Non-pharmacological Interventions For Pain Management Research Articles

The effectiveness, acceptability, and sustainability of non-pharmacological interventions for chronic pain management in older adults in mainland China: A systematic review

ObjectivesThis systematic review aims to assess the effectiveness, acceptability, and sustainability of non-pharmacological pain management interventions for older adults in mainland China. Materials and MethodsArticles searching was conducted across six databases, including MEDLINE, PubMed, PsycINFO, Web of Science, China National Knowledge Infrastructure (CNKI), and WanFangdata. Quality appraisal was performed using the revised Cochrane risk of bias tool. ResultsA total of 26 articles met the inclusion criteria, involving 2,197 participants with a mean age of 69.19 years. The participants' ages ranged from 63.85 to 81.75 years. The evaluated non-pharmacological interventions included psychotherapy, acupuncture, exercise, massage, neurotherapy, and multidisciplinary interventions. The overall changes in pain intensity varied from -5.19 to -0.65 on a numeric rating scale ranging from zero to ten. ConclusionsNon-pharmacological interventions proved effective in alleviating pain intensity among older adults in mainland China. The findings suggest that mindfulness, exercise and pain education can be promoted as viable strategies for enhancing the well-being of the elderly population.

Quality Improvement Protocol: Improving the Use of Nonpharmacological Pain Management Strategies within the Inpatient Hospital Setting.

Background: There are many nonpharmacological pain management services available to hospitalized youth; however, not all youth are offered these services. Lack of knowledge about resources, difficulty with the referral process, and lack of understanding about nonpharmacological pain management services and when to refer patients are among the main reasons for lack of utilization. Quality improvement (QI) initiatives have grown within hospital settings and can serve to create change in fast-paced environments. Methods: The current QI project aimed to pilot an educational program to increase the use of nonpharmacological pain management interventions. Staff located on one floor of a pediatric hospital on the East Coast were selected because of the wide range of patient presentations and likelihood that these youth may present with pain during the hospitalization. Following several incremental changes and multiple PDSA cycles, utilization of nonpharmacological pain management services was assessed. Results: Education only did not result in increases in nonpharmacological pain management services ordered. A best practice alert for nursing staff, implemented within the electronic medical record, led to a 50% increase in services ordered. Conclusions: These results suggest that to improve use of nonpharmacological pain management strategies, hospital systems may need to consider more than education.

The trends and hotspots of research on non-pharmacological interventions for labor pain management: a bibliometric analysis

Introduction This study aimed to examine important points of focus, trends, and depth of research on non-pharmacological interventions for the management of labor pain worldwide from a macro perspective and present an extensive definition of research fields regarding non-pharmacological interventions. Methods Bibliometric methods were used in this study. With comprehensive keyword lists, the Web of Science and PubMed databases were searched using different screening strategies for publications made until 25 February 2023. Results Studies on non-pharmacological interventions in the management of labor pain have continued to develop since 2003 with great momentum. In this study, the most productive country in research on non-pharmacological interventions was found to be Iran, while Australia, the USA, China, and the United Kingdom were the most notable ones in terms of collaboration. The most prevalently studied non-pharmacological interventions were hydrotherapy and acupuncture. The results of the co-word analysis revealed 5 main themes about this field of research. Conclusion The results of this study showed that interest in studies on non-pharmacological interventions in the management of labor pain has increased, the quality of research in the field is high, international collaboration is increasingly higher, and technological approaches have started to emerge in relevant studies.

Effect of non-pharmacological interventions on pain in preterm infants in the neonatal intensive care unit: a network meta-analysis of randomized controlled trials

ObjectiveTo evaluate the effectiveness of different non-pharmacological interventions for pain management in preterm infants and provide high-quality clinical evidence.MethodsRandomized controlled trials (RCTs) of various non-pharmacological interventions for pain management in preterm infants were searched from PubMed, Web of Science, Embase, and the Cochrane Library from 2000 to the present (updated March 2023). The primary outcome was pain score reported as standardized mean difference (SMD). The secondary outcomes were oxygen saturation and heart rate reported as the same form.ResultsThirty five RCTs of 2134 preterm infants were included in the meta-analysis, involving 6 interventions: olfactory stimulation, combined oral sucrose and non-nutritive sucking (OS + NNS), facilitated tucking, auditory intervention, tactile relief, and mixed intervention. Based on moderate-quality evidence, OS + NNS (OR: 3.92, 95% CI: 1.72, 6.15, SUCRA score: 0.73), facilitated tucking (OR: 2.51, 95% CI: 1.15, 3.90, SUCRA score: 0.29), auditory intervention (OR: 2.48, 95% CI: 0.91, 4.10, SUCRA score: 0.27), olfactory stimulation (OR: 1.80, 95% CI: 0.51, 3.14, SUCRA score: 0.25), and mixed intervention (OR: 2.26, 95% CI: 0.10, 4.38, SUCRA score: 0.14) were all superior to the control group for pain relief. For oxygen saturation, facilitated tucking (OR: 1.94, 95% CI: 0.66, 3.35, SUCRA score: 0.64) and auditory intervention (OR: 1.04, 95% CI: 0.22, 2.04, SUCRA score: 0.36) were superior to the control. For heart rate, none of the comparisons between the various interventions were statistically significant.ConclusionThis study showed that there are notable variations in the effectiveness of different non-pharmacological interventions in terms of pain scores and oxygen saturation. However, there was no evidence of any improvement in heart rate.

Non-pharmacological pain relief interventions in preterm neonates undergoing screening for retinopathy of prematurity: a systematic review

ObjectiveThe objective of this review was to determine the efficacy of non-pharmacological interventions for pain management during retinopathy of prematurity (ROP) screening.Methods and analysisElectronic search of Ovid MEDLINE, PubMed, EMBASE,...

A Randomized Clinical Trial Testing the Effect of Digital Behavioral Interventions on Pain and Mental Health Among Adults with Sickle Cell Disease

Background: Patients with sickle cell disease (SCD) suffer a significant disease burden that affects their psychosocial well-being. Digital cognitive-behavioral therapy (CBT) has been utilized in other patient populations and shown to have clinical benefits. Although evidence-based, non-pharmacological interventions for pain management are widely used in other populations, this is not well studied in SCD. There are currently no large-scale, adequately powered clinical trials that evaluate the effectiveness and dissemination potential of digital behavioral pain management interventions for adults with SCD. Objective: The primary goal was to compare the effectiveness of two mobile-phone-delivered programs: 1) digital CBT program tailored for adults with SCD (CBT); or 2) pain and SCD education (Education) for reducing pain symptoms. The secondary goal was to assess whether baseline depression symptoms moderated the effect of these interventions on pain outcomes. Methods: Cognitive Behavioral Therapy and Real-Time Pain Management Intervention for Sickle Cell via Mobile Application (CaRISMA) is a multisite, randomized, pragmatic, comparative effectiveness trial conducted at seven comprehensive sickle cell centers and several community-based organizations in the U.S. The study enrolled adults with SCD who reported chronic pain or using short or long-acting opioids daily. Participants were randomized in a 1:1 ratio to receive either the CBT or Education programs. Both programs utilized identical Facebook Messenger chatbot apps, only the content differed. All intervention participants received health coach support involving weekly phone calls or text messages for a duration of 12 weeks. Participants completed follow up assessments at 3 and 6 months, and daily e-diary entries of 0-10 pain numerical rating scale, mood, and opioid use. The primary outcome was the 6-month change in the PROMIS pain interference. Secondary outcomes included average daily pain intensity for a 2-week period at each time point, change in mean % body area affected by pain (measured by a ‘paintable’ body image within the mobile app), PHQ-9 depression, GAD-7 anxiety, Adult Sickle Cell Quality of Life Measurement Information System (ASCQ-Me) quality of life (social functioning and emotional impact), and Sickle Cell Self-Efficacy Scale (SCSES). Generalized linear mixed models were used to compare changes in 6-month outcomes between study arms after accounting for design variables (study site and baseline depression). Results: Of the 574 participants screened for eligibility, 359 (63%) were consented and randomized (178 to CBT and 181 to Education). Seventy-five percent of participants connected with the chatbot but only 47% completed at least one CBT/education lesson. However, 80% of participants had at least one text message, phone or video session with a health coach. At 6-months, there was a significant decline in pain interference within each arm (CBT [-2.13, 95%CI (-3.42, -0.84)] and Education [-2.66, 95%CI (-3.97, -1.36)]); however, this decline did not differ between arms (p=0.57). There was not a significant 6-month change in daily pain intensity for either arm, however, for % body area covered in pain, both CBT and education conferred a similar relative decrease, 19.2% and 17.1%, respectively. There were significant 6-month improvements within-arms for PHQ-9, GAD-7, and both ASCQ-Me measures, but no between-arm differences emerged. (Table 1). Of these, only the 6-month change in ASCQ-Me emotional impact approached a significant difference between arms with digital CBT conferring slightly greater improvement in scores, 3.51 (95%CI: 2.29, 4.73) compared to education,1.79 (95%CI: .55, 3.04; p=.05). Baseline PHQ depression score (>= 10 vs < 10) did not moderate the effect of treatments on pain interference (p=0.52). Conclusions: Preliminary trial findings suggest that both digital CBT and Education, with health coach support, are effective approaches for management of SCD pain and mental health symptoms. Most participants connected with a health coach and may have derived benefit from this support, however, poor engagement with the digital CBT and education component of the study may have limited the study's ability to detect between arm differences. Secondary analyses will examine the effect of intervention engagement on treatment outcomes.

Prompting and Modeling of Coping Strategies during Childbirth

There is ample evidence to suggest that upright positions and mobility during labor improve birth outcome, including shorter duration of childbirth and reduced risk of cesarean section. The use of nonpharmacological interventions for pain management during childbirth are recommended by major health-care institutions and medical providers, however, the current methodologies for training coping strategies for use during labor have not shown to be effective on mobility or birth outcome. The purpose of this study was to apply an in-vivo teaching technology to the current childbirth model to prompt an imitative repertoire of empirically demonstrated labor coping strategies. Results of this study concluded that the introduction of a software using immediate prompting and video modeling increased the frequency and variability of labor behaviors during unmedicated labor for birthing persons and their partners.

What non-pharmacological and non-invasive pain management interventions are available for individuals from Turkish-speaking ethnic groups with non-malignant chronic pain? A scoping review of published literature.

A scoping review was selected to explore what non-pharmacological and non-invasive pain management interventions are available for individuals from Turkish-speaking ethnic groups with chronic pain and what represents the most appropriate intervention. Adults with non-malignant chronic pain from Turkish-speaking ethnic groups residing in or outside of Turkey. All non-pharmacological and non-invasive pain management interventions were considered. No limits were placed on geographic location, gender, sex or healthcare setting. The MEDLINE database was searched for published literature in April 2022. An English language filter was applied. No limits were placed on study design or date of publication. Data was charted from eligible studies into a data extraction table. Key concepts were identified during data extraction by DN. Eleven studies were included in the final review. All were conducted within a quantitative research paradigm. The studies were completed in Turkey (7), Belgium (1), Sweden (1) and Switzerland (1). One was a multi-country review. No studies were conducted in the UK. The primary interventions were heterogenous and included: pain science education (2), cognitive behavioural therapy (2), transcranial magnetic stimulation (1), balneotherapy (1), extracorporeal shockwave therapy (1), transcutaneous electrical nerve stimulation (1), wool therapy (1), exercise and patient dialogues (1) and aromatherapy massage and reflexology (1). Location of pain, outcome measures and timings of follow-ups were heterogeneous. Intervention heterogeneity, exclusively quantitative methodology and absence of studies completed in the UK meant no conclusions could be made on what represents the most appropriate non-pharmacological and non-invasive interventions intervention for individuals from Turkish speaking ethnic groups with non-malignant chronic pain.

Non-Pharmacological Interventions for Pain Management in Hemodialysis: A Narrative Review.

This narrative review aims to summarize non-pharmacological interventions for pain management in hemodialysis patients, assessing their potential benefits and limitations in enhancing patient well-being and quality of life. We reviewed the current literature on five primary non-pharmacological interventions: acupuncture, cognitive behavioral therapy, relaxation techniques, virtual reality, and alternative methods such as transcutaneous electrical nerve stimulation, music therapy, and aromatherapy. We analyzed the evidence regarding their effectiveness, feasibility, and optimal implementation strategies. The existing evidence supports the potential benefits of these interventions in managing pain and improving the well-being of hemodialysis patients. However, further high-quality research is needed to confirm their effectiveness, establish implementation best practices, and assess their long-term impact on patient outcomes. Non-pharmacological interventions hold promise for pain management in hemodialysis patients. Additional research is required to optimize these interventions and validate their effectiveness, contributing to comprehensive pain management strategies for this vulnerable patient population.

Non-pharmacological intervention to reduce pain post-appendectomy: A rapid review of randomized controlled trial studies

Background: Appendicitis leads to post-appendectomy pain with significant physical and mental implications, necessitating non-pharmacological pain management approaches. Objective: This study aimed to determine which non-pharmacological interventions can effectively reduce postoperative pain following an appendectomy. Design: A rapid review study design was employed. Data Sources: The databases used were EBSCOhost-CINAHL and PubMed. The article search was conducted on March 14, 2022. Review Methods: The identified articles were described using PRISMA guidelines and sorted based on inclusion criteria. These criteria included patients with appendicitis aged 18-59 years who underwent appendectomy, non-pharmacological pain management interventions, studies utilizing the Randomized Controlled Trial (RCT) method, full-text articles available, English language, and articles published between 2012-2022. Studies involving pediatric and elderly appendectomy patients, as well as studies with insignificant results, were excluded. Results: Four articles were analyzed, revealing four types of interventions: Foot and Hand Reflexology (Massage), Lavender Aromatherapy and Almond oil (Aromatherapy), Inhalation aromatherapy with sweet-scented geranium essential oil, and Acupressure Le7. These interventions were then classified into two categories: aromatherapy-based interventions and neurostimulation-based interventions. All interventions were found to significantly reduce pain in appendectomy patients. Conclusions: Non-pharmacological therapies, such as lavender and almond oil aromatherapy, sweet-scented geranium aromatherapy, foot and hand reflexology, and Le7 acupressure, have demonstrated positive effects in reducing long-term pain after an appendectomy.

Broadening the lens through which we view pain and its management: an interview with Mark Johnson.

Mark Johnson, PhD is Professor of Pain and Analgesia and Director of the Centre for Pain Research at Leeds Beckett University. Having initially trained as a neurophysiologist, Professor Johnson has expanded his research into the science of pain and its management, leading a team of pain scholars at the university. His research covers a wide range of topics including studying the effects of nonpharmacological interventions (transcutaneous electrical nerve stimulation [TENS], acupuncture, low-level laser therapy and Kinesio tape) for pain management, individuality and pain, epidemiology of pain and more recently health promotion and pain. His expertise spans a range of research methodologies including evidence syntheses such as meta-ethnography and meta-analysis includingCochrane Reviews, as well as conducting clinical trials and laboratory studies. In addition to his research, Professor Johnson is involved in pain education for healthcare professionals, patients, and the general public toprovide people with up-to-date knowledge for a better understanding of the science of pain and its management.

Pain Management in Older Adults Before and During the First Year of COVID-19 Pandemic: Prevalence, Trends, and Correlates.

There is limited knowledge on whether and how health care access restrictions imposed by the coronavirus disease of 2019 pandemic have affected utilization of both opioid and nonpharmacological treatments among US older adults living with chronic pain. We compared prevalence of chronic pain and high impact chronic pain (ie, chronic pain limiting life or work activities on most days or every day in the past 6 months) between 2019 (pre-pandemic) and 2020 (first year of pandemic) and utilization of opioids and nonpharmacological pain treatments among adults aged ≥65 years enrolled in the National Health Interview Survey, a nationally representative sample of noninstitutionalized civilian U.S. adults. Of 12 027 survey participants aged ≥65 (representing 32.6 million noninstitutionalized older adults nationally), the prevalence of chronic pain was not significantly different from 2019 (30.8%; 95% confidence interval [CI], 29.7%-32.0%) to 2020 (32.1%; 95% CI, 31.0%-33.3%; p = .06). Among older adults with chronic pain, the prevalence of high impact chronic pain was also unchanged (38.3%; 95% CI, 36.1%-40.6% in 2019 versus 37.8%; 95% CI, 34.9%-40.8% in 2020; p = .79). Use of any nonpharmacological interventions for pain management decreased significantly from 61.2% (95 CI, 58.8%-63.5%) in 2019 to 42.1% (95% CI, 40.5%-43.8%) in 2020 (p < .001) among those with chronic pain, as did opioid use in the past 12 months from 20.2% (95% CI, 18.9%-21.6%) in 2019 to 17.9% (95% CI, 16.7%-19.1%) in 2020 (p = .006). Predictors of treatment utilization were similar in both chronic pain and high-impact chronic pain. Use of pain treatments among older adults with chronic pain declined in the first year of coronavirus disease of 2019 pandemic. Future research is needed to assess long-term effects of coronavirus disease of 2019 pandemic on pain management in older adults.

Nonpharmacological pain management practices among nurses working in multiple centers in Saudi Arabia: A cross-sectional study

Objective: The aim of the study was to investigate the prevalence, and determinants, of nonpharmacological pain management practices among nurses in multiple settings. Materials and Methods: A cross-sectional examination was conducted involving 324 nurses from 16 hospitals in Hai’l, Saudi Arabia. Participants completed a self-reported survey utilizing established tools to assess the frequency of nonpharmacological pain management interventions utilization and identify associated barriers. Data analysis was performed using SPSS version 29.0. Results: Nonpharmacological pain management practices were found to be utilized “sometimes,” with a score of 2.89 ± 0.48. Commonly employed techniques included placing patients in comfortable positions and providing a tranquil environment. Gender was the sole demographic factor significantly affecting the use of these techniques (P &lt; 0.001), with female nurses demonstrating higher utilization. Barriers to implementation varied based on the hours of recent pain management education (P = 0.004), with prevalent barriers including nurse shortages, multiple responsibilities, heavy workloads, and nurse fatigue. Conclusion: The study reveals moderate utilization of nonpharmacological pain management approaches, primarily focusing on patient positioning and creating a calm environment. Female nurses exhibited higher adoption rates of these techniques. Barriers to implementation, such as nurse shortages and heavy workloads, were influenced by recent pain management education. Consequently, enhancing education and fostering supportive work environments are crucial for surmounting these barriers and promoting pain management awareness among nurses.

Algorithm-based pain management for people with dementia in nursing homes.

Algorithm-based pain management for people with dementia in nursing homes.

Non-pharmacological interventions for pain management in patients with dementia: A mixed-methods systematic review.

To systematically identify, summarise and compare evidence from studies related to the non-pharmacological interventions used to manage pain in patients with dementia. Secondly, this study aims to provide evidence on the effectiveness of non-pharmacological interventions used to manage pain in patients with dementia. The number of people diagnosed with dementia is rising rapidly in the context of ageing. Pain is considered to be one of the most common neuropsychiatric symptoms of dementia. To date, little research has focused on non-pharmacological interventions to manage pain in patients with dementia. Therefore, a systematic review on the non-pharmacological interventions used to manage pain in patients with dementia and how effective these interventions are, is warranted. The extensive search strategy included electronic database searches for CINAHL, MEDLINE and PsycINFO from January 2009 to February 2020. A mixed-methods systematic review was undertaken in accordance with the PRISMA statement and relevant papers were chosen based on inclusion criteria and quality assessment measures. Eligibility criteria defined the characteristics of inclusion studies using the PICO framework. Results were extracted to a synthesis table. The quality appraisal was conducted using JBI and CASP checklist. Eight studies met the inclusion criteria. These included six randomised controlled trials, one quasi-experimental study and one qualitative descriptive study. The current review identified various non-pharmacological interventions for pain management in patients with dementia including singing, painting, massage, ear acupressure, play activities program and robot. The most common intervention was massage while the most effective intervention was play activities program. All studies provided evidence that non-pharmacological interventions have an effect on pain management in patients with dementia or that there was a tendency for non-pharmacological intervention to reduce pain in patients with dementia. Overall, the quality of the included studies was interpreted as strong (n=8). Overall, interactive pharmacological interventions were more effective than non-interactive non-pharmacological interventions. While this review highlighted a limited number of studies investigating the use of non-pharmacological interventions to manage pain in patients with dementia, it did however uncover a range of non-pharmacological interventions used to manage pain in these patients along with their level of effectiveness. Further research is required to explore which non-pharmacological interventions are most effective in the management of pain in patients with varying degrees of cognitive impairment. Further qualitative research is also needed to explore nurses' views on the use of non-pharmacological interventions to manage pain in patients with dementia.

Efficacy and safety of non-pharmacological interventions for labour pain management: A systematic review and Bayesian network meta-analysis.

To compare and rank the efficacy and safety of non-pharmacological interventions in the management of labour pain. Recently, various non-pharmacological interventions have been applied to manage labour pain and have shown positive effects. However, evidence identifying which type of non-pharmacological intervention is more efficient and safer is limited. Systematic review and Bayesian network meta-analysis based on PRISMA-NMA. Seven databases were searched from database inception-March 2020. Two reviewers independently performed study selection, quality appraisal and data extraction. Conventional meta-analysis was conducted using either fixed-effects model or random-effects model according to statistical heterogeneity. The Bayesian network meta-analysis was conducted using the consistency model. 43 studies involving nine non-pharmacological interventions were included. The Bayesian network meta-analysis showed that acupressure (SMD=-2.00, 95% CrI -3.09 to -0.94), aromatherapy (SMD=-2.01, 95% CrI -3.70 to -0.35) and massage therapy (SMD=-1.26, 95% CrI -2.26 to -0.30) had significant positive effects on alleviating labour pain, with aromatherapy being the most effective. The results also revealed that yoga (SMD=-130.85, 95% CrI -212.01 to -59.32) and acupressure (SMD=-10.14, 95% CrI -20.24 to -0.41) were the most effective interventions for shortening the first stage and the second stage of labour, respectively. There were no significant differences between non-pharmacological interventions and usual care or placebo control on the use of pharmacological methods and neonatal 5-min Apgar score. The evidence in this network meta-analysis illustrates that non-pharmacological interventions are effective and safe for labour pain management in low-risk pregnant women. In the future, well-designed studies are needed to validate the conclusion of this network meta-analysis. The results support the use of non-pharmacological interventions, especially aromatherapy and acupressure, to relieve labour pain in low-risk pregnant women. Non-pharmacological interventions for labour pain management are recommended to apply according to maternal women's preference and values.

Comparing the Effectiveness of Education Versus Digital Cognitive Behavioral Therapy for Adults With Sickle Cell Disease: Protocol for the Cognitive Behavioral Therapy and Real-time Pain Management Intervention for Sickle Cell via Mobile Applications (CaRISMA) Study.

BackgroundPatients with sickle cell disease (SCD) experience significant medical and psychological stressors that affect their mental health, well-being, and disease outcomes. Digital cognitive behavioral therapy (CBT) has been used in other patient populations and has demonstrated clinical benefits. Although evidence-based, nonpharmacological interventions for pain management are widely used in other populations, these treatments have not been well studied in SCD. Currently, there are no adequately powered large-scale clinical trials to evaluate the effectiveness and dissemination potential of behavioral pain management for adults with SCD. Furthermore, some important details regarding behavioral therapies in SCD remain unclear—in particular, what works best for whom and when.ObjectiveOur primary goal is to compare the effectiveness of two smartphone–delivered programs for reducing SCD pain symptoms: digital CBT versus pain and SCD education (Education). Our secondary goal is to assess whether baseline depression symptoms moderate the effect of interventions on pain outcomes. We hypothesize that digital CBT will confer greater benefits on pain outcomes and depressive symptoms at 6 months and a greater reduction in health care use (eg, opioid prescriptions or refills or acute care visits) over 12 months.MethodsThe CaRISMA (Cognitive Behavioral Therapy and Real-time Pain Management Intervention for Sickle Cell via Mobile Applications) study is a multisite comparative effectiveness trial funded by the Patient-Centered Outcomes Research Institute. CaRISMA is conducted at six clinical academic sites, in partnership with four community-based organizations. CaRISMA will evaluate the effectiveness of two 12-week health coach–supported digital health programs with a total of 350 participants in two groups: CBT (n=175) and Education (n=175). Participants will complete a series of questionnaires at baseline and at 3, 6, and 12 months. The primary outcome will be the change in pain interference between the study arms. We will also evaluate changes in pain intensity, depressive symptoms, other patient-reported outcomes, and health care use as secondary outcomes. We have 80% power to detect a difference of 0.37 SDs between study arms on 6-month changes in the outcomes with 15% expected attrition at 6 months. An exploratory analysis will examine whether baseline depression symptoms moderate the effect of the intervention on pain interference.ResultsThis study will be conducted from March 2021 through February 2022, with results expected to be available in February 2023.ConclusionsPatients with SCD experience significant disease burden, psychosocial stress, and impairment of their quality of life. CaRISMA proposes to leverage digital technology and overcome barriers to the routine use of behavioral treatments for pain and depressive symptoms in the treatment of adults with SCD. The study will provide data on the comparative effectiveness of digital CBT and Education approaches and evaluate the potential for implementing evidence-based behavioral interventions to manage SCD pain.Trial RegistrationClinicalTrials.gov NCT04419168; https://clinicaltrials.gov/ct2/show/NCT04419168.International Registered Report Identifier (IRRID)PRR1-10.2196/29014

Non-pharmacological interventions for acute pain management in adult trauma victims: a scoping review.

This scoping review aimed to map non-pharmacological interventions to reduce acute pain in adult trauma victims. Acute pain is a consequence of a pathological or traumatic event, and a result of invasive or non-invasive health care procedures. Acute trauma pain, as well as its treatment, is one of the least-studied areas of acute pain. Although non-pharmacological interventions are responsible for pain relief among a significant number of patients, only a small percentage of patients receive non-pharmacological interventions. This scoping review considered all studies conducted on adult victims of trauma, aged 18 years or over, in pre-hospital emergency care, emergency rooms, and trauma-center settings. Studies were considered if they focused on non-pharmacological interventions designed to reduce acute pain, and were implemented and evaluated by health professionals. Non-pharmacological interventions of any type, duration, frequency, and intensity were considered. A comprehensive search strategy across 11 bibliometric databases and gray literature sources was developed. Full texts of selected citations were assessed in detail for eligibility by two independent reviewers. No other relevant studies were identified by searching the references of the included articles. Data extraction was performed independently by two reviewers using an instrument previously developed, and those reviewers were later responsible for its validation. Findings were then extracted directly into tables that are accompanied by a narrative summary to show how they relate to the objectives of the review conducted. This scoping review included nine studies: two retrospective cohort studies, five randomized controlled trials, one case report, and one literature review for five different countries. Non-pharmacological interventions identified and administered to trauma victims in pre-hospital settings, emergency services, and trauma centers were as follows: acupressure, auricular acupressure, auricular acupuncture, transcutaneous electrical nerve stimulation, repositioning, use of pressure relief devices, massage, heat therapy, music therapy, relaxation therapy, immobilization, ice therapy, compression, elevation, and bandage. Non-pharmacological interventions were mainly developed by nurses, physicians, and paramedics. They were, in most studies, poorly described in terms of their efficacy and were mostly reported in minor traumas, such as simple fractures or small wounds. Currently, there is no consensus for the implementation of non-pharmacological interventions in the treatment of acute trauma pain. Their application is primarily used for minor traumas, and their potential for the treatment of major traumas is yet unknown. No studies on the use of non-pharmacological interventions aimed at reducing the impact of traumatic adverse environments were identified. Further investigation on the effects of these interventions should be encouraged so that robust decisions and recommendations can be made.

Understanding Barriers and Facilitators to Nonpharmacological Pain Management on Adult Inpatient Units

Interprofessional staff are in a position to champion nonpharmacological pain management interventions, which can be effective when used in conjunction with analgesic medications. The purposes of this study were to understand the barriers and facilitators to using nonpharmacological pain management interventions as perceived by interprofessional staff, as well as to describe current knowledge, attitudes, and practices of interprofessional staff. An interpretive, descriptive study design at a large, urban, academic teaching hospital in the United States was used. This study provides a starting point for further understanding the potential implementation of nonpharmacological pain management interventions at the bedside. Recommendations include further evaluation of the current use of nonpharmacological pain management interventions as well as promoting education about available resources.

An interprofessional education workshop focusing on pain management and prescription opioid abuse

Abstract Interprofessional education (IPE) provides an opportunity to explore health professionals' contributions to pain management and to develop students' competencies in interprofessional (IP) collaborative practice. The purpose of this IPE workshop was to measure students' knowledge gains and changes in perceptions of core competencies for IP collaborative practice. The objectives for the workshop were that students would be able to: 1) Identify roles of healthcare team members in pain management, 2) Describe means of effective communication with the pain management healthcare team members, 3) Describe two pharmacological and two non-pharmacological interventions for pain management to decrease the use of opioids and 4) Reflect on the core competencies for IP collaborative practice. This IPE workshop on pain management and opioid abuse included a keynote speaker, an interprofessional panel and a patient case study. This format provided a comprehensive learning experience in a reasonable amount of time and was logistically feasible for health care professional students at one university.Demographic questions and the Interprofessional Attitudes Scale (IPAS) post-workshop surveys. The IPAS was modified to decrease response bias by removing the five subscale headings and reordering the questions. The post-survey also had three questions to measure achievement of workshop objectives. Scores for the core competencies of Teamwork, Roles and Responsibilities and Community- Centeredness demonstrated statistically significant increases. Post-survey analysis revealed a statistically significant difference by gender (females higher than males) on Teamwork, Roles and Responsibilities. Following the workshop students and faculty participants were emailed an online evaluation. The participants were asked to rate the effectiveness of the workshop: 1) components (keynote speaker, panel discussion and case study), 2) in helping participants to develop competence in IPE, and 3) as a learning experience. The effectiveness of the workshop in all three of these areas was rated as good to excellent by a majority of respondents. This IPE workshop format was effective and could be replicated to develop healthcare professional students’ knowledge of interprofessional pain management and to develop the core competencies of collaborative practice.