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Found 224 results
  1. Content Article
    Paula Goss had surgery to implant rectopexy and vaginal meshes which left her with severe pain and other serious complications. In this blog, Paula talks about why she set up Rectopexy Mesh Victims and Support to campaign for adequate treatment, redress and justice for people injured by surgical mesh. She outlines the need for greater awareness of mesh injuries amongst both healthcare professionals and the public and talks about what still needs to be done to enable people to access the treatment and support they need.
  2. Content Article
    Orchard Care Homes had noticed high numbers of antipsychotic medicines being prescribed to people living with dementia. There appeared to be little consideration of why these people were distressed and communicating this through behaviour. Orchard staff were convinced pain was a key factor in these distress responses—they were not necessarily because the person had a diagnosis of dementia. Orchard adopted PainChek, a digital pain assessment tool, in 2021 to support their dementia promise framework. They worked with the PainChek team and ran a pilot with the app. They were one of the first care providers to use this solution in the UK. It was originally launched it in one of their specialist dementia care communities, but is now in all 23 Orchard homes. Since the rollout of the app, there has been an increase in available pain relief and a decrease in conflict-related safeguarding referrals. There is increased time available for colleagues and a reduction in polypharmacy. There has been a 10% decrease in antipsychotic medicine use across all 23 homes, promoting a greater quality of life. People now have effective pain management plans. Orchard have also been able to ensure distress plans are in place which firstly considers if pain is the cause of distress. This case study was submitted to the Care Quality Commission's (CQC's) Capturing innovation to accelerate improvement project by Orchard Care Homes.
  3. Content Article
    World Hospice and Palliative Care Day takes place on 14 October 2023.  Patient safety in hospice and palliative care involves ensuring that every patient is able to access the services, support and pain relief that they need when they reach the end of life. It is also vital that families and carers are given relevant and timely support and information by healthcare services during their loved one’s hospice or palliative care, and following their death.
  4. Content Article
    Researchers at the University of Hertfordshire are carrying out a study to better understand women’s negative experiences of IUD procedures. They hope this research will be used to develop new guidance for patients and professionals that reduces the risk of coil procedures being experienced as distressing. If you are aged 16+, have had a coil fitting/removal in the last 2 years in a UK health settings (GPs, sexual health clinics, gynaecologist, and any other medical setting) that you found distressing, and are able to provide a valid UK phone number (mobile or landline), then you are eligible to participate. Full details of the research and how to take part can be found via the link below or by contacting Sabrina at s.pilav@herts.ac.uk.
  5. News Article
    Millions of women and girls experience debilitating periods, yet nearly one-third never seek medical help, and more than half say their symptoms are not taken seriously, according to research. A survey of 3,000 women and girls for the Wellbeing of Women charity found that they are often dismissed as “just having a period”, despite experiencing severe pain, heavy bleeding and irregular cycles that can lead to mental health problems. Almost all of those surveyed, who were between 16 and 40 years old and based in the UK, had experienced period pain (96%), with 59% saying their pain was severe. 91% had experienced heavy periods, with 49% saying their bleeding was severe. Prof Dame Lesley Regan, the chair of Wellbeing of Women, said: “It’s simply unacceptable that anyone is expected to suffer with period symptoms that disrupt their lives, including taking time off school, work, or their caring responsibilities, all of which may result in avoidable mental health problems. “Periods should not affect women’s lives in this way. If they do, it can be a sign of a gynaecological condition that requires attention and ongoing support – not dismissal.” Wellbeing of Women has launched its “Just a Period” campaign, which Regan said aims to address “the many years of medical bias, neglect and stigma in women’s health”. This includes tips on how to get the most out of seeing your GP and what women should do if they feel they have been dismissed. Read full story Source: The Guardian, 14 September 2023
  6. Content Article
    From endometriosis to heart attacks, this Guardian article look into the causes and symptoms, and explore gender disparities in quality of care
  7. News Article
    Staffing shortages are likely to restrict the use of a beneficial painkiller in birthing suites, even once its use has been recommended by national guidance. Research by HSJ suggests that just over half of trusts are already offering remifentanil to women in labour, although some are having to restrict its use due to lack of staffing. Responses to freedom of information requests from 108 trusts revealed 55 offered remifentanil during labour in 2022-23. Recent draft National Institute for Health and Care Excellence guidance on intrapartum care, published in April, suggested healthcare professionals “consider intravenous remifentanil patient-controlled analgesia” in obstetric units. This is partly because it reduces the likelihood of forceps or ventouse being required compared to intramuscular pethidine (an opioid commonly used in labour). However, the drug is not yet mentioned in official NICE guidelines and the opioid’s use in labour is currently off-label (its more common licenced use is alongside anaesthesia in surgery). A Royal College of Anaesthetists spokesperson said the use of drugs off-label “is extremely common in obstetrics given that drug trials do not often include pregnant women”. Read full story (paywalled) Source: HSJ, 1 September 2023
  8. News Article
    Almost 180,000 patients have been prescribed strong painkillers every month for two years, a rise of over a third compared to levels recorded just before the pandemic, data obtained by HSJ shows. The figures collected by the NHS Business Services Authority showed 179,353 patients had been prescribed an opioid analgesic every month between April 2021 and March 2023, a 36% increase compared with 131,876 receiving the same prescription between April 2017 and March 2019. Guidelines issued by the National Institute for Health and Care Excellence in 2021 advised clinicians not to prescribe opioids to manage chronic pain. A statement published alongside an earlier draft of these guidelines explained: “While there was little or no evidence that they made any difference to people’s quality of life, pain or psychological distress, there was evidence that they can cause harm, including possible addiction.” In 2020, the Medicines and Healthcare Products Regulatory Agency asked healthcare professionals to discuss the risks of dependency and addiction with any patient taking or planning to take an opioid-containing medicine and made sure such warnings were reinforced in the patient information leaflet. The regulator at the time defined long-term use as longer than three months. Read full story (paywalled) Source: HSJ, 18 August 2023
  9. Content Article
    The pain and distress of not being able to see an NHS dentist are "totally unacceptable", an inquiry has told the government. A review was launched after a BBC investigation found 9 in 10 NHS dental practices across the UK were not accepting new adult patients. Some people drove hundreds of miles for treatment or even resorted to pulling out their own teeth, the BBC found. The government says it invests more than £3bn a year in dentistry. But a damning report, by the Commons' Health and Social Care Committee, says more needs to be done, and quickly. The House of Commons Committee report with recommendations to government can be viewed at the link below. The Government has two months to respond.
  10. Content Article
    This story is part one of a series by AP News, examining the health disparities experienced by Black Americans across a lifetime.
  11. Content Article
    Davina McCall’s documentary Pill Revolution missed an opportunity to validate painful experiences of intrauterine devices and promote better practice, writes Stephanie O'Donohue, Patient Safety Learning's Content and Engagement Manager, in an opinion piece for the BMJ.
  12. Content Article
    Epistemic injustice sits at the intersection of ethics, epistemology, and social justice. Generally, this philosophical term describes when a person is wrongfully discredited as a knower; and within the clinical space, epistemic injustice is the underlying reason that some patient testimonies are valued above others. The following essay, published in Philosophy, Ethics, and Humanities in Medicine, seeks to connect patterns of social prejudice to the clinical realm in the United States: illustrating how factors such as race, gender identity, and socioeconomic status influence epistemic credence and associatively, the quality of healthcare a person receives.
  13. Content Article
    Trust is central to the therapeutic relationship, but the epistemic asymmetries between the expert healthcare provider and the patient make the patient, the trustor, vulnerable to the provider, the trustee. The narratives of pain sufferers provide helpful insights into the experience of pain at the juncture of trust, expert knowledge, and the therapeutic relationship. While stories of pain sufferers having their testimonies dismissed are well documented, pain sufferers continue to experience their testimonies as being epistemically downgraded. This kind of epistemic injustice has received limited treatment in bioethics. In this paper, Buchman and colleagues examine how a climate of distrust in pain management may facilitate what Fricker calls epistemic injustice. They critically interrogate the processes through which pain sufferers are vulnerable to specific kinds of epistemic injustice, such as testimonial injustice. They also examine how healthcare institutions and practices privilege some kinds of evidence and ways of knowing while excluding certain patient testimonies from epistemic consideration. 
  14. News Article
    A pensioner is furious with Northern Ireland politicians who, she said, left her with no option but to spend her savings on knee surgery in Poland. Christine Wallace was told the wait for her knee replacement surgery could be five years - although the health department says most waits are shorter. She spent £8,500 on her hospital stay. While Ms Wallace said the relief of her new knee was fantastic, she felt she had no alternative but to pay as she could no longer live with the pain. The latest available health department figures, from 31 March, showed 25,075 patients were waiting for inpatient or day case admission under the trauma and orthopaedic surgery specialty. The department said its median waiting time for such operations was 74 weeks, with only 1 in 20 patients waiting more than five years. "Our preferred measure of average is the median... because waiting times tend to be skewed by longer waits and therefore more patients are waiting for less time than the mean," said a department statement. Read full story Source: BBC News, 28 June 2023
  15. Content Article
    Doctors are taught from medical school about the benefits of IUDs, and often encourage patients that they are a good contraceptive option. However, recent media attention on the pain that some women suffer when having their IUDs fitted has started conversations about the need for cervical blocks and more honest counselling of women about the procedure. Rebekah Fenton, adolescent medicine fellow at Lurie Children's Hospital of Chicago, joins us to talk about how she counsels her patients, and why the most important thing is to make sure women are in charge of their reproductive healthcare decisions.
  16. Content Article
    In this article, published by British Vogue, Alexa Chung shares her experiences of endometriosis and the barriers and attitudes she faced in seeking a diagnosis and treatment.
  17. Content Article
    This report was prepared by the Endometriosis Task and Finish Group and submitted to the Welsh Government on 16 April 2018. Authors propose a robust care pathway based on NICE guidance using a life course approach to ensure that symptoms are recognised and responded to promptly and appropriately, as they emerge. 
  18. News Article
    A new treatment could help people to stop taking addictive opioid painkillers for chronic pain, research suggests. Data suggests there are one million people at risk from longer-term continuous opioid prescriptions, and more than 50,000 have been taking these for six months or more. While recent NHS initiatives have managed to reduce opioid prescribing by 8%, saving an estimated 350 lives, the new research has found evidence that could help many more people stop their opioid painkiller use. A team of researchers and doctors has developed and successfully trialled a programme designed to guide people in coming off prescription painkillers, tapering their opioid intake and learning how to manage their pain using alternative techniques with a course which combines one-to-one and group support. According to the findings, after one year, one in five people were able to stop taking opioids without their pain increasing. The scientists suggest the new treatment is an alternative to opioid use and has potential to give patients a better quality of life. Read full story Source: The Independent, 23 May 2023
  19. Content Article
    This recent cohort study, published in Evidence Based Medicine, investigated ‘the risk of transitioning from acute to prolonged use’ of opioid analgesics in patients undergoing elective surgery. Patients given tramadol or long-acting opioids after discharge were at greater risk of prolonged opioid use than those who were given other short-acting opioids.
  20. Content Article
    The opioid crisis in the United States (US) is one of the most high-profile public health scandals of the 21st century with millions of people unknowingly becoming dependent on opioids. The United Kingdom (UK) had the world’s highest rate of opioid consumption in 2019, and opiate-related drug poisoning deaths have increased by 388% since 1993 in England and Wales. This article, published in the British Journal of Pain, explores the epidemiological definitions of public health emergencies and epidemics in the context of opioid use, misuse, and mortality in England, to establish whether England is facing an opioid crisis.
  21. Content Article
    Many AI models are being developed and applied to understand opioid use. However, authors of this paper, published in BMJ Innovations, found there is a need for these AI technologies to be externally validated and robustly evaluated to determine whether they can improve the use and safety of opioids.
  22. News Article
    Antidepressants commonly used to treat chronic pain lack evidence as to whether or not they work, researchers have said, declaring the situation a global public health concern. Chronic pain, typically defined as pain lasting three months or more, is a widespread problem affecting up to one in three people, with conditions ranging from osteoarthritis to fibromyalgia. While exercise is often recommended, this is difficult for some patients, while there are concerns that opioids and other painkillers such as aspirin and paracetamol could do more harm than good. Increasing numbers of patients are prescribed antidepressants to treat their pain, with hundreds of thousands in the UK estimated to be taking amitriptyline. Antidepressants affect chemicals known as neurotransmitters, which is how they are thought to relieve pain. But a new Cochrane review, led by Prof Tamar Pincus, professor in health psychology at the University of Southampton, has revealed there is little evidence whether or not amitriptyline and many other common antidepressants work when it comes to tackling chronic pain. “The fact that we don’t find evidence whether it works or not, is not the same as finding evidence that it doesn’t work,” she said. “We don’t know. The studies simply are not good enough.” Read full story Source: The Guardian, 10 May 2023
  23. News Article
    A leading consultant has warned that poor care is at the root of a growing outcry over an invasive medical test that has left women in agony. Dr Helgi Johannsson, vice-president of the Royal College of Anaesthetists, has spoken out about the hysteroscopy after the Sunday Mail revealed the suffering of a series of female patients. His intervention comes amid a growing backlash around the procedure used to investigate and treat problems in the womb, with more than 3000 women now reporting being left with post-traumatic stress and excruciating pain. The test involves a long scope being inserted into the womb, often without anaesthetic, leaving one in three in pain. Dr Johannsson, a consultant anaesthetist at Charing Cross Hospital in London, said: “It sounds like a lot of this is poor care and badly handled, and emotionally badly handled, and (they) didn’t stop when they were supposed to. “Stories of being held down to finish the procedure are just awful. It’s important that we make the OH as good as we can possibly make it, including some sort of inhalation sedation, but having the ability to say stop when you need to is so important and a measure of good care.” Read full story Source: Daily Record, 7 May 2023 Further reading on the hub: Women share their experiences of painful hysteroscopy in the hub community. My experience of an outpatient hysteroscopy procedure Hysteroscopy: 6 calls for action to prevent avoidable harm
  24. News Article
    Women in labour should be offered an alternative to an epidural spinal block injection, say new draft guidelines for the NHS. The National Institute for Health and Care Excellence (NICE) is recommending remifentanil, which is a fast-acting morphine-like drug given into a vein. Women control the medication themselves, by pressing a button to get more of the drug for pain relief. A timer ensures the user cannot administer too much of it. Women who decide to try remifentanil and do not like it could still decide to have an epidural instead if there is no medical reason why they should not. They can use gas and air, also called Entonox, which is a mix of oxygen and nitrous oxide, at the same time. NICE says having remifentanil as a treatment option has advantages - it might enable women to be more mobile than with an epidural, which makes the legs numb and weak, for example. Evidence suggests fewer epidurals might mean fewer births using instruments like forceps and ventouse vacuum suction, says NICE. Read full story Source: BBC News, 25 April 2023
  25. Content Article
    Chronic pain is the most common complication affecting adults with sickle cell disease (SCD).Pain profoundly affects people’s quality of life, functional ability, and health care utilization. Clinicians are often unsuccessful at addressing chronic pain in SCD, especially among the large number of patients for whom nonopioid analgesics aren’t sufficient and those who have developed opioid tolerance. Why aren’t we doing better? In this perspective article in the New England Journal of Medicine, Childerhose et al. discuss how a biopsychosocial model can help capture people’s experience of chronic pain by affirming that biologic, neuropsychological, and socioenvironmental elements play a role in pain-related processes. 
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