TIP OF THE WEEK
Non-pharmacological approaches to pain management
One in four U.S. adults say they suffered a day-long bout of pain in the past month, and one in 10 say the pain lasted a year or more, according to the 2006 report of the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics.[1]
Whether pain is a physical sensation or a psychological event has been a subject of much debate. Some argue that it is in fact a combination of both. A 2005 study confirmed that negative and positive thinking have direct effects on the pain a person feels.[2]
Thus, consider following the National Guideline Clearinghouse (NGC) guideline of developing a combination strategy that includes both pharmacological and non-pharmacological approaches.[3] The NGC recommends investigating the patient’s attitudes and beliefs about, preference for, and experience with non-pharmacological pain treatment strategies.[4]
A variety of non-pharmacological pain relief techniques exist, which is why it is important to develop a non-pharmacological pain management plan that is tailored to the individual. Below are just a few ideas:
- Music can be a powerful tool for managing pain. According to an article published in the Journal of Advanced Nursing in 2006, listening to music can reduce chronic pain by up to 21 percent and depression by up to 25 percent.[5]
- Deep relaxation techniques such as meditation, autogenic training, and progressive muscle relaxation, as well as brief relaxation techniques such as self-control relaxation, paced respiration, and deep breathing are helpful for some individuals.[6]
- Read more about How to Meditate from Arthritis Today.
- Imagery or “guided imagery” is the use of imagination to create sights, sounds, smells, tastes, or other sensations to create a purposeful dream. Similar to meditation, supporters of this technique attribute many potential health benefits, including pain relief.[7]
- Massages can help some patients relax, relieve pain/stiffness, increase mobility, rehabilitate injured muscles, and reduce the pain of headaches and backaches.[8]
- Acupuncture relieves pain for some people. Clinical trials to relieve cancer pain have shown positive results.[9]
- Other non-drug treatments for pain identified by the National Cancer Institute[10] include:
- Relaxation
- Visual concentration and rhythmic massage
- Slow rhythmic breathing
- Distraction
- Hypnosis
- Skin stimulation, pressure, vibration
- Application of cold, heat, or menthol
- Emotional support and counseling
Note: Not all pharmacological treatments work for all patients, and some may have negative effects. Talk to your patients about which non-pharmacological approaches to pain management. may be best for them.
RESOURCE SPOTLIGHT
Fast Facts – Integrating Non-Pharmacological Interventions into Pain Management Plans
This fact sheet from July 2006 focuses on integrating non-pharmacological interventions into pain management plans.
IN THE NEWS
MEDICARE/MEDICAID REVISIT FEES OVERVIEW
The 2007 Continuing Appropriations Resolution (Pub. L. No. 110-5, H.J.Res.20, §20615(b)(2007)) directed the Department of Health and Human Services to charge user fees necessary for conducting revisit surveys on health care facilities cited for deficiencies during initial certification, recertification, or substantiated complaint surveys. Revisit surveys are performed when there are findings of deficiencies in patient care or processes that were identified in an earlier survey and are conducted to assure that the deficiencies have been corrected. The primary purpose for the user fees is to provide for the continuation of Centers for Medicare & Medicaid Services (CMS) Survey and Certification quality assurance efforts to improve patient care and safety.
The fees were effective on September 19, 2007 until the end of the 2007 federal fiscal year, which concludes on September 30, 2007. CMS will use the current fee schedule until such time as a new fee schedule notice is proposed and published in final form. The final fee schedule for revisit surveys in home health agencies is $168 per offsite revisit survey and $1,613 per onsite revisit survey.
Fees are based on the cost that CMS incurs as a result of the time and effort for State surveyors to conduct follow up as a result of deficiencies found. Providers and suppliers have the right to reconsideration if they feel an error of fact has been made in the application of the user fee, such as clerical errors, billing for a fee already paid or assessment of a fee when there was no revisit scheduled. A request for reconsideration must be received by CMS within 14 calendar days from the date identified on the revisit user fee assessment notice.
Providers who are assessed a revisit user fee will receive a notice in the mail which will include the amount of the assessed fee. Payment must be received within 30 days or CMS could terminate the facility’s enrollment and participation in the Medicare program. If you have additional questions, contact Carla.McGregor@cms.hhs.gov.
ELDERLY PERSON HOME ALONE? TAKE STEPS TO BOOST SAFETY
September 21, 2007 -- Clarion Ledger -- For an elderly person, the home can be a dangerous place, with accidents waiting to happen. But smart ways of forestalling accidents need not wait. They can be quick, easy and inexpensive. This article includes a few tips on how to quickly and easily "elderproof" the home from Marion Somers, author and director of the professional geriatric-care management program at Hunter College's Brookdale Center on Aging. Read more >>
AGING IN PLACE SOLUTIONS TO BE HIGHLIGHTED IN EVENTS AROUND THE NATION, OCT. 1-7
September 20, 2007 -- PR Newswire -- Most Americans want to age in place. Current Census Bureau data tells us that over 90 percent of seniors who move stay within their county. Survey after survey indicates that a majority of those 65 and over -- say they would like to stay where they are for as long as possible. Read more >>
SCHIP PLAN TO FORGO MEDICARE CUTS
September 19, 2007 -- The Washington Times -- Congressional negotiators tentatively have agreed to avoid cutting funds to a Medicare program to pay for the expansion of a federally funded healthcare plan for low-income children, senior Capitol Hill aides say. Read more >>
STRICKLAND ORDERS UP HEALTH ADVISORY BOARD
September 18, 2007 -- Dayton Daily News -- Gov. Ted Strickland created a state advisory board aimed at reducing the growth in healthcare costs partly by improving the exchange of health information between providers and patients. The board's mission is to bring together representatives from the public and private sectors to work on health information technology issues and to coordinate that work with the Ohio Broadband Council. Read more >>
OIG RELEASES A NEW RESOURCE GUIDE ON CORPORATE RESPONSIBILITY AND HEALTH CARE QUALITY
September 10, 2007 -- OIG -- The Office of Inspector General (OIG) for the Department of Health and Human Services (HHS), in partnership with the American Health Lawyers Association (AHLA), released a resource guide on quality of care entitled “Corporate Responsibility and Health Care Quality: A Resource for Health Care Boards of Directors.” Read more (PDF) >>
Download the resource guide (PDF)
COMING ATTRACTIONS
Preventing Pressure Ulcers
IHI Teleconference -- October 4, 2007, 1:00 to 2:00 p.m.
Dial: 800-860-2442. No PIN code is required. Ask the operator to connect you to the Campaign Office.
Preventing Adverse Drug Events (Medication Reconciliation)
IHI Teleconference -- October 9, 2007, 1:00 to 2:00 p.m.
Dial: 800-860-2442. No PIN code is required. Ask the operator to connect you to the Campaign Office.
CMS Home Health, Hospice & DME Open Door Forum
October 10, 2007, 2:00 p.m.
Dial: 1.800.837.1935, ID #: 17456028
Improving AMI Care
IHI Teleconference -- October 18, 2007, 1:00 to 2:00 p.m.
Dial: 800-860-2442. No PIN code is required. Ask the operator to connect you to the Campaign Office.
OCHC Home Health Reform PPS Workshop
A full day in-depth program is scheduled for October 24, 2007 to provide detailed instruction on how to implement the changes at your agency. Download flyer >>
OHCO: Connecting OASIS and Clinical Decisions in the post-PPS Reform Environment
October 30, 2007
Contact Karen Lowe at (614)763-0036, Ext. 206 for more information.
The Many Facets of Pain Management: An Integrated Approach
November 7, 2007, 8:00 a.m. to 4:30 p.m.
MetroHealth Medical Center, Cleveland.
Call (216) 778-7707 for more information.
The Tip of the Week Archive is available on the Ohio KePRO Web Site.
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