FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W3123139498> ?p ?o ?g. }

• W3123139498 endingPage "1067" @default.
• W3123139498 startingPage "1067" @default.
• W3123139498 abstract "INTRODUCTION Novel coronavirus disease (COVID)-19 has created a global health crisis. Health agencies across the globe are engaged in containing the disease and limiting the spread of infection by following “social distancing” norms. This has led to the cancellation of elective surgeries and elective consultations. This has also affected pain clinics, including interventional pain management (IPM) procedures. This can not only have an adverse impact on chronic pain (CP) patients (pain >6 months) but can also affect pain physicians who care for the patients. The Indian Society of Anaesthesiologists recently published guidelines on anaesthesia and intensive care practices, but guidelines on the management aspect of CP patients were missing at the beginning of the pandemic.[12] Thus, we decided to conduct a survey among Indian pain physicians to get an insight into the impact of COVID-19 pandemic on various aspects of pain practices. METHODS A survey questionnaire was developed and approved by the Indian Society for Study of Pain (ISSP) secretariat. The questionnaire involved various aspects related to COVID-19 and its impact on pain practice: continuation or closing pain clinics, the scope of interventional pain practice, steroid use, safety precautions, and alternative consultation modality [Appendix 1]. The survey was sent to pain physicians who had an active email in the ISSP database. Members were reminded four times to participate in the survey with repeat emails at an interval of seven days. The survey was conducted between June 13, 2020 and July 12, 2020 (when lockdown measures were relaxed). This survey was sent in “Google forms” which was used for data collection and analysis. Voluntary participation and informed consent were obtained from our survey respondents. The cover letter to introduce the survey provided all information regarding the procedures of the survey including its purpose, potential use of data, methods of collecting it, and any potential risks. Our survey did not contain any sensitive questions and we maintained the confidentiality and anonymity of our survey subjects. The data was analysed using Statistical Package for the Social Sciences (SPSS, Version 16, Armonk, NY) and has been presented as percentages. RESULTS The survey questionnaire was sent to a total of 1040 member physicians having an active email in the database and the response rate was 20% (n = 209). Irrespective of place of pain practice, 95.2% of physicians reported that their pain practice was affected. Physicians reported that less number of patients visited the pain clinic, and fewer number of interventions were performed [Table 1].Table 1: Impact of COVID-19 on pain practiceAll the physicians who responded to the survey mentioned that they were taking precautionary measures like frequent hand washing, maintaining physical distance, and using protective gear (N95 mask, face shield/goggles) during consultations. Even during IPM procedures, 32.5% of physicians used personal protective equipment (PPE). The majority of the physicians (61.7%) used N95 mask and face shield during IPM. Seventy-eight percent of physicians used a COVID-19 checklist before giving an appointment for IPM. However, only 39.2% of physicians tested the patients for COVID-19 using nasal swab before proceeding for planned IPM procedure. Virtual consultation in the form of Telehealth(TH) played a significant role during the COVID-19 pandemic [Table 2]. COVID-19 pandemic did have an impact on the health of pain physicians: 63.16% pain physicians had the fear of contracting or spreading the disease to their family members, 8.14% had feelings of anxiety, 26.79% had impaired sleep, 1.43% physicians were feeling depressed and 26.79% had all the health problems mentioned above.Table 2: Utilisation of Telehealth services during the COVID-19 pandemicThere were changes in the patterns of steroid use by physicians during the pandemic; 24.4% physicians reduced the steroid dosage for IPM procedures, 18.66% physicians preferred dexamethasone over methylprednisolone acetate (depomedrol), 16.27% physicians avoided steroid use and the rest (40.67%) did not make any changes in steroid use. More than half of the respondents (54.1%) felt that patients faced difficulty in getting their regular opioid medications. As many as 58.4% physicians expressed that they are better prepared to deal with future pandemics. DISCUSSION COVID-19 has challenged healthcare providers, hospitals, and our ability to care for patients who are not affected by COVID. Our survey revealed that pain practice in India was also affected to a great extent as many physicians stopped providing routine consultations following the central government's advisory to prevent further spread of the virus [Table 1]. CP patients are at a high risk of psychiatric problems including suicide and depression which ultimately leads to poor quality of life.[3] Hence, continuity of care must be maintained even during the pandemic. Early reports from China and other authors suggested that TH is an important cost-effective alternative.[45] Studies have demonstrated high levels of patient satisfaction, convenience, and acceptance for TH.[6] Recent international and Indian guidelines and consensus statements on pain management during COVID-19 strongly encourage TH services for providing continuity in pain care.[789] In countries like the United States, and the United Kingdom, the governments had made urgent changes in the provisions of Telemedicine so that barriers were eliminated to help in effective TH care. Similarly, the Ministry of Health and Family Welfare, Government of India announced Telemedicine guidelines on 25th March, 2020 for the widespread use of TH services towards patient care during the nation-wide lockdown.[10] Our survey found that 79.4% of physicians utilised TH for providing pain consultations. A vast majority of the physicians (79.4%) provided TH services to the needy patients, but 39.2% of physicians felt that TH is a good alternative to provide continuity in care during the current pandemic [Table 2]. Specific guidelines on chronic pain management during pandemics were lacking until early April when the international consensus statement followed by the multi-organisational practice statement from the United States of America came into force.[78] These guidelines strongly emphasise adopting TH services, and provide recommendations for steroid use, opioid therapy, anti-inflammatory use, and selective utilisation of IPM procedures based on the urgency. Our survey revealed that 59.3% of physicians felt the lack of guidelines while caring for CP patients during the pandemic. Many IPM procedures include perineural or epidural or intraarticular steroid injection for the management of CP despite a lack of strong evidence. Steroids have the potential to cause adrenal insufficiency, immune suppression, and may aggravate virus spread. Though the depot form of methylprednisolone acetate (depomedrol) is commonly used by physicians for IPM, non-depot steroids like dexamethasone and betamethasone have been shown to produce a lesser duration of immune suppression.[1112] Keeping the above potential side effects in view, recent guidelines suggest using the lowest effective steroid dose for pain management and the use of dexamethasone instead of depomedrol.[8] A major limitation of our study was that we did not collect any information from the patients suffering from CP. This would have helped us understand their perspectives on accessibility to TH and other basic and urgent aspects of pain management. Another drawback is the low response rate (20%) from the physicians despite making efforts to improve the response rate in the form of repeat e-mails. However, this survey is the first-of-its-kind and provides some useful insights into the various aspects of pain management practices in our country during the ongoing COVID-19 pandemic. CONCLUSION COVID-19 has caused a significant impact on CP patients as health resources are diverted in treating the virus-infected patients and containing the spread of the virus. Our survey revealed that against all odds, Indian pain physicians adopted TH modality and provided continued care and followed best practices during the pandemic. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest. Acknowledgement The authors sincerely acknowledge the help and guidance of Dr Muralidhar Joshi for his critical review in the preparation of the manuscript. In addition, authors also thank Ms Jayati Bhattacharyya, Senior Research Fellow, University of Calcutta for her help in statistics." @default.
• W3123139498 created "2021-02-01" @default.
• W3123139498 creator A5063272056 @default.
• W3123139498 creator A5064160945 @default.
• W3123139498 creator A5064387402 @default.
• W3123139498 creator A5077361997 @default.
• W3123139498 date "2020-01-01" @default.
• W3123139498 modified "2023-09-23" @default.
• W3123139498 title "COVID-19 and its impact on pain management practices: A nation-wide survey of Indian pain physicians" @default.
• W3123139498 cites W1490769489 @default.
• W3123139498 cites W2787108594 @default.
• W3123139498 cites W2791244222 @default.
• W3123139498 cites W3013176720 @default.
• W3123139498 cites W3013491383 @default.
• W3123139498 cites W3014113547 @default.
• W3123139498 cites W3014296112 @default.
• W3123139498 cites W3014320382 @default.
• W3123139498 cites W3016541072 @default.
• W3123139498 doi "https://doi.org/10.4103/ija.ija_1072_20" @default.
• W3123139498 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/7852441" @default.
• W3123139498 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/33542572" @default.
• W3123139498 hasPublicationYear "2020" @default.
• W3123139498 type Work @default.
• W3123139498 sameAs 3123139498 @default.
• W3123139498 citedByCount "2" @default.
• W3123139498 countsByYear W31231394982022 @default.
• W3123139498 crossrefType "journal-article" @default.
• W3123139498 hasAuthorship W3123139498A5063272056 @default.
• W3123139498 hasAuthorship W3123139498A5064160945 @default.
• W3123139498 hasAuthorship W3123139498A5064387402 @default.
• W3123139498 hasAuthorship W3123139498A5077361997 @default.
• W3123139498 hasBestOaLocation W31231394981 @default.
• W3123139498 hasConcept C116675565 @default.
• W3123139498 hasConcept C126322002 @default.
• W3123139498 hasConcept C159047783 @default.
• W3123139498 hasConcept C1862650 @default.
• W3123139498 hasConcept C2779134260 @default.
• W3123139498 hasConcept C2983098980 @default.
• W3123139498 hasConcept C3006700255 @default.
• W3123139498 hasConcept C3007834351 @default.
• W3123139498 hasConcept C3008058167 @default.
• W3123139498 hasConcept C512399662 @default.
• W3123139498 hasConcept C524204448 @default.
• W3123139498 hasConcept C545542383 @default.
• W3123139498 hasConcept C71924100 @default.
• W3123139498 hasConceptScore W3123139498C116675565 @default.
• W3123139498 hasConceptScore W3123139498C126322002 @default.
• W3123139498 hasConceptScore W3123139498C159047783 @default.
• W3123139498 hasConceptScore W3123139498C1862650 @default.
• W3123139498 hasConceptScore W3123139498C2779134260 @default.
• W3123139498 hasConceptScore W3123139498C2983098980 @default.
• W3123139498 hasConceptScore W3123139498C3006700255 @default.
• W3123139498 hasConceptScore W3123139498C3007834351 @default.
• W3123139498 hasConceptScore W3123139498C3008058167 @default.
• W3123139498 hasConceptScore W3123139498C512399662 @default.
• W3123139498 hasConceptScore W3123139498C524204448 @default.
• W3123139498 hasConceptScore W3123139498C545542383 @default.
• W3123139498 hasConceptScore W3123139498C71924100 @default.
• W3123139498 hasIssue "12" @default.
• W3123139498 hasLocation W31231394981 @default.
• W3123139498 hasLocation W31231394982 @default.
• W3123139498 hasLocation W31231394983 @default.
• W3123139498 hasOpenAccess W3123139498 @default.
• W3123139498 hasPrimaryLocation W31231394981 @default.
• W3123139498 hasRelatedWork W3009669391 @default.
• W3123139498 hasRelatedWork W3036314732 @default.
• W3123139498 hasRelatedWork W3198183218 @default.
• W3123139498 hasRelatedWork W3198269889 @default.
• W3123139498 hasRelatedWork W4200329650 @default.
• W3123139498 hasRelatedWork W4205317059 @default.
• W3123139498 hasRelatedWork W4206669628 @default.
• W3123139498 hasRelatedWork W4210260738 @default.
• W3123139498 hasRelatedWork W4382894326 @default.
• W3123139498 hasRelatedWork W3127156785 @default.
• W3123139498 hasVolume "64" @default.
• W3123139498 isParatext "false" @default.
• W3123139498 isRetracted "false" @default.
• W3123139498 magId "3123139498" @default.
• W3123139498 workType "article" @default.