Canadian Journal of Pain-Revue Canadienne de la Douleur最新文献

{"title":"Chronic pain and disability in organizations: It's time to pay attention to work and workers.","authors":"Duygu Gulseren","doi":"10.1080/24740527.2021.2010023","DOIUrl":"https://doi.org/10.1080/24740527.2021.2010023","url":null,"abstract":"The Canadian pain community knows that one in every five adults in Canada suffers from pain. What is less well known is that many of those adults stay in the workforce despite their pain. According to the Canadian Survey on Disabilities, more than half of working-age adults (i.e., between the ages 15 and 64 years) in pain are employed. Depending on the requirements of their jobs, these individuals continue to go to work, sit or stand on their feet during long shifts, work in awkward positions and in noisy environments, or lift heavy objects. Many also have comorbidities associated with pain such as anxiety or depression, which can make it harder for them to deal with difficult customers, travel for work, or stay focused on a task. In this editorial, I will (1) present a brief overview of the current state of the chronic pain and work literature, (2) make a case for why we need more pain-related research focused on the workplace and on employees with chronic pain who opt to continue working, and (3) invite pain researchers to collaborate with management scholars to better understand, prevent, and design interventions for chronic pain in the workplace. Chronic pain is a prevalent problem in Canadian workplaces. The prevalence of pain in the workplace is expected to be even more common in the future because work conditions are changing. Factors such as an aging workforce, increasingly demanding jobs, longer work hours, and working more than one job are expected to cause an increase in chronic pain cases. Despite the prevalence of pain in the workplace, very little research has examined the experiences of employees with pain. Although initial attempts have been made on this topic, significant and worrisome gaps exist in the literature. Except for general pain management interventions tested in workplace settings, most studies at the intersection of work and pain focus on absenteeism or on facilitating a return to work. Though these topics are important for our field, they assume, erroneously, that employees who have pain leave work and employees who return to work have no pain or pain that is effectively controlled; unfortunately, this is not the case for many. Employees who are working despite their pain are generally overlooked. We need more research on this topic because the majority of the people with chronic pain are still in the workforce. They struggle with unique challenges at the intersection of the organizational life and their health conditions. Understanding what conditions at work help or hinder their pain and functioning could lead to the development of more effective interventions and policies. Most individuals spend about one-third of their lives at work. Nonetheless, the influence of work is not limited to work hours and should not be underestimated. Work is a place where a person can earn their living, make social connections, and even find a sense of identity and purpose. Due to its wide sphere of influence in a person’s life, work","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 1","pages":"45-47"},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9176257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10380953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Special issue: Developmental perspectives on the transition of acute to chronic pain after surgery.","authors":"Brittany N Rosenbloom, Maria Pavlova, Joel Katz","doi":"10.1080/24740527.2022.2090323","DOIUrl":"https://doi.org/10.1080/24740527.2022.2090323","url":null,"abstract":"It is with great enthusiasm that we present the Canadian Journal of Pain’s Special Issue titled Developmental Perspectives on the Transition of Acute to Chronic Pain after Surgery. Over the past 25 years there has been an exponential growth in research on the factors involved in the transition from acute to chronic pain in infants, children, and adolescents. This Special Issue features novel advances in research and theory underlying the transition from acute to chronic pain using surgery as a model. These advances span basic, clinical, and translational perspectives that highlight a biopsychosocial framework of the development and treatment of pediatric chronic postsurgical pain (CPSP). CPSP develops in 11% to 54% of children and adolescents after major surgery and significantly impacts individual functioning, including school attendance and participation in social and physical activities. The articles in this Special Issue, authored by leading international experts, make it clear that the development of pediatric CPSP is multifactorial and influenced by biological, psychological, and social factors that necessitate a multipronged approach to treatment. Using an eight-step process, Sieberg and colleagues set the stage for future research in pediatric CPSP. They promote the use of ongoing and continuous evaluation and treatment of premitigating factors including premorbid status, surgery, and immediate postsurgery treatments, as well as objective assessment of the transition to chronicity and treatment rehabilitative processes. Essential to the effective assessment and treatment of pediatric CPSP in humans is understanding the biological mechanisms underlying the transition to pain chronicity. Walker’s state-of-the-art review describes the parallels between clinical observation and translational laboratory studies that investigate the acute and long-term effects of surgical injury on nociceptive pathways. Importantly, Walker draws attention to the potential sex-dependent effects of various forms of peripheral and central neuroplasticity, including hyperalgesic or nociceptive priming, that may contribute to an increased risk of CPSP in adults scheduled for surgery who underwent a prior medical procedure or surgery in infancy or childhood. Dourson and colleagues review the current preclinical and clinical evidence for genetic and epigenetic mechanisms relevant to infant, childhood, and adolescent CPSP. They, too, focus on the complex interactions between neurons and immune cells in contributing to the phenomenon of nociceptive priming and to establishing a cellular “memory” of early life injury. Their forward-looking view anticipates the possibility of epigenetically programmed drugs to prevent pediatric CPSP. Individual psychological processes are a key part of pediatric CPSP with psychological factors often preceding the onset of and contributing to the maintenance of CPSP. Higher levels of anxiety, depression, and parent pain catastrophizing, as","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 2","pages":"46-48"},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9331195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10257085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"My Fibro Family!\" A qualitative analysis of facebook fibromyalgia support groups' discussion content.","authors":"Lyndsay Crump,&nbsp;Diane LaChapelle","doi":"10.1080/24740527.2022.2078183","DOIUrl":"https://doi.org/10.1080/24740527.2022.2078183","url":null,"abstract":"<p><strong>Background: </strong>Fibromyalgia (FM) is a diagnostically controversial syndrome characterized by chronic widespread pain, fatigue, sleep difficulties, cognitive dysfunction, and mental health symptoms. Though online peer support groups (OPSGs) may help persons with FM access support and information, there are concerns that such groups can be harmful.</p><p><strong>Aims and methods: </strong>Using a nonparticipatory observational stance, the authors analyzed discussions in three Facebook FM OPSGs (approximately 15,000 members, mostly women) to determine what themes best characterize their discussion content and whether being in a particular group was related to the type of thematic content to which they were exposed.</p><p><strong>Results: </strong>Two themes were identified that represented explicit reasons group members participated in the OPSG (trying to understand FM and seeking/offering emotional support). Six themes represented underlying reasons members sought informational and emotional support in FM OPSGs (fighting FM, learning to live with FM, struggling with identity, distressing thoughts and feelings, judgment, empowerment-seeking). No salient differences were identified between the thematic content of each group.</p><p><strong>Conclusions: </strong>The findings suggest that FM OPSGs may provide much needed psychosocial and emotional support regarding important aspects of psychological adjustment to living with FM while also inadvertently encouraging approaches to living with FM that do not align with evidence-based FM management recommendations (e.g., investment in fighting rather than accepting FM). These findings may be useful to patients considering joining an FM OPSG and to health providers helping patients navigate to resources that can address their emotional or psychological support needs.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 1","pages":"95-111"},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9733682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10331840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient satisfaction with virtual evaluation, diagnosis, and treatment of CRPS.","authors":"Emma Loy,&nbsp;Anna Scheidler,&nbsp;Tara Packham,&nbsp;Heather Dow,&nbsp;Paul Winston","doi":"10.1080/24740527.2022.2063113","DOIUrl":"https://doi.org/10.1080/24740527.2022.2063113","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has led to an increased reliance on virtual care in the rehabilitation setting for patients with conditions such as complex regional pain syndrome (CRPS).</p><p><strong>Aims: </strong>The aim of this study was to perform a quality improvement initiative to assess patient satisfaction and ensure that outcomes following virtual assessment, diagnosis, and treatment of CRPS with prednisone are safe and effective.</p><p><strong>Methods: </strong>An online survey was distributed to 18 patients with CRPS who had been seen virtually between March and December 2020 through a rehabilitation clinic and treated with oral prednisone. Thirteen participants completed the survey, which was designed de novo by our team to evaluate participant perceptions and satisfaction regarding the virtual care experience. Also included in the survey was a CRPS-specific validated patient-report questionnaire (Hamilton Inventory for CRPS: PR-HI-CRPS), which allowed participants to describe their specific symptoms and associated functional and psychosocial impacts, both previously (pretreatment baseline) and at the time of survey (posttreatment).</p><p><strong>Results: </strong>CRPS symptoms and related impacts were scored as significantly improved from baseline following treatment with prednisone. Likert scale results from survey responses related to patients' experiences and satisfaction with the virtual care process were analyzed; the majority of patients reported satisfaction with a virtual appointment for evaluation of CRPS, as well as with subsequent treatment decisions based on virtual assessment.</p><p><strong>Conclusions: </strong>This quality improvement study suggests that virtual care is a potential option for a patient-accepted approach to overcoming challenges with in-person care imposed by the COVID-19 pandemic and could help inform future considerations in addressing geographic and patient-specific disparities in access to specialist care for CRPS.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 1","pages":"77-84"},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9176228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10380950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of cannabis use for pain management in Quebec: A post-legalization estimate among generations living with chronic pain.","authors":"Marimée Godbout-Parent,&nbsp;Hermine Lore Nguena Nguefack,&nbsp;Adriana Angarita-Fonseca,&nbsp;Claudie Audet,&nbsp;Andréanne Bernier,&nbsp;Ghita Zahlan,&nbsp;Nancy Julien,&nbsp;M Gabrielle Pagé,&nbsp;Line Guénette,&nbsp;Lucie Blais,&nbsp;Anaïs Lacasse","doi":"10.1080/24740527.2022.2051112","DOIUrl":"https://doi.org/10.1080/24740527.2022.2051112","url":null,"abstract":"<p><strong>Background: </strong>Medical cannabis has been legal in Canada since 2001, and recreational cannabis was legalized in October 2018, which has led to a widespread increase in the accessibility of cannabis products.</p><p><strong>Aims: </strong>This study aimed to estimate the prevalence of cannabis use among adults living with chronic pain (CP) and investigate the relationship between age and cannabis use for CP management.</p><p><strong>Methods: </strong>A cross-sectional analysis of the COPE Cohort data set, a large Quebec sample of 1935 adults living with CP, was conducted. Participants completed a web-based questionnaire in 2019 that contained three yes/no questions about past-year use of cannabis (i.e., for pain management, management of other health-related conditions, recreational purposes).</p><p><strong>Results: </strong>Among the 1344 participants who completed the cannabis use section of the questionnaire, the overall prevalence of cannabis use for pain management was 30.1% (95% confidence interval 27.7-32.7). Differences were found between age groups, with the highest prevalence among participants aged ≤26 years (36.5%) and lowest for those aged ≥74 years (8.8%). A multivariable logistic model revealed that age, region of residence, generalized pain, use of medications or nonpharmacological approaches for pain management, alcohol/drug consumption, and smoking were associated with the likelihood of using cannabis for pain management.</p><p><strong>Conclusions: </strong>Cannabis is a common treatment for the management of CP, especially in younger generations. The high prevalence of use emphasizes the importance of better knowledge translation for people living with CP, rapidly generating evidence regarding the safety and efficacy of cannabis, and clinicians' involvement in supporting people who use cannabis for pain management.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 1","pages":"65-77"},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9176231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10380952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do pain management apps use evidence-based psychological components? A systematic review of app content and quality.","authors":"Megan MacPherson,&nbsp;A Myfanwy Bakker,&nbsp;Koby Anderson,&nbsp;Susan Holtzman","doi":"10.1080/24740527.2022.2030212","DOIUrl":"https://doi.org/10.1080/24740527.2022.2030212","url":null,"abstract":"<p><strong>Background: </strong>With hundreds of pain management apps on the Canadian marketplace, it can be challenging for patients and clinicians to select effective and evidence-based mobile health (mHealth) apps that address pain from a biopsychosocial perspective.</p><p><strong>Aims: </strong>The aim of this study is to identify pain management apps within the Canadian app marketplaces to aid clinicians in recommending apps.</p><p><strong>Methods: </strong>The iOS and Android marketplaces were systematically searched to identify pain management apps that included at least one core component of cognitive behavioral therapy (CBT) or mindfulness- and acceptance-based therapies. Selected apps were assessed using a researcher developed psychological components checklist, and the Mobile App Rating Scale (MARS). These two measures provided a robust assessment of the apps' technical abilities and psychological principles being implemented.</p><p><strong>Results: </strong>Five hundred eight pain management apps were identified, yet only 12 included a psychological component and were available for evaluation. On average, apps contained 8.10 out of 18 psychological components (SD = 2.77) with a MARS quality rating of 4.02 out of 5 (SD = 0.32). The most common psychological components were grounded in CBT, including psychoeducation, sleep hygiene, behavioral activation, coping skills training, and social support. Among the least commonly included components were goal setting, values, and culture/diversity. Two-thirds of the apps involved health care practitioners in their development, but independent scientific review of apps was scarce.</p><p><strong>Conclusion: </strong>The highest scoring apps (Curable, Pathways, Vivify) are highlighted for health care practitioners who may wish to recommend mHealth technologies to their patients for pain management. Future directions for research and app development are discussed.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 1","pages":"33-44"},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9176230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10380951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pilot feasibility and acceptability study of an Internet-delivered psychosocial intervention to reduce postoperative pain in adolescents undergoing spinal fusion","authors":"C. Murray, Anthea Bartlett, Alagumeena Meyyappan, T. Palermo, R. Aaron, J. Rabbitts","doi":"10.1080/24740527.2021.2009334","DOIUrl":"https://doi.org/10.1080/24740527.2021.2009334","url":null,"abstract":"ABSTRACT Background Spinal fusion surgery is a common and painful musculoskeletal surgery performed in the adolescent population. Despite the known risk for developing chronic postsurgical pain, few perioperative psychosocial interventions have been evaluated in this population, and none have been delivered remotely (via the Internet) to improve accessibility. Aims The aim of this single-arm pilot study was to evaluate the feasibility and acceptability of the first Internet-based psychological intervention delivered during the perioperative period to adolescents undergoing major spinal fusion surgery and their parents. Methods Thirteen adolescents (M age = 14.3; 69.2% female) scheduled for spine fusion surgery and their parents were provided access to the online psychosocial intervention program. The program included six lessons delivering cognitive-behavioral therapy skills targeting anxiety, sleep, and acute pain management during the month prior to and the month following surgery. Feasibility indicators included recruitment rate, intervention engagement, and measure completion. Acceptability was assessed via quantitative ratings and qualitative interviews. Results Our recruitment rate was 81.2% of families approached for screening. Among participating adolescent–parent dyads, high levels of engagement were demonstrated (100% completed all six lessons). All participants completed outcome measures. High treatment acceptability was demonstrated via survey ratings and qualitative feedback, with families highlighting numerous strengths of the program as well as areas for improvement. Conclusions These findings suggest that this online psychosocial intervention delivered during the perioperative period is feasible and acceptable to adolescents and their parents. Given favorable feasibility outcomes, an important next step is to evaluate the intervention in a full-scale randomized controlled trial.","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"6 1","pages":"12 - 23"},"PeriodicalIF":2.4,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45114289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-sectional study of pediatric pain prevalence, assessment, and treatment at a Canadian tertiary hospital.","authors":"Alex Senger,&nbsp;Rhonda Bryce,&nbsp;Casey McMahon,&nbsp;Krista Baerg","doi":"10.1080/24740527.2021.1961081","DOIUrl":"https://doi.org/10.1080/24740527.2021.1961081","url":null,"abstract":"<p><strong>Background: </strong>Painful experiences are common among hospitalized children. Long-term negative biopsychosocial consequences of undertreated pain are recognized.</p><p><strong>Aims: </strong>The study benchmarks pain prevalence, assessment, and treatment as first steps to improve pain care in a Canadian tertiary hospital.</p><p><strong>Methods: </strong>Single-day audits were undertaken on the pediatric ward (PW), pediatric emergency department (ED), and maternal services (MS). Participants (child or caregiver proxy) reported hospital pain experiences in the preceding 24 h; medical records were reviewed for assessment and treatment.</p><p><strong>Results: </strong>Among 84 participants, pain prevalence ranged from 75% to 88%; mean pain intensity ranged from 5.7 to 6.5/10. Prevalence of moderate to severe pain was 78% on PW, 65% in ED, and 55% on MS; needle pokes were the most frequent cause of worst pain. Documentation of pain assessment varied by setting (PW, 93%; ED, 13%; MS, 0%). Documented maximum pain scores were significantly lower compared to participant report (mean difference 4.5/10, SD 3.1, <i>P</i> < 0.0001). A total 29% (6/21) of infants with heel lance or injection received breastfeeding or sucrose, and 29% (7/24) of participants receiving other needle procedures had documented or reported topical lidocaine use. All participants on MS underwent needle procedures.</p><p><strong>Conclusions: </strong>Pain is experienced commonly by infants and children in PW, ED, and MS. Pain assessment documentation is not routine and underestimates participant report. Evidence-based pain management strategies are underutilized. An institution-wide quality improvement approach is required to address pain care. Pain assessment and needle pain prevention and treatment should be prioritized in these pediatric acute care and newborn care settings.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"5 1","pages":"172-182"},"PeriodicalIF":2.4,"publicationDate":"2021-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8489950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39491750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 Pandemic Impact and Response in Canadian Pediatric Chronic Pain Care: A National Survey of Medical Directors and Pain Professionals.","authors":"Tieghan Killackey,&nbsp;Melanie Noel,&nbsp;Kathryn A Birnie,&nbsp;Manon Choinière,&nbsp;M Gabrielle Pagé,&nbsp;Lise Dassieu,&nbsp;Anaïs Lacasse,&nbsp;Chitra Lalloo,&nbsp;Sarah Brennenstuhl,&nbsp;Patricia Poulin,&nbsp;Pablo Ingelmo,&nbsp;Samina Ali,&nbsp;Marco Battaglia,&nbsp;Fiona Campbell,&nbsp;Andrew Smith,&nbsp;Lauren Harris,&nbsp;Vina Mohabir,&nbsp;Myles Benayon,&nbsp;Isabel Jordan,&nbsp;Justina Marianayagam,&nbsp;Jennifer Stinson","doi":"10.1080/24740527.2021.1931069","DOIUrl":"https://doi.org/10.1080/24740527.2021.1931069","url":null,"abstract":"<p><p><b>Background</b>: The COVID-19 pandemic presents one of the greatest threats to pediatric pain care seen in generations. Due to public health restrictions, many pediatric pain clinics halted in-person appointments, delaying and disrupting access to care. There is no existing research on the impacts of COVID-19 on pediatric chronic pain care in Canada or the challenges experienced by health care professionals and pain clinics. <b>Aims</b>: The aim of this study was to evaluate the impact of COVID-19 on Canadian pediatric chronic pain care by documenting how health care professionals provided care during the first six months of the pandemic. <b>Methods</b>: Two Canadian online cross-sectional surveys were conducted: one among Canadian pediatric pain clinic directors (Study 1) and another among multidisciplinary pediatric pain health care professionals (Study 2). <b>Results</b>: Responses from 13/13 Canadian pediatric pain clinics/rehabilitation programs indicated that all clinics provided virtual care during the pandemic. No significant changes were reported on the frequency of appointment requests. Most clinics reported no perceived change in patient pain levels (<i>n</i> = 9/13, 69%) or occurrence of pain flares (<i>n</i> = 10/13, 77%). Results from 151 individual health care professionals indicated that the majority (90%) of non-emergency department respondents were providing virtual care. The main challenges of virtual care included technological barriers, financial concerns, infrastructure and logistics, privacy, and clinical challenges. <b>Conclusions</b>: This study documented the impact of the COVID-19 pandemic on pediatric chronic pain care in Canada and highlighted the rapid shift to using virtual solutions. Simultaneously, respondents outlined current challenges and potential solutions to consider in the development of virtual care guidelines and policy in Canada.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"5 1","pages":"139-150"},"PeriodicalIF":2.4,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24740527.2021.1931069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39185228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Cohort Study of Healthcare Utilization Associated with Paravertebral Blocks for Chronic Pain Management in Ontario.","authors":"George Deng,&nbsp;Michael Gofeld,&nbsp;Jennifer N Reid,&nbsp;Blayne Welk,&nbsp;Anne Mr Agur,&nbsp;Eldon Loh","doi":"10.1080/24740527.2021.1929883","DOIUrl":"https://doi.org/10.1080/24740527.2021.1929883","url":null,"abstract":"<p><p><b>Background</b>: Injections, particularly paravertebral blocks (PVBs), are frequently performed procedures in Ontario, Canada, for the management of chronic pain, despite limited evidence and risk of complications. <b>Aim:</b> This study examines usage patterns of PVBs to evaluate their effects on healthcare utilization and opioid prescribing. <b>Methods:</b> A retrospective cohort study in Ontario using administrative data. Ontario residents receiving their initial PVBs between July 1, 2013 and March 31, 2018 were included. Changes in use of other interventions, physician visits, and opioids were compared to the 12-month periods before and after index PVBs. Data use was authorized under section 45 of Ontario's Personal Health Information Protection Act. <b>Results:</b> 47,723 patients received their initial PVBs in the study period. The rate of index PVBs increased from 1.61 per 10,000 population (2013) to 2.26 per 10,000 (2018). Initial PVBs were performed most commonly by family physicians (<i>N</i> = 25,042), followed by anesthesiologists (<i>N</i> = 14,195). 23,386 patients (49%) received 1 to 9 repeat PVBs in the 12 months after index PVB; 12,474 patients (26.15%) received 10 or more. Use of other nonimage guided interventional pain procedures per patient (mean±SD) increased from 2.19 ± 9.35 to 31.68 ± 52.26 in the year before and after index PVB. Relevant physician visits per patient (mean±SD) also increased from 2.92 ± 3.61 to 9.64 ± 11.77. Mean opioid dosing did not change significantly between the year before and the year after index PVB. <b>Conclusion:</b> PVBs are associated with increases in healthcare utilization and no change in opioid use patterns.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"5 1","pages":"130-138"},"PeriodicalIF":2.4,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24740527.2021.1929883","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39185227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}