Evidence Based Medicine Interventional Pain Management :
As a center of excellence, a pain management center must be more than a successful clinic. At Advanced Pain Treatment Center, we strive to practice evidence based medicine. Evidence based medicine is a conscientious, explicit, judicious and reasonable use of current best evidence in making decisions about the care of individual patient (1). There is no cook book approach to pain management. At the Advanced Pain Treatment Center, we integrate external validated evidence with individual clinical expertise in formulating appropriate care for each individual patient. We access and apply valid and relevant summaries of research evidence (evidence based guidelines and systematic reviews). We evaluate the strength of the evidence based on the below given classification of evidence:
Evidence obtained by meta-analysis of several randomized controlled research (RCR)
Evidence from only one RCR
Evidence from well-designed controlled research RCR
Evidence from one quasi experimental research.
Evidence from non-experimental studies (comparative research, case study), according t some, for example Text books.
Evidence from experts and clinical practice.
Evidence Based Medicine – New Approaches and Challenges. Acta Informatic Medica, 2008; 16(4)219.
Craig JC, Irwiq LM et al; Evidence-based medicine: useful tolls for decision making; Med J Aust 2001 Mar 5:174(5):248-53.
New Patient Evaluation :
Each new patient is evaluated anywhere for 30 – 45 minutes by the physician. Patient is required fill out a detailed back ground questionnaires. Relevant test results are reviewed and discussed with the patient and finally a detailed treatment plan is formulated tailored to patient’s need. Usually evidence based interventional pain management
plan is recommended rather than relying on habit forming medicine. If opioid medication is recommended than appropriate combination therapy is recommended and patient is evaluated at a frequent interval using validated tools
to measure efficacy of the medicine in keeping patient functional.
Pain Research :
Keeping in line with the mission statement of the Advanced Pain Treatment Center, Otrimed Clinical Research organization was created. The Otrimed Clinical Research is dedicated to help pain research initiatives
by various organizations. We at the research unit, try to find out ongoing clinical research that is going to help our patient population, that are safe and had good outcome in the early phases of their research (animal studies and phase 1 studies). We focus on studies that are for chronic low back pain, neuropathic pain, Migraine headache, degenerative osteoarthritis such as Knee joint, sciatica, shoulder joint and hip joint OA. We also participate in clinical research conducting Major depression clinical trials, Opioid abuse, Nicotine dependence etc.
Participation in clinical trials expands our understanding of the disease process and gives us opportunity to learn innovative treatment approach to painful conditions.
INDEPENDENT MEDICAL EVALUATION
This is service is provided to the patients applying for disability determination. The IME is performed based on the latest edition of the Guides to the Evaluation of Permanent Impairment published by the AMA. We identify, as stated in the preface of the guidelines, the severity of an illness or injury considering four basic considerations such as diagnosis, resulting functional disability, physical findings and clinical studies. Our goal is to document functional limitations resulting from the disease or injury. Please call 859-331-4159 or 513-492-9317 for an appointment.
This treatment is offered to opioid dependent patients or to the patients with the history of opioid abuse or other substance abuse. During treatment with opioid, some patients become physically dependent on opioid and are unable to wean off opioid. Suboxone treatment is a maintenance treatment and is offered to opioid dependent patients. The dose that is given for maintenance is not for analgesia or pain relief. Before Suboxone treatment is initiated, a full detailed physical examination is performed. Patient is typically referred to psychologists or psychiatrist for detailed evaluation. Induction of Suboxone treatment is done only when a patient is in withdrawal state (symptoms of withdrawal are nervousness, anxiety, shaking, goose bumps in the skin, abdominal cramps, diarrhea with or without vomiting etc.). Patient is administered Suboxone under supervision and if necessary with appropriate monitoring and is observed in the recovery area. The dose is the dose is titrated until patient’s withdrawal symptoms are under control. Patients are required to follow up with the physician per the center’s guidelines. Patients are required to sign an opioid contract. The goal of this therapy is to give a patient total relief. At all time of the treatment at this center, Health Insurance Portability and Accountability (HIPAA) guidelines are strictly followed to protect patients confidential health information.
Second opinion service is provided for chronic pain patients scheduled to undergo any therapeutic interventions or for ongoing conservative pain management. Call our office (859) 331 4159 to schedule an appointment or email us at email@example.com.