Acute pain management can be improved

Article Abstract:

The Agency for Health Care Policy and Research has issued a clinical practice guideline for the management of pain. The impetus for this report came from studies showing that pain control in half of the 23 million individuals who have surgery each year is inadequate. The guideline recommends pain management that is adapted to each individual's medical condition and personal preference. Both patient and doctor should agree on the plan, and the patient should provide feedback on the effectiveness of the plan. Treatment should begin early, and should include techniques such as relaxation, massage and electroanalgesia. Treatment should be provided continuously, and patients should be closely monitored. Patients should be encouraged to control their own treatment if appropriate. Nonsteroidal anti-inflammatory drugs should be used to control moderate pain, and opioids should be used for more severe pain. Nerve blockade can also be used to control pain.

Care and treatment, Pain, Pain management

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Improving clinical practice

Article Abstract:

The Agency for Health Care Policy and Research (AHCPR) has been charged by Congress to review various treatment options and publish clinical practice guidelines to help doctors make appropriate treatment choices. The agency awards contracts to public and private organizations and also convenes panels of health care professionals and consumers to review these guidelines. The first guideline on postoperative pain management was published in the May 20, 1992 issue of JAMA. The guideline calls for aggressive pain control that involves the patient, uses non-drug treatments as well as drugs and administers drugs on a 24-hour basis. Guidelines will be updated to incorporate innovative treatments. Guidelines are available from the agency by calling 1-800-358-9295 or by writing to the AHCPR Publications Clearinghouse, PO Box 8547, Silver Spring, MD 20907.

Editorial

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Depression in primary care

Article Abstract:

The Agency for Health Care Policy and Research has issued practice guidelines for diagnosing and treating depression. General practitioners are often the first to see depressed patients yet they often fail to diagnose depression. Symptoms of depression often include indecisiveness, loss of concentration, weight fluctuation, lack of interest in most activities and a change in sleep patterns. Risk factors for the development of depression include a family history of depression, a history of suicide attempts, substance abuse and a personal history of depression. Both medication and psychotherapy can be used to treat depression. Follow-up is important to prevent a relapse.

Standards, Diagnosis, Depression, Mental, Depression (Mood disorder)

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