Three Core Principles Of Non-Pharmacological Approaches To Chronic Care

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SECTION 2: NON-PHARMACOLOGIC APPROACHES TO CHRONIC PERSISTENT PAIN

Abstract: Non-pharmacological therapies have become a vital part of treating CPP. The combination of both non-pharmacological and pharmacological therapies is termed multi modal. In general non-pharmacological measures are used to augment and complement pharmacological treatments. They can be classified as non-invasive or invasive methods. They include physical, cognitive, behavioral or complementary therapies. Clinicians should become familiar with several of these interventions, which will enable them to offer their patients flexibility in the pain management approach. Most treatment modalities are based largely on expert panel recommendation rather than data from randomized
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Wagner in 1996 which has since become a widely adopted approach to improve the care of chronic illnesses in an ambulatory care setting.2 In this model, improved outcomes are achieved when patients are informed, motivated, practice balanced and are prepared and proactive, patient care is patient-centric and collaborative, and community and other resources are appropriately assessed. The clinician should apply the three Core Principles that serve as pillars to this framework and discuss these in detail with their patients. These include: 1. Explanation of the nature of the chronic pain condition. 2. Setting appropriate treatment goals (5 R’s and 2 E’s). 3. Developing a comprehensive treatment approach and making sure that the patient is able to follow this. The encouragement is necessary since many patients already lost function and have poor coping skills, and will have to adopt significant life-style changes, and take a more active role in taking care of their CPP. Realize that above is very difficult for patients to accept, and generally takes time. Change will often require support from health care professionals, employers, and family. A "start low go slow" approach is most …show more content…
Available randomized trials of opioids are best described as efficacy studies conducted in ideal settings and with selected populations, usually with less than 6 months follow up. Evidence on opioids for CLBP, MFPS, and headache is very limited or did not show a clear benefit.

The clinician (health care professional) patient relationship can be a powerful tool for healing. To maintain an open, health-promoting relationship, the clinician needs to ensure that patients feel they are heard and understood, and involve the patient in designing and monitoring the treatment plan. Despite little research to explicitly examined empathy in the treatment of pain, clinicians should approach their pain patients with empathy, which is the foundation for effective pain management.4

Clinicians, treating patients with CPP, need to apply self-care, and address appropriate boundaries with their patients. Maintaining a balance lifestyle will decreased burn out while taking caring of CPP

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