Quality and usability of arthritic pain self-management apps for older adults: A systematic review

© 2017 American Academy of Pain Medicine. Objective. To appraise the quality and usability of currently available pain applications that could be used by community-dwelling older adults to selfmanage their arthritic pain. Methods. A systematic review. Searches were conducted in App Store and Google Play to identify pain self-management apps relevant to arthritic pain management. English language pain management apps providing pain assessment and documentation function and pain management education were considered for inclusion. A quality evaluation audit tool based on the Stanford Arthritis Self-Management Program was developed a priori to evaluate app content quality. The usability of included apps was assessed using an established usability evaluation tool. Results. Out of the 373 apps that were identified, four met the inclusion criteria. The included apps all included a pain assessment and documentation function and instructions on medication use, communication with health professionals, cognitive behavioral therapy-based pain management, and physical exercise. Management of mood, depression, anxiety, and sleep were featured in most apps (N =3). Three-quarters (N = 3) of the apps fell below the acceptable moderate usability score (≥3), while one app obtained a moderate score (3.2). Conclusions. Few of the currently available pain apps offer a comprehensive pain self-management approach incorporating evidence-based strategies in accordance with the Stanford Arthritis Self- Management Program. The moderate-level usability across the included apps indicates a need to consider the usability needs of the older population in future pain self-management app development endeavors

Pain Management: A Flowsheet for Providers

Many different factors led to the trend of providers prescribing opioids for chronic pain. However, the misuse of and many deaths related to opioid prescriptions have caused the trend to reverse its direction. National organizations call for providers to stay clear of opioid medication and increase the use of nonpharmacological pain management, but also to treat pain adequately. There are still many barriers to decreasing the use of opioids and increasing the use of nonpharmacological methods. This scholarly project hoped to use an educational flowsheet to assist providers in meeting the demands from national organizations to decrease the use of pain medications and patients to treat pain adequately

Axial Spondyloarthropathies in the Western Cape

Impaired Health-Related Quality of Life and Work Productivity amongst South African patients with Axial Spondyloarthritis. Background: No studies have investigated health-related quality of life (HRQoL) or work productivity in patients with axial spondyloarthritides (axSpA) living in sub-Saharan Africa. Methods: This cross-sectional study of adults with axSpA collated demographic particulars and patient questionnaires: Bath Ankylosing Spondylitis Disease Activity Index (BASDAI); Bath Ankylosing Spondylitis Functional Index (BASFI); Bath Ankylosing Spondylitis Global Score (BASG); Medical Short Form (SF)-36; and Work Productivity and Activity Impairment Questionnaire: Specific Health Problem (WPAI:SHP). Results: Of 36 patients, the mean (SD) age was 40.3 (13.3) years and mean (SD) diagnostic delay was 8.7 (8.4) years. Most patients were male (80.6%) and of mixed racial ancestry (69.4%). Most (66.7%) patients were smokers and only 5 (13.9%) patients received tumor necrosis factor inhibitor (TNFi) therapy. The mean (SD) BASDAI was 5.3 (2.1), and 72.2% had a BASDAI ≥ 4. Patients with a high BASDAI (i.e. BASDAI ≥ 4) had higher BASG scores (p=0.003), higher WPAI:SHP activity impairment scores (p=0.003), and poorer SF-36 scores, particularly in the role-physical, bodily pain, and social functioning domains (p=0.0001, 0.001 and 0.02 respectively). Activity impairment according to the WPAI:SPH was 57.4%, with the BASDAI and activity impairment correlating closely (p=0.006). The SF-36 scores were low in physical (particularly role-physical, bodily pain, and general health) and mental (notably vitality and role emotional) domains. 6 Conclusion: This study describes a cohort of South African patients with axSpA who have poor prognostic features including diagnostic delay and cigarette smoking. Active disease, impaired function, poor physical- and mental HRQoL, and work disability are unmet needs

RA-MAP, molecular immunological landscapes in early rheumatoid arthritis and healthy vaccine recipients

Rheumatoid arthritis (RA) is a chronic inflammatory disorder with poorly defined aetiology characterised by synovial inflammation with variable disease severity and drug responsiveness. To investigate the peripheral blood immune cell landscape of early, drug naive RA, we performed comprehensive clinical and molecular profiling of 267 RA patients and 52 healthy vaccine recipients for up to 18 months to establish a high quality sample biobank including plasma, serum, peripheral blood cells, urine, genomic DNA, RNA from whole blood, lymphocyte and monocyte subsets. We have performed extensive multi-omic immune phenotyping, including genomic, metabolomic, proteomic, transcriptomic and autoantibody profiling. We anticipate that these detailed clinical and molecular data will serve as a fundamental resource offering insights into immune-mediated disease pathogenesis, progression and therapeutic response, ultimately contributing to the development and application of targeted therapies for RA

RA-MAP, molecular immunological landscapes in early rheumatoid arthritis and healthy vaccine recipients

Rheumatoid arthritis (RA) is a chronic inflammatory disorder with poorly defined aetiology characterised by synovial inflammation with variable disease severity and drug responsiveness. To investigate the peripheral blood immune cell landscape of early, drug naive RA, we performed comprehensive clinical and molecular profiling of 267 RA patients and 52 healthy vaccine recipients for up to 18 months to establish a high quality sample biobank including plasma, serum, peripheral blood cells, urine, genomic DNA, RNA from whole blood, lymphocyte and monocyte subsets. We have performed extensive multi-omic immune phenotyping, including genomic, metabolomic, proteomic, transcriptomic and autoantibody profiling. We anticipate that these detailed clinical and molecular data will serve as a fundamental resource offering insights into immune-mediated disease pathogenesis, progression and therapeutic response, ultimately contributing to the development and application of targeted therapies for RA.</p

Sleep Quality Screening in Primary Care Patients with Chronic Pain

Background: Many patients receive treatment for chronic pain from a primary care provider. There is a known relationship between sleep and pain perception, making sleep an important factor to assess in patients with chronic pain. Unlike in specialist pain management settings, sleep is not routinely assessed in the primary care setting, resulting in missed treatment opportunities and suboptimal chronic pain management. Objective: To assess the sleep quality of patients with chronic pain in the primary care setting through the use of the Pittsburgh Sleep Quality Index (PSQI) questionnaire during the patient intake process. Methods: Patients meeting inclusion criteria received a PSQI while waiting to see a provider at chronic care visits. The primary care provider was alerted to the result, and patients who were identified as having poor sleep quality scoring \u3e 5 on the PSQI had the opportunity to receive further assessment and treatment from the provider. Results: Sample data scores revealed 77.7% (n = 7) of patients with chronic pain had global PSQI greater than 5, which is indicative of impaired sleep quality (M = 13, SD = 5.24). All patients (n = 9) received educational handouts from their providers concerning sleep hygiene. The number of patients with an insomnia diagnosis (n = 7) and the number of patients receiving prescribed medication for insomnia (n = 2) did not change after the screening implementation. Conclusion: Implementation of a sleep assessment tool such as the PSQI did not support the increased identification of an insomnia diagnosis or increased management of insomnia with medication in the primary care setting