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30% of Canadians suffer daily from chronic pain. Patients may be
affected differently depending on the intensity, but all chronic pain
is debilitating and difficult to treat. A study carried out by Louise
Lamb, a clinician nurse at the Pain Centre of the Montreal University
Health Centre (MUHC), and Dr. Yoram Shir, the Director of the Centre,
shows that methadone in combination with innovative and high-quality
case management can provide relief for many patients. The study results
are published in the September issue of Pain Management
Methadone is most often
associated with drug addiction treatment, yet this opioid is regularly
used in hospital settings to relieve acute pain from cancer or
arthritis or following an accident.
body metabolizes methadone slowly, intense monitoring is required to
avoid toxicity. "As an ambulatory centre, we needed a way to monitor
patients effectively after they go home with their prescriptions,"
explained Ms. Lamb. The centre implemented an innovative program and
then measured its precise impact by following 75 patients over 9
months. Patients, with their family members, began with an education
session. They received medication information and treatment guidelines,
as well as a diary so they could note any related changes of the pain
intensity, and its associated impact on mood and activities. "The pain
diary is a very important tool as it allows us to track symptoms. Also,
paying attention to bodily changes helps patients become more aware of
their physical state," stated Ms. Lamb.
telephone communication was initiated after the first session to allow
nurses, in consultation with a doctor when required, to adjust
treatment as required. Out of the 194 phone calls recorded during the
study, 44% led to a dosage increase while 11% led to a decrease or
cessation. After 9 months, 57% of patients said they were satisfied or
very satisfied with the follow-up. "This case management program has a
lot of potential, as it does not create additional work for nurses and
allows them to follow patients easily and closely without the patient
having to travel," observed Dr. Shir. "This is why the program is now
in general use at our centre for all patients on methadone."
www.Joint-Pain-Forum.com from original press release.
The McGill University Health Centre
(MUHC) is a comprehensive academic health institution with an
international reputation for excellence in clinical programs, research
and teaching. The MUHC is a merger of five teaching hospitals
affiliated with the Faculty of Medicine at McGill University -- the
Montreal Children's, Montreal General, Royal Victoria, and Montreal
Neurological Hospitals, as well as the Montreal Chest Institute.
Building on the tradition of medical leadership of the founding
hospitals, the goal of the MUHC is to provide patient care based on the
most advanced knowledge in the health care field, and to contribute to
the development of new knowledge. http://www.muhc.ca/
McGill University Health Centre
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