of waiting for evaluation. Wait times averaged 197.5 days (range = 69–758 days) from the time of referral to the first-attended appointment, and 86.6% of youths completed appointments. Longitudinal repeated measures analyses demonstrated little improvement in Pain or other domains of functioning over the 12-week period. In qualitative interviews, families described anxious anticipation for the upcoming appointment, combined with frustration in waiting. Findings highlight the need to consider approaches to reduce wait times and provide early intervention for youths awaiting Pain Clinic evaluation. Perspective: This study extends the literature on the characteristics and symptom trajectories of adolescents during the wait period for interdisciplinary Pain Clinic evaluation, described previously only in adults with chronic Pain. Findings demonstrated an average wait time of 6.5 months, during which youths’ Pain and physical and social health remained impaired.
