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Chronic non cancer pain in primary care and use of opioids (Nicholson & Pasik, 2007). In the USA estimates suggest that 50 million people suffer from chronic non cancer pain, with 41% dissatisfied with the outcomes of their pain treatment. The frequent site at which these patients seek health care is from primary care. In the primary care environment prevalence of chronic non cancer pain ranges from 5% to 33% (Nicholson & Pasik, 2007).3) Extent of opioid misuse in primary care and causes (Von Korff et al, 2011).
True estimates of the extent to which prescription opioids are misused among primary care patients are not available, but the limited evidence from surveys conducted suggest that the prevalence of prescription opioid misuse in primary care could range from 4% to 26% (Von Korff et al, 2011)4) Primary care givers need to have adequate knowledge on preventing opioid misuse Salloum, 2010). Though the true prevalence of prescription opioid misuse remains elusive the indications of high abuse of prescription opioids raises the relevance of prevention practices at the point of misuse (Ruiz & Strain, 2010).B. Establish a working definition of prescription opioid abuse and identification of the characteristics of prescription opioid abuse 1) According to Friedman et al p, 454, NUPM in a wide perspective may be taken to mean “the use of a scheduled prescription medication without the prescribing clinician’s knowledge” (Friedman et al, 2009).2) Characteristics of abuse of prescription narcotics (Liebschutz et al, 2010).
ry care patients diagnosed with chronic pain and prescribed opioids shows that the characteristics for PDUD in such patients include cigarette smoking, high severity of pain, personal and family history of substance abuse, post-traumatic stress disorder, and experience of a jail sentence (Liebschutz et al, 2010). 3) Caregiver knowledge and attitudes in the prescribing of narcotics for non cancer chronic pain (Srivatsava, 2007). Evidence coming from surveys conducted on care givers points to knowledge deficits in care givers and attitudinal issues acting as barriers to efficient management of pain.
Quite often fear of addiction and misuse of prescribed narcotics is the basis of unsatisfactory management of pain (Srivatsava, 2007). 4) Patient perspective on prescribing of narcotics for non cancer chronic pain (Srivatsava, 2007). From the perspective of patients it is the care providers in the form of medical and nursing professionals that are knowledgeable on issues pertaining to employing narcotics in the treatment of pain, and they expect that these professionals provide them with the appropriate information on narcotics in the treatment of non cancer chronic pain, to make it a useful part in their treatment (Srivatsava, 2007).
II Theoretical Considerations (Not done as no guidelines received and not mandatory for the annotated outline) III Review of Literature A literature review matrix has been generated for effectively developing the literature review. 15 peer reviewed primary research articles relevant to the topic of the dissertation were selected. The inclusion criterion was that these articles were published on or later than 2006. The rationale behind such an inclusion criteria was to make the literature deliver the currently relevant body of knowledge on the
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