Research encourages re-evaluation of special nerve treatment for chronic pain
Study examines impact of Paravertebral blocks on health care utilization and opioid prescriptions
2021-07-08
(Press-News.org) LONDON, ON - Hospital researchers from Lawson Health Research Institute have published a recent study that assessed the use of a specialized treatment for chronic pain and its impact on health care use and opioid prescribing.
Paravertebral blocks (PVBs) belong to a broader group of procedures called "nerve blocks." A recent Toronto Star report noted that OHIP has been billed $420 million for nerve block procedures since 2011. PVBs involve injecting medication around the nerves where they exit the bones of the spine, at different locations depending on the patient and the chronic pain they are experiencing.
The regular use of these procedures has been questioned by health care providers due to the high cost and limited evidence of their benefit in reducing chronic pain. While the effectiveness of PVBs has been examined in trauma, cancer pain and regional anesthesia during surgery, they have not been evaluated for use in chronic pain despite widespread use in Ontario.
It is estimated that one in five Canadians live with chronic pain. Pain that persists can affect all aspects of someone's life and health, particularly when it is not being managed.
This new study from London researchers found that 66,310 patients had a PVB between July 2013 and March 2018, and 47,723 patients were included in the study. In the year after a patient's first PVB, there was a significant increase in the number of physician visits. Additional PVBs were frequently performed after the first treatment, with over 26 per cent of patients receiving a PVB ten or more times in one year, with almost eight per cent of patients receiving 30 or more. No overall change was found in opioid dosage in the year after PVB was initiated compared to the year before.
"Frequent use of PVB is common. Initiating treatment with PVCs is associated with marked increases in health care utilization, which includes physician visits and other injection procedures," explains Dr. Eldon Loh, Lawson Associate Scientist and Physiatrist at St. Joseph's Health Care London.
This research provides a broad perspective on the use of PVBs in Ontario, and on the use of nerve blocking treatments in general. There has been a concern for several years about the over use of these procedures; however, this is the first study to systematically document the impact on health care utilization and opioid use.
"We hope that from this study, the appropriate use of PVBs and other pain interventions will be re-evaluated at a provincial level to ensure the use of health resources is being properly managed and we achieve the best outcome for patients," Dr. Loh adds.
INFORMATION:
The study, "A Retrospective Cohort Study of Healthcare Utilization Associated with Paravertebral Blocks for Chronic Pain Management in Ontario," published in the Canadian Journal of Pain.
ELSE PRESS RELEASES FROM THIS DATE:
2021-07-08
A new study shows that individuals with bipolar disorder who are exposed to significant trauma may be at greater risk for suicide death, suggesting that clinical diagnosis of or genetic predisposition to trauma-related conditions could be important factors to consider in suicide prevention.
Suicide is the 10th leading cause of death in the United States, accounting for over 40,000 deaths each year, and suicide death rates are 10 to 30 times higher for people with bipolar disorder than for the general population.
The research, spearheaded by Eric Monson, MD, PhD, and Hilary Coon, PhD, from the University of Utah, in collaboration with Virginia Willour, PhD, from the University of Iowa, set out to identify unique risk factors for suicide attempt and death ...
2021-07-08
Researchers have made significant advancements in correlating aberrations in specific brain circuits with neuropsychiatric conditions like depression. However, it remains difficult to prove that damage to these circuits causes the symptoms themselves and that targeting them with therapeutics could help patients. By integrating brain lesion datasets with data on how two treatments -- deep brain stimulation (DBS) and transcranial magnetic stimulation (TMS) -- influence neuropsychiatric disorders, researchers from Brigham and Women's Hospital and collaborators developed a new brain mapping approach that may help clarify the cause of a variety of neuropsychiatric conditions and identify promising stimulation sites to target therapeutically. Findings are published ...
2021-07-08
As the world continues to warm, many arid regions that already have marginal conditions for agriculture will be increasingly under stress, potentially leading to severe food shortages. Now, researchers at MIT have come up with a promising process for protecting seeds from the stress of water shortage during their crucial germination phase, and even providing the plants with extra nutrition at the same time.
The process, undergoing continued tests in collaboration with researchers in Morocco, is simple and inexpensive, and could be widely deployed in arid regions, the researchers say. ...
2021-07-08
As atmospheric concentrations of CO2 continue to rise, we are putting future generations at risk of having to deal with a massive carbon debt. IIASA researchers and international colleagues are calling for immediate action to establish responsibility for carbon debt by implementing carbon removal obligations, for example, during the upcoming revision of the EU Emissions Trading Scheme.
Over the last several decades, governments have collectively pledged to slow global warming through accords such as the Kyoto Protocol and the Paris Agreement. Despite the ratification of these agreements by a large number of countries, the atmospheric concentration of CO2 continues to rise. At the rate we are going, we are well on our way to using up the remaining quantity of CO2 emissions to limit temperature ...
2021-07-08
Doha, Qatar, July 8, 2021: In March 2020, thousands of scientists around the world united to answer a pressing and complex question: which genetic factors influence the wide variation in COVID-19 severity? Why are some patients severely affected while others escape with mild or no symptoms at all?
A comprehensive summary of their findings to date, published in Nature - the world's leading multidisciplinary science journal - revealed 13 loci, or locations in the human genome, that are strongly associated with infection or severe COVID-19. The researchers also identified causal factors such ...
2021-07-08
In March of 2020, thousands of scientists around the world united to answer a pressing and complex question: what genetic factors influence why some COVID-19 patients develop severe, life-threatening disease requiring hospitalization, while others escape with mild symptoms or none at all?
A comprehensive summary of their findings to date, published in Nature, reveals 13 loci, or locations in the human genome, that are strongly associated with infection or severe COVID-19. The researchers also identified causal factors such as smoking and high body mass index. These results come from one of the largest ...
2021-07-08
What The Study Did: The SARS-CoV-2 BNT162b2 (Pfizer-BioNTech) vaccine appeared to be safe and achieve satisfactory serologic status in patients with cancer. While there was a lag in antibody production compared with the rate in the noncancer control group, seroconversion occurred in most patients after the second dose.
Authors: Irit Ben-Aharon, M.D., Ph.D., of the Rambam Health Care Campus in Haifa, Israel, is the corresponding author.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamaoncol.2021.2675)
Editor's Note: The article includes conflict of interest and funding/support disclosures. Please ...
2021-07-08
Tumor fragments in the lab are able to predict whether the corresponding real-life patients will benefit from immunotherapy. "We've solved a major problem many scientists had been facing: preserving a tumors original composition and structure outside of the patient in the lab", says cancer researcher Daniela Thommen from the Netherlands Cancer Institute. On 8 July, the results of her study are published in Nature Medicine.
While some cancer patients experience incredible results from immunotherapy, many others do not benefit from this treatment, which puts patients' ...
2021-07-08
What The Study Did: A decline in COVID-19 cases after the vaccination of health care workers in a region of California that experienced high rates of COVID-19 disease over the winter is reported in this single-center study.
Authors: Shruti K. Gohil, M.D., M.P.H., of the University of California, Irvine School of Medicine, is the corresponding author.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamanetworkopen.2021.15980)
Editor's Note: Please see the article for additional information, including other ...
2021-07-08
A research team at Washington University School of Medicine in St. Louis has identified potential new treatment targets for Alzheimer's disease, as well as existing drugs that have therapeutic potential against these targets.
The potential targets are defective proteins that lead to the buildup of amyloid in the brain, contributing to the onset of problems with memory and thinking that are the hallmark of Alzheimer's. The 15 existing drugs identified by the researchers have been approved by the Food and Drug Administration (FDA) for other purposes, providing the possibility of clinical trials that could begin sooner than is typical, according to the researchers.
In addition, the experiments yielded seven drugs that may be useful for treating faulty proteins linked to Parkinson's ...
LAST 30 PRESS RELEASES:
[Press-News.org] Research encourages re-evaluation of special nerve treatment for chronic pain
Study examines impact of Paravertebral blocks on health care utilization and opioid prescriptions
