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Found 230 results
  1. News Article
    A patients group representing several British victims has launched legal action against the Spanish government over claims it failed to safeguard people against the potentially fatal side effects of one of the country’s most popular painkillers, involved in a series of serious illnesses and deaths. The drug metamizole, commonly sold in Spain under the brand name Nolotil, is banned in several countries, including Britain, the US, India and Australia. It can cause a condition known as agranulocytosis, which reduces white blood cells, increasing the risk of potentially fatal infection. The Association of Drug Affected Patients (ADAF) says adverse reactions to the drugs have led to sepsis, organ failure and amputations. It has identified about 350 suspected cases of agranulocytosis between 1996 and 2023, including those of 170 Britons who live in Spain or were on holiday there. The ADAF is examining more than 40 fatalities in which it considers the drug may have led, or contributed, to death. The patients group says that case reports, including a 2009 study, suggest the British population may be more susceptible to the drug’s side effects, but this has not been confirmed by independent scientific study. The group is demanding an investigation into the drug and new controls. It filed its action on 14 November in the national court in Madrid. Cristina García del Campo, founder of the organisation, said: “This drug has destroyed people’s lives and it should now be withdrawn. One lady took three tablets and she had part of her feet amputated and several fingers. Even if it doesn’t kill you, once you’ve had sepsis your body is never the same.” Read full story Source: The Guardian, 26 November 2023
  2. News Article
    Undergoing a medical procedure without an anaesthetic felt like being "flayed alive", according to Dee Dickens. The 53-year-old is one of many in the UK who have reported having a hysteroscopy, which is used to examine the uterus, without enough pain relief. Clinical guidelines say patients must be given anaesthetic options before the gynaecological exam. Cwm Taf Morgannwg health board said it was concerned by the experiences of Ms Dickens and urged her to get in touch. Ms Dickens, from Pontypridd, Rhondda Cynon Taf, had a hysteroscopy as an outpatient at the Royal Glamorgan Hospital in Llantrisant after experiencing bleeding despite being menopausal. Ms Dickens said her medical notes and past childhood sexual abuse were not considered and she was not offered a local anaesthetic prior to the procedure in October 2022. Due to underlying health conditions, including fibromyalgia and Ehlers-Danlos Syndromes (EDS), she was reluctant to have a general anaesthetic as it would have left her "poorly for weeks" so she had the hysteroscopy on painkillers only. "Everybody's bustling, so it's really difficult to advocate for yourself," said Ms Dickens. When the procedure began, she said she felt extreme pain, adding: "I was very aware that I was a black woman who felt like she was being experimented on with no anaesthetic. "They took out my coil and then they started on the biopsies and good God, that felt like being flayed alive. It was awful. "It was like having my insides scraped out and blown up all at the same time." Read full story Source: BBC News, 27 November 2023 What is your experience of having a hysteroscopy? Add your story to our painful hysteroscopy hub community thread.
  3. Content Article
    In this episode of the British Journal of General Practice podcast, the host talks to Dr Georgia Richards, a Research Fellow in the Centre for Evidence-Based Medicine at the University of Oxford, about her recent study into opioid prescribing. Opioids can also be acquired from outside of NHS services, including private prescribers, over-the-counter (e.g. CoCodamol), and through online healthcare services and pharmacies or the “dark web”. Without exploring non-NHS data, the full picture of opioid use in England cannot be understood. This is one of the first studies that sought to fill this important gap by investigating opioid prescribing in the private sector.
  4. Content Article
    During a fellowship rotation in gynaecology, Rebekah Fenton, asked the attending physicians what pain management options they could offer patients for insertion of an intrauterine device (IUD). Their answer surprised her: none.  The research on the effectiveness of pain management techniques during the procedure were not strong enough to warrant providing potential relief.  But Fenton knew the attending physician was wrong: she'd received the drug lidocaine during a recent visit to her own ob/gyn to get an IUD placed. The local anesthetic enabled her to avoid the experiences of many patients who often withstand debilitating cramping and pain during insertion, side effects that can last for hours after the procedure has ended.  By not teaching her how to administer pain treatment options such as lidocaine gel or injection, "they made the decision for me, whether I could give patients this option," said Fenton, now an adolescent medicine specialist at Alivio Medical Center in Chicago. Related hub content: See our Pain during IUD fitting community thread.
  5. Content Article
    People with chronic pain need personalised care – an approach offering patients choice and control over their mental and physical health, basing care on what matters to them personally, and focusing on individual strengths and needs. People in this position need someone to listen and acknowledge that these symptoms are real, not all in their head. They need someone to explain their chronic pain and other symptoms, but also someone for everything else too. As well as medical care, people need time and emotional care. But how on earth can this be achieved in UK primary care in 2023? Is this really the role of a modern GP? Even if it was how can it now be in our over-stretched, fragmented, target-driven services? In North-West London, Selena Stellman and Benjamin Ellis have tested a personalised care model to improve the care offered to patients with fibromyalgia and high impact chronic pain. In this opinion piece in BJGP Life, they discuss the two key changes in their approach.
  6. Content Article
    In this interview we talk to Trainee Clinical Psychologist, Sabrina Pilav, about her latest research project exploring negative experiences of coil/ intrauterine device (IUD) procedures. Sabrina explains how their in-depth qualitative methodology could contribute to improvements in the future and shares details of how people can participate.
  7. Content Article
    Paula Goss had surgery to implant rectopexy and vaginal meshes which left her with severe pain and other serious complications. In this blog, Paula talks about why she set up Rectopexy Mesh Victims and Support to campaign for adequate treatment, redress and justice for people injured by surgical mesh. She outlines the need for greater awareness of mesh injuries amongst both healthcare professionals and the public and talks about what still needs to be done to enable people to access the treatment and support they need.
  8. Content Article
    Orchard Care Homes had noticed high numbers of antipsychotic medicines being prescribed to people living with dementia. There appeared to be little consideration of why these people were distressed and communicating this through behaviour. Orchard staff were convinced pain was a key factor in these distress responses—they were not necessarily because the person had a diagnosis of dementia. Orchard adopted PainChek, a digital pain assessment tool, in 2021 to support their dementia promise framework. They worked with the PainChek team and ran a pilot with the app. They were one of the first care providers to use this solution in the UK. It was originally launched it in one of their specialist dementia care communities, but is now in all 23 Orchard homes. Since the rollout of the app, there has been an increase in available pain relief and a decrease in conflict-related safeguarding referrals. There is increased time available for colleagues and a reduction in polypharmacy. There has been a 10% decrease in antipsychotic medicine use across all 23 homes, promoting a greater quality of life. People now have effective pain management plans. Orchard have also been able to ensure distress plans are in place which firstly considers if pain is the cause of distress. This case study was submitted to the Care Quality Commission's (CQC's) Capturing innovation to accelerate improvement project by Orchard Care Homes.
  9. Content Article
    World Hospice and Palliative Care Day takes place on 14 October 2023.  Patient safety in hospice and palliative care involves ensuring that every patient is able to access the services, support and pain relief that they need when they reach the end of life. It is also vital that families and carers are given relevant and timely support and information by healthcare services during their loved one’s hospice or palliative care, and following their death.
  10. Content Article
    Researchers at the University of Hertfordshire are carrying out a study to better understand women’s negative experiences of IUD procedures. They hope this research will be used to develop new guidance for patients and professionals that reduces the risk of coil procedures being experienced as distressing. If you are aged 16+, have had a coil fitting/removal in the last 2 years in a UK health settings (GPs, sexual health clinics, gynaecologist, and any other medical setting) that you found distressing, and are able to provide a valid UK phone number (mobile or landline), then you are eligible to participate. Full details of the research and how to take part can be found via the link below or by contacting Sabrina at s.pilav@herts.ac.uk.
  11. News Article
    Millions of women and girls experience debilitating periods, yet nearly one-third never seek medical help, and more than half say their symptoms are not taken seriously, according to research. A survey of 3,000 women and girls for the Wellbeing of Women charity found that they are often dismissed as “just having a period”, despite experiencing severe pain, heavy bleeding and irregular cycles that can lead to mental health problems. Almost all of those surveyed, who were between 16 and 40 years old and based in the UK, had experienced period pain (96%), with 59% saying their pain was severe. 91% had experienced heavy periods, with 49% saying their bleeding was severe. Prof Dame Lesley Regan, the chair of Wellbeing of Women, said: “It’s simply unacceptable that anyone is expected to suffer with period symptoms that disrupt their lives, including taking time off school, work, or their caring responsibilities, all of which may result in avoidable mental health problems. “Periods should not affect women’s lives in this way. If they do, it can be a sign of a gynaecological condition that requires attention and ongoing support – not dismissal.” Wellbeing of Women has launched its “Just a Period” campaign, which Regan said aims to address “the many years of medical bias, neglect and stigma in women’s health”. This includes tips on how to get the most out of seeing your GP and what women should do if they feel they have been dismissed. Read full story Source: The Guardian, 14 September 2023
  12. Content Article
    From endometriosis to heart attacks, this Guardian article look into the causes and symptoms, and explore gender disparities in quality of care
  13. News Article
    Staffing shortages are likely to restrict the use of a beneficial painkiller in birthing suites, even once its use has been recommended by national guidance. Research by HSJ suggests that just over half of trusts are already offering remifentanil to women in labour, although some are having to restrict its use due to lack of staffing. Responses to freedom of information requests from 108 trusts revealed 55 offered remifentanil during labour in 2022-23. Recent draft National Institute for Health and Care Excellence guidance on intrapartum care, published in April, suggested healthcare professionals “consider intravenous remifentanil patient-controlled analgesia” in obstetric units. This is partly because it reduces the likelihood of forceps or ventouse being required compared to intramuscular pethidine (an opioid commonly used in labour). However, the drug is not yet mentioned in official NICE guidelines and the opioid’s use in labour is currently off-label (its more common licenced use is alongside anaesthesia in surgery). A Royal College of Anaesthetists spokesperson said the use of drugs off-label “is extremely common in obstetrics given that drug trials do not often include pregnant women”. Read full story (paywalled) Source: HSJ, 1 September 2023
  14. News Article
    Almost 180,000 patients have been prescribed strong painkillers every month for two years, a rise of over a third compared to levels recorded just before the pandemic, data obtained by HSJ shows. The figures collected by the NHS Business Services Authority showed 179,353 patients had been prescribed an opioid analgesic every month between April 2021 and March 2023, a 36% increase compared with 131,876 receiving the same prescription between April 2017 and March 2019. Guidelines issued by the National Institute for Health and Care Excellence in 2021 advised clinicians not to prescribe opioids to manage chronic pain. A statement published alongside an earlier draft of these guidelines explained: “While there was little or no evidence that they made any difference to people’s quality of life, pain or psychological distress, there was evidence that they can cause harm, including possible addiction.” In 2020, the Medicines and Healthcare Products Regulatory Agency asked healthcare professionals to discuss the risks of dependency and addiction with any patient taking or planning to take an opioid-containing medicine and made sure such warnings were reinforced in the patient information leaflet. The regulator at the time defined long-term use as longer than three months. Read full story (paywalled) Source: HSJ, 18 August 2023
  15. Content Article
    The pain and distress of not being able to see an NHS dentist are "totally unacceptable", an inquiry has told the government. A review was launched after a BBC investigation found 9 in 10 NHS dental practices across the UK were not accepting new adult patients. Some people drove hundreds of miles for treatment or even resorted to pulling out their own teeth, the BBC found. The government says it invests more than £3bn a year in dentistry. But a damning report, by the Commons' Health and Social Care Committee, says more needs to be done, and quickly. The House of Commons Committee report with recommendations to government can be viewed at the link below. The Government has two months to respond.
  16. Content Article
    This story is part one of a series by AP News, examining the health disparities experienced by Black Americans across a lifetime.
  17. Content Article
    Davina McCall’s documentary Pill Revolution missed an opportunity to validate painful experiences of intrauterine devices and promote better practice, writes Stephanie O'Donohue, Patient Safety Learning's Content and Engagement Manager, in an opinion piece for the BMJ.
  18. Content Article
    Epistemic injustice sits at the intersection of ethics, epistemology, and social justice. Generally, this philosophical term describes when a person is wrongfully discredited as a knower; and within the clinical space, epistemic injustice is the underlying reason that some patient testimonies are valued above others. The following essay, published in Philosophy, Ethics, and Humanities in Medicine, seeks to connect patterns of social prejudice to the clinical realm in the United States: illustrating how factors such as race, gender identity, and socioeconomic status influence epistemic credence and associatively, the quality of healthcare a person receives.
  19. Content Article
    Trust is central to the therapeutic relationship, but the epistemic asymmetries between the expert healthcare provider and the patient make the patient, the trustor, vulnerable to the provider, the trustee. The narratives of pain sufferers provide helpful insights into the experience of pain at the juncture of trust, expert knowledge, and the therapeutic relationship. While stories of pain sufferers having their testimonies dismissed are well documented, pain sufferers continue to experience their testimonies as being epistemically downgraded. This kind of epistemic injustice has received limited treatment in bioethics. In this paper, Buchman and colleagues examine how a climate of distrust in pain management may facilitate what Fricker calls epistemic injustice. They critically interrogate the processes through which pain sufferers are vulnerable to specific kinds of epistemic injustice, such as testimonial injustice. They also examine how healthcare institutions and practices privilege some kinds of evidence and ways of knowing while excluding certain patient testimonies from epistemic consideration. 
  20. News Article
    A pensioner is furious with Northern Ireland politicians who, she said, left her with no option but to spend her savings on knee surgery in Poland. Christine Wallace was told the wait for her knee replacement surgery could be five years - although the health department says most waits are shorter. She spent £8,500 on her hospital stay. While Ms Wallace said the relief of her new knee was fantastic, she felt she had no alternative but to pay as she could no longer live with the pain. The latest available health department figures, from 31 March, showed 25,075 patients were waiting for inpatient or day case admission under the trauma and orthopaedic surgery specialty. The department said its median waiting time for such operations was 74 weeks, with only 1 in 20 patients waiting more than five years. "Our preferred measure of average is the median... because waiting times tend to be skewed by longer waits and therefore more patients are waiting for less time than the mean," said a department statement. Read full story Source: BBC News, 28 June 2023
  21. Content Article
    Doctors are taught from medical school about the benefits of IUDs, and often encourage patients that they are a good contraceptive option. However, recent media attention on the pain that some women suffer when having their IUDs fitted has started conversations about the need for cervical blocks and more honest counselling of women about the procedure. Rebekah Fenton, adolescent medicine fellow at Lurie Children's Hospital of Chicago, joins us to talk about how she counsels her patients, and why the most important thing is to make sure women are in charge of their reproductive healthcare decisions.
  22. Content Article
    In this article, published by British Vogue, Alexa Chung shares her experiences of endometriosis and the barriers and attitudes she faced in seeking a diagnosis and treatment.
  23. Content Article
    This report was prepared by the Endometriosis Task and Finish Group and submitted to the Welsh Government on 16 April 2018. Authors propose a robust care pathway based on NICE guidance using a life course approach to ensure that symptoms are recognised and responded to promptly and appropriately, as they emerge. 
  24. News Article
    A new treatment could help people to stop taking addictive opioid painkillers for chronic pain, research suggests. Data suggests there are one million people at risk from longer-term continuous opioid prescriptions, and more than 50,000 have been taking these for six months or more. While recent NHS initiatives have managed to reduce opioid prescribing by 8%, saving an estimated 350 lives, the new research has found evidence that could help many more people stop their opioid painkiller use. A team of researchers and doctors has developed and successfully trialled a programme designed to guide people in coming off prescription painkillers, tapering their opioid intake and learning how to manage their pain using alternative techniques with a course which combines one-to-one and group support. According to the findings, after one year, one in five people were able to stop taking opioids without their pain increasing. The scientists suggest the new treatment is an alternative to opioid use and has potential to give patients a better quality of life. Read full story Source: The Independent, 23 May 2023
  25. Content Article
    This recent cohort study, published in Evidence Based Medicine, investigated ‘the risk of transitioning from acute to prolonged use’ of opioid analgesics in patients undergoing elective surgery. Patients given tramadol or long-acting opioids after discharge were at greater risk of prolonged opioid use than those who were given other short-acting opioids.
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