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Found 224 results
  1. Content Article
    Each year, up to 100 million people in the US experience acute or chronic pain, mainly because of short-term illnesses, injury and medical procedures. It is therefore important that patients are offered effective treatment options to reduce symptoms and improve function. Nonopioid management is the preferred option, but there are circumstances for which short-term opioid therapy is appropriate and beneficial. Finding the balance between these approaches is an ongoing problem in the management of acute noncancer pain. This cluster randomised clinical trial featured in JAMA Health Forum, aimed to assess whether clinician-targeted interventions prevent unsafe opioid prescribing in ambulatory patients with acute noncancer pain. The authors found that the use of comparison emails decreased the proportion of patients with acute pain who had never taken opioids receiving an opioid prescription. The emails also reduced the number of patients who progressed to treatment with long-term opioid therapy or were exposed to concurrent opioid and benzodiazepine therapy. They concluded that healthcare systems could add clinician-targeted nudges to other initiatives as an efficient, scalable approach to further decrease potentially unsafe opioid prescribing.
  2. Content Article
    This year, the World Health Organisation’s annual World Patient Safety Day on 17 September 2022 will focus on medication safety, promoting safe medication practices to prevent medication errors and reducing medication-related harm. Patient Safety Learning has pulled together some useful resources from the hub about different aspects of medication safety. Here we list seven tools and articles related to patient engagement and medication safety, including an interview with a patient advocate campaigning for transparency in medicines regulation, a blog outlining family concerns around prescribing and consent, and a number of projects that aim to enhance patient involvement in using medications safely.
  3. News Article
    Ongoing research underway at The University of Queensland in Australia is focusing on stopping children undergoing chemotherapy from feeling pain and other debilitating side effects. Dr Hana Starobova from UQ’s Institute for Molecular Bioscience has been awarded a Fellowship Grant from the Children’s Hospital Foundation to continue her research to relieve children from the side effects of cancer treatments. “Although children have a higher survival rate than adults following cancer treatments, they can still be suffering side-effects well into their adulthood,” Dr Starobova said. “A five-year-old cancer patient could be suffering severe pain, gastrointestinal problems or difficulty walking 20 years on from treatment. “There has been a lack of studies on children, which is an issue because they are not just small adults — they suffer from different cancers, their immune systems work differently and they have a faster metabolism, all of which affect how treatments work. “Our aim is to treat children before the damage happens so that the side-effects are dramatically reduced or don’t occur in the first place.” Dr Starobova is currently analysing how specific drugs could prevent a cascade of inflammation caused by chemotherapy drugs, which lead to tingling and numbness in hands and feet, and muscle pain and weakness that makes everyday tasks, like walking and doing up buttons, a challenge. She is focusing on Acute lymphoblastic leukaemia, one of the most frequently diagnosed cancers in children, with over 700 children diagnosed in Australia each year. “We are studying the most commonly used chemotherapy treatment for children, which is a mix of drugs that are very toxic, but have to be used to treat cancer fast and stop it becoming resistant to the drugs,” Dr Starobova said. “It’s a fine balance — too little chemotherapy and cancer won’t be killed but sometimes the side effects are so bad, patients have to stop the therapy. “I hope that by having a treatment to reduce side-effects, it will be one less thing for these kids and their families to worry about.” Read full story Source: The Print, 15 August 2022
  4. Content Article
    This guide by the Royal College of Physicians explains what a hip fracture is and answers questions about how patients will be cared for before and after a hip operation. It is written for patients and their families and carers. The guide covers aspects of hip fracture care such as: pain relief memory problems who should be involved in your care how soon an operation should take place eating and drinking bladder problems rehabilitation and physiotherapy following surgery when you will be able to go home future falls prevention bone strengthening medication
  5. News Article
    A mother has said an NHS hospital failed to offer her daughter adequate pain relief in a pattern of poor treatment that left the teenager suicidal. Ella Copley, 17, from Tingley, West Yorkshire, has suffered from ME (myalgic encephalomyelitis), sometimes known as chronic fatigue syndrome, for seven years. She has been in Leeds General Infirmary since March, when she was taken there by ambulance with an infection later diagnosed as sepsis. Her mother, Joanne McKee, 49, said the treatment Ella had received “feels like neglect and abuse”. She has posted videos on social media of the teenager screaming in pain when medicine is given by nasogastric tube. “I don’t think they believe that her pain is real at all,” she said. McKee said doctors had told Ella she was “hypersensitive”, and suggested that she stroke a piece of material against her skin as part of a desensitisation programme. “I have just never, ever known anything so dismissive,” McKee said. In an interview with Times Radio, she added: “No one has any understanding of her conditions. That really is the issue." The charity Action for ME has written a letter to the hospital’s chief executive raising concerns over Ella’s case. In it, Sonya Chowdhury, chief executive of the charity, said she was “aware of several other situations that bear similarity with Ella’s illness and care”. Questions have been raised over the treatment of Maeve Boothby-O’Neill, who died in October last year. Her death will be the subject of an inquest in Exeter next month. Read full story (paywalled) Source: The Times, 18 July 2022
  6. News Article
    Emma Hardy MP has secured a Westminster debate on gynaecological wait times. Gynaecology waiting lists across the UK have now reached a combined figure of more than 610,000 – a 69% increase on pre-pandemic levels. New analysis by the Royal College of Obstetricians and Gynaecologists (RCOG) shows that in England, gynaecology waiting lists have grown the most by percentage increase of all elective specialties. Emma is co-chair of the All Party Parliamentary Groups (APPGs) for Surgical Mesh and Endometriosis - both come under the heading of ‘gynaecological conditions’ and both are being impacted by increased waiting times. Through her involvement with these APPGs, Emma has heard the testimony of so many women whose lives have been impacted by conditions that can be so painful and debilitating that they impact on every aspect of family, social and work life. Emma will ask the minister to launch an investigation into possible gender bias in the prioritisation of gynaecology services and ensure that elective recovery will address the unequal growth of gynaecology waiting lists compared to other specialties. Emma said: "It is completely unacceptable that 610,000 women are waiting for gynaecological care across the UK. The reality is that many of these women will be in excruciating pain awaiting treatment, unable to go about their day-to-day lives." Read full story Source: Hull Daily Mail, 5 July 2022
  7. News Article
    Women who underwent damaging surgery in Irish hospitals have accused health authorities of dragging them into a "nightmare" of "gaslighting, ignorance and disrespect". Having had vaginal mesh implants, the women told an Oireachtas committee that they were "maimed" and then led on "a fool's errand" when they sought support from the HSE. The Health Committee heard from members of Mesh Ireland and Mesh Survivors Ireland who represent around 750 women. While the HSE said that it would be "extremely difficult" to provide accurate figures, it estimates that around 10,000 women had this surgery in Ireland. More than one in ten have suffered complications, Dr Cliona Murphy, Clinical Lead for the National Women and Infants Health Programme, revealed. Mary McLaughlin, Mesh Ireland, said that at one point, "I lay in bed 16 hours a day", because of the pain she was in. She demanded dignity and respect for survivors in the face of this "global scandal". The women are calling for access to a US-based expert in complete mesh removal, to mirror schemes in Scotland and the Canadian state of Quebec. Read full story Source: RTE, 29 March 2022
  8. News Article
    Suffering is “the new norm” in the NHS and people can expect to spend their last few years in pain, the outgoing chairman of the British Medical Association said. Chaand Nagpaul, who steps down this week, said the NHS was in a “perilous state”. He also wants people to have sympathy for the “plight” of junior doctors, who have said they will prepare for a ballot on strikes over pay. There are 6.5 million people on NHS waiting lists, many of whom have been waiting a year or more. Nagpaul, who has been a GP for 33 years, said: “I have not come across this scale of suffering, of unmet need. And what we’re going to be seeing is people spending the last years of their lives, literally in pain, unable . . . to have a hip operation. That will be the final years of their lives.” He said there was a “whole, larger population of patients just literally not featuring in the statistics” waiting for outpatient treatment, mental health care and diabetes checks. Read full story (paywalled) Source: The Times, 27 June 2022
  9. Content Article
    With waiting lists for gynaecology having grown by 60% since before the pandemic, many women are being left to cope with conditions like endometriosis, fibroids and prolapse on their own while waiting for NHS care. In this article, four women describe how NHS waiting lists and attitudes to gynaecological symptoms have left them living with severe pain and feeling like their health is not being taken seriously.
  10. Content Article
    The use of pelvic mesh was paused in the UK in 2018 after some patients developed complications and severe pain following the treatment. In this report for CNA, a Singapore-based news channel, Kath Sansom, founder of campaign group Sling The Mesh, talks about the severe pain and life-changing side effects she experienced after pelvic mesh surgery. The report highlights the risks associated with mesh removal surgery, the fact that women harmed by mesh have been dismissed and ignored by the healthcare system, and concerns that the number of patients who experience complications from pelvic mesh has been underestimated. It also outlines the need for stronger medical device regulation in the UK, and looks at issues with compensation and redress for patients harmed by mesh.
  11. Content Article
    In this letter to the Guardian newspaper, a specialist nurse writes on an NHS service that puts women in control of pain relief, Sara Davies on the torturous pain she endured to have an intrauterine device fitted, and Lee Bennett on why it pays to speak up persistently. Have you experienced pain during a medical procedure? Share your experience along with hundreds of women to one of our community forums: Do women experience poorer medical attention when it comes to pain? Pain during IUD fitting Painful hysteroscopy
  12. Content Article
    According to patient safety campaigners, hundreds of women have been forced to endure “barbaric” pain while undergoing hysteroscopy tests after being denied pain relief options and anaesthetists were not available. HSJ recently reported that campaigners have identified at least 240 women who underwent the procedure without being told they were entitled to a general anaesthetic to manage the pain of the invasive test and we have seen similar stories on the hub community forum on the topic. Guidance for doctors says pain relief should always be discussed. Instead, these women were found to be underinformed about their own rights and expected to simply endure what can be an incredibly painful process of internal investigation. Just because some women report only minimal or no discomfort, that does not mean this is a painless procedure; for those who do suffer, the experience can be very traumatic. To say these women did not need and could not be provided with a choice of anaesthetic or other analgesic is a form of medical gaslighting, writes Hannah Fearn in this article for the Independent.
  13. News Article
    Two years ago, it seemed that thousands of British women afflicted with crippling pain, ruined sex lives, shattered relationships and wrecked careers would finally get justice and practical redress. A government-commissioned report, following a campaign backed by Good Health, recognised that the plastic mesh tape surgeons had used to treat their incontinence and prolapse had caused some women catastrophic harm. How many women’s lives have been ruined by this mesh is unknown, but Baroness Cumberlege, who led the official review, estimated it to be ‘tens of thousands’. The use of the mesh for stress urinary incontinence was paused in July 2018 as recommended by the inquiry’s preliminary report — then the concluding report, in July 2020, said that this pause should continue until strict requirements on safety and recompense are met. These include the establishment of specialist centres to remove mesh from afflicted women, and financial compensation from government and mesh manufacturers for women affected, as well as the setting up of a database of victims to ascertain the numbers involved and their injuries. The final report also urged that the watchdog, the Medicines and Healthcare products Regulatory Agency (MHRA), which had approved the use of mesh tape in the 1990s, should be reformed to improve its vigilance on such problems. Matt Hancock, then Health Secretary, apologised for the women’s pain. ‘We are going to look carefully at the recommendations,’ he told reporters in July 2020. ‘We need to take action.’ But words can be cheap: a Good Health investigation has found none of the recommendations has been implemented properly and the use of mesh in women is continuing. Read full story Source: MailOnline, 6 June 2022
  14. Content Article
    BMJ opinion piece from BMJ Chair Richard Smith.
  15. News Article
    Patient safety campaigners have said ‘too many women’ are still not being offered a general anaesthetic for a diagnostic test because of staff shortages, leaving them in severe pain. A survey by the Campaign Against Painful Hysteroscopies found around 240 women – which equates to 80 per cent of respondents – who had a hysteroscopy since the start of 2021 said they were not told they could have a general anaesthetic prior to the procedure. This suggests the situation has only improved marginally since 2019, when the campaign group first started collecting data. A spokeswoman from the campaign group called the pain being endured by women “barbaric” and said staffing shortages need to be addressed. Guidance from the Royal College of Obstetricians and Gynaecologists said all pain relief options, including general anaesthetic, should be discussed. Helen Hughes, chief executive of Patient Safety Learning, said: “We are hearing from too many women that they are not being given the full information about the procedure. It damages their trust and makes them worry about accessing future services.” She said: “It’s distressing that despite what we know, [the guidance] is not being implemented properly. Informed consent is essential for patient safety as well as a legal requirement.” Read full story (paywalled) Source: HSJ, 7 June 2022 What is your experience of having a hysteroscopy? Share your experiences on the hub in our community forum. Further reading: House of Commons Debate - NHS Hysteroscopy Treatment Through the hysteroscope: Reflections of a gynaecologist Minister acknowledges patients’ concerns about painful hysteroscopies; but will action be taken? Improving hysteroscopy safety: Patient Safety Learning blog Outpatient hysteroscopy: RCOG patient leaflet
  16. News Article
    When a couple decides to try to have a child by in vitro fertilisation, it’s often accompanied by anticipation, anxiety and worry about whether the egg and sperm will unite and produce a healthy baby. So when the procedure to retrieve eggs from a woman’s ovary turns out to be physically painful, it can create long-term emotional pain as well, according to a lawsuit and two women who underwent the procedure at the Yale University Reproductive Endocrinology and Infertility Clinic. They are among dozens of women and spouses who are suing Yale University, claiming the staff at the clinic should have known that, instead of receiving fentanyl to relieve pain during the procedure, they instead were being injected with saline — salt water. “The result was that dozens, perhaps hundreds, of women underwent the most painful fertility surgeries and procedures offered at the REI Clinic with little or no analgesia,” the lawsuit states. Angela Cortese, 33, of Vernon, who first had her eggs retrieved on Dec. 3, 2019, said the pain was “excruciating” as a nurse wiped tears from her eyes and Cortese tried “not to flinch every time they’re using this giant needle to retrieve the follicles.” “I want to say it was probably around 45 minutes that I was very much aware of what exactly was happening and feeling every pinch and prod,” she said. “And it doesn’t feel like somebody’s just pinching you. It feels like somebody’s stabbing you through your vagina. It was horrific.” Read full story Source: ctpost, 31 May 2022
  17. News Article
    Two talented physicians, a patient who sacrificed his life and a selfless receptionist were the four people killed on 1 June 1 a shooting inside a medical office building on the Saint Francis Health System campus in Tulsa, Oklahoma. Police in Tulsa say the gunman, Michael Louis, had gone to the hospital for back surgery 19 May and was treated by Dr Preston Phillips. Louis was discharged from the hospital 24 May and subsequently called Dr Phillips' office several times complaining of pain and seeking additional treatment. The surgeon saw Mr. Louis on 31 May for more treatment, police said. On 1 June, Mr Louis called Dr Phillips' office again complaining about pain and seeking additional care. Mr Louis purchased an AR-15-style rifle that afternoon, just hours before the shooting, police said. Dr Phillips was killed in the shooting and was the gunman's primary target, police said. "He blamed Dr Phillips for the ongoing pain following surgery," Tulsa Police Chief Wendell Franklin said at a news conference. Read full story Source: Becker's Hospital Review, 2 June 2022
  18. Content Article
    Twelve years ago, Iona Winters had a TVT-O (transvaginal tape through the obturator region) implanted to assist her bladder, after decades of gynaecological surgeries. Last year she had the mesh removed by two specialist surgeons. In this blog, Iona describes the pain she has to endure, her experiences of medical misogyny and discusses the international mesh scandal.
  19. Content Article
    This study in Clinical Epidemiology aimed to investigate the long-term complications associated with surgical mesh devices used to treat stress urinary incontinence (SUI) and pelvic organ prolapse (POP). The authors looked at rates of diagnoses of depression, anxiety or self-harm (composite measure) and sexual dysfunction, and rates of prescriptions for antibiotics and opioids in women with and without mesh surgery, with a diagnostic SUI/POP code, registered in the Clinical Practice Research Datalink (CPRD) gold database. The study found that mesh surgery was associated with poor mental and sexual health outcomes, alongside increased opioid and antibiotic use, in women with no history of these outcomes and improved mental health, and lower opioid use, in women with a previous history of these outcomes. The authors highlight the need to carefully consider the risks and benefits of mesh surgery on an individual basis.
  20. News Article
    In England, only a third of adults – and half of children – now have access to an NHS dentist. As those in pain turn to charity-run clinics for help, can anything stop the rot? It is over an hour before the emergency dental clinic is due to open, but Jodie Manning is taking no chances. She hasn’t been able to eat for four days – “I can’t physically bite down any more” – and is determined to get an appointment. Aged 19, she has been to hospital with severe toothache “three-and-a-half times” in the previous year. The half is when they sent her home without treatment; on the other occasions, she was kept in overnight after collapsing from pain and dehydration, when even drinking liquids hurt her swollen mouth. Morphine has become her crutch: she fell asleep in college recently after taking the powerful painkiller. Like many of those waiting grimly in line, she has been struck off by her NHS dentist after not attending for two years, even though surgeries were shut to all but emergency cases during Covid. The same desperation can be seen across England, particularly in the north and east. Only a third of adults – and less than half of English children – now have access to an NHS dentist, according to the Association of Dental Groups (ADG). At the same time, three million people suffer from oral pain and two million have undertaken a round trip of 40 miles for treatment, the ADG calculated recently, calling dentistry “the forgotten healthcare service”. Tooth extraction is now the most common reason for a child to be admitted to hospital, costing the NHS £50m a year. The decline of NHS dentistry has deep roots. Years of underfunding and the current government contract, blamed for problems with burnout, recruitment and retention. Dentists are paid a flat fee for services regardless of how long a treatment takes (they get the same amount if they extract one tooth or five, for example). Covid exacerbated existing challenges, with the airborne disease posing a health risk for dentists peering into strangers’ mouths all day. As the British Dental Association put it in its most recent briefing: “NHS dentistry is facing an existential threat and patients face a growing crisis in access, with the service hanging by a thread.” Read full story Source: The Guardian, 24 May 2022
  21. Event
    This Westminster Health Forum conference will discuss the next steps for diagnosis, treatment and management of conditions that cause chronic pain, and the priorities for supporting people living with its effects. Delegates will examine the development of integrated healthcare in local communities and developing best practice for delivering patient-centred care - as well as the support required for the health workforce to deliver quality care and pain management for patients. It will be an opportunity to evaluate the recent updates to NICE’s guidance for chronic pain management, and the development of integrated care systems in the context of the Health and Care Bill. There will also be discussion on alternative approaches to chronic pain management including psychological therapies, social prescribing and complementary medicine, with NICE commencing medical cannabis clinical trials for people with chronic pain. Overall, areas for discussion include priorities and next steps for: long-term management of chronic pain conditions improving diagnosis and treatment of chronic pain, and developing person-centred community care widening awareness and understanding of chronic pain conditions understanding risk factors for developing chronic pain conditions, and approaches to prevention supporting the wellbeing of people living with chronic pain, and improving access to mental health services new, diverse treatment programmes for sufferers of chronic pain regulation and guidance for new treatments for chronic pain. Register
  22. News Article
    The National Institute for Health and Care Excellence has issued an unprecedented implementation statement1 setting out the practical steps needed for its updated guideline on the diagnosis and management of myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome (ME/CFS)2 to be implemented by the NHS. Such statements are only issued when a guideline is expected to have a “substantial” impact on NHS resources, and this is thought to be the first. It outlines the additional infrastructure and training that will be needed in both secondary and primary care to ensure that the updated ME/CFS guideline, published in October 2021, can be implemented. The statement is necessary because the 2021 guideline completely reversed the original 2007 guideline recommendations that people with mild or moderate ME/CFS be treated with cognitive behavioural therapy (CBT) and graded exercise therapy (GET). Instead the guideline recommends that any physical activity or exercise programmes should only be considered for people with ME/CFS in specific circumstances and should begin by establishing the person’s physical activity capability at a level that does not worsen their symptoms. It also says a physical activity or exercise programme should only be offered on the basis that it is delivered or overseen by a physiotherapist in an ME/CFS specialist team and is regularly reviewed. Although cognitive behavioural therapy (CBT) has sometimes been assumed to be a cure for ME/CFS, the guideline recommends it should only be offered to support people who live with ME/CFS to manage their symptoms, improve their functioning and reduce the distress associated with having a chronic illness. Read full story Source: BMJ, 16 May 2022
  23. News Article
    Relentless. Unbearable. Overwhelming. These are just some of the words used by the thousands of people who have revealed their battle with long-term, persistent pain. An exclusive survey of over 4,000 adults aged 16-75 for BBC News, carried out by research company Ipsos, suggests that a quarter of people in the UK are living with chronic pain - an often hidden and misunderstood condition. And pain specialists warn the health service is not set up to deal with such complex conditions. They say the treatments on offer are decades behind the science, leaving millions of patients without the support they need to manage their pain. Jen Proudler says chronic pain has left her grieving for "the person she was". It started four years ago with sporadic back pain. After several incorrect diagnoses, Jen was eventually told by a neurosurgeon that she had a "pretty massive" far lateral disc herniation in her spine. The pain has now spread around her body - Jen has burning pins and needles sensations down her leg, as well as sharp pain, as if being cut by a razor. Sometimes it's so bad, she can't even bear any fabric to touch it. "Our nervous system becomes more and more protective, it feels danger and sends warning signals - and those warning signals contribute to the pain," explains Dr Chris Barker, clinical director of an NHS community pain service in Ainsdale, Merseyside. He says such pain can be hard to diagnose, and the difficulty of getting the correct treatment can make things worse. "Incorrect diagnoses, delayed diagnoses, poor experiences in and out of the health system, not being believed - all of these can contribute to a more intense experience of pain." Dr Barker says the NHS is not set up to deal with such a complex condition, despite the fact it is so common. "The prevalence of pain is huge. It dwarfs most other conditions." Read full story Source: BBC News, 11 May 2022 Further reading: Is pain a patient safety issue? Blog from Patient Safety Learning
  24. Content Article
    In the 2017 Health Survey for England, 34% of adults reported experiencing chronic pain. The survey found that 5.5 million people (12%) are affected by high-impact pain that prevents them from enjoying social, family and recreational activities, and from working, including carrying out household tasks. This document sets out what the Arthritis and Musculoskeletal Alliance (ARMA) believes should be available in every area for people living with long term pain. It covers four areas: Underpinning framework Treatment for underlying conditions Services for people living with chronic pain Prevention and inequalities
  25. News Article
    People in England are struggling to get dental treatment, as dentists close to new NHS patients, a watchdog says. Healthwatch England, the NHS body representing patients, said the problem was made worse by the rising cost of living and needed "urgent attention". It said some people were living in pain, unable to speak or eat properly, because they could not find treatment. And it warned the poorest were suffering most as they were least able to afford to pay for private dentistry. Healthwatch England said the issue was creating a two-tier system - dividing the rich and the poor - and called on the government to take action. "There is now a deepening crisis," said Louise Ansari, of Healthwatch England. "With millions of households bearing the brunt of the escalating living costs, private treatment is simply not an option - and even NHS charges can be a challenge. "This needs urgent attention." Read full story Source: BBC News, 9 May 2022
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