This paper addresses a pharmacological management plan for Mr. NX, including consideration of possible contraindications for CAMs, prescriptive, and non-prescriptive recommendations for management of acute pain and other ongoing disease processes, followed by evaluation strategies.
Pharmacological Management Plan
Chronic pain is viewed as a condition that is not only costly but can also be seen as prevalent and disabling as part of the workplace environment. Regarding its treatment, one of the key aspects to note is that there does not exist a universally accepted approach to treatment and management of chronic pain. Smith & Grimmer ‐ Somers (2010) argue that chronic pain can be associated with other mental health conditions that result from loss of sleep or anxiety disorders, which tend to have severe implications for one's ability to deliver on his or her set out actions. In the subsequent sections, in this report, the focus will be on examining the case of Mr. NX with the aim being towards highlighting effective approaches to help in his management of chronic pain, which is seen as a critical factor for his condition. The sections will also examine different pain mechanisms that can be adopted as part of ensuring that the patient can live a quality life.
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CAMs Contraindicated with Current Prescriptions
A significant number of patients are seeking great contemporary and alternative medicine (CAMs) to help in the management of chronic pain even though little information has been presented on the effective use of CAMs in ensuring that patients are well positioned to deal with chronic pain. In the case of Mr. NX, it would be vital for him to embark on a general analysis of prospective cohort study that can be embedded within a randomized controlled trial. The use of CAMs can be viewed as a forward-looking approach towards complementing the use of alternative forms of medicine, which plays a critical role in ensuring that the patient can achieve the desired outcome (Lee, Glass, Harris, Bernard, Blais, & Genovese, 2008). Data from the case of Mr. NX reflects on an objective mood, which builds on the general perception that indeed his use of CAMs would enhance the overall possibility for prospective treatment.
CAMs Contraindicated with Diagnoses
The extensive use of CAMs among patients that suffer from chronic pain acts as a clear indication of the fact that indeed CAMs are seen as key towards promoting effective treatment of back pain. In rehabilitation centers, practitioners tend to offer the option of having to ensure that patients embark on the use of CAMs at a higher rate when compared to the medical indication (Williams et al., 2013). In the case of Mr. NX, it would be vital for him to focus on the following CAMs as part of enhancing overall possibilities in ensuring that he is well positioned in the management of chronic pain.
Massage
Massage is regarded as one of the classical forms of CAMs when dealing with back pain, especially in the lower back section, as it is commonly used as part of an effective treatment of patients within rehabilitation facilities. In the case of Mr. NX, the use of massage would be recommended, as it offers a low-cost solution to his ability to ensure that he is well positioned in the management of chronic pain, which is one of the key symptoms that can be noted from the case study information given.
Acupuncture
Acupuncture is a traditional CAMs used in the Asian countries but has become common in different parts of the world, as it is considered as being useful in the management of pain. In the case of Mr. NX, the use of acupuncture will be viewed as a critical remedy allowing him to deal with the back pain that he is experiencing.
Prescription for Back Pain
The use of prescription medication may serve as an alternative to ensuring that Mr. NX can deal with the pain that he is experiencing. When evaluating the prescription for Mr. NX, one of the critical aspects to consider is that his condition has prolonged over a long period, which means that the prescription medication that would be regarded as must offer a high level of relief. The following are some of the medicine that Mr. NX may take as part of his treatment for back pain.
Acetaminophen (Tylenol)
The first line of medication that can help in the effective management of back pain, in the case of Mr. NX, is Acetaminophen (Tylenol). The main advantage of this medication is that it allows for effective relief when dealing with back pain and is gentle on the stomach when compared to some of the other drugs. Multiple clinical trials have sought to build on the effective use of this medication for purposes of effective treatment of back pain; thus, relying on confidence on its capacity to deliver on set out objectives.
NSAIDs (Aspirin, Ibuprofen, Motrin)
Nonsteroidal anti-inflammatory drugs (NSAIDs) may also be considered as compelling alternatives for effective management of back pain, in the case of Mr. NX. The use of this medication may be considered as being viable, as it not only helps in the management of pain but also helps in fighting swelling and fever if the patient may show any of these symptoms.
Muscle Relaxants
The use of muscle relaxants may also be seen as key towards ensuring that Mr. NX can effectively deal with back pain that he has been experiencing for quite some period. The use of muscle relaxants is seen as being advantageous, as the help in easing spasm occurring within the muscles for efficiency in effective handling of any understanding contraction or expansion.
Regarding the CAMs to use, it is essential to consider some of the key options that include embarking on massages, acupuncture, and spinal manipulation. In each of the CMAs selected, it would be important for Mr. NX to consult with the health facility, as this would serve as one of the ways through which to ensure that the approaches used are safe. Additionally, Mr. NX will also be expected to embark on in-depth researches on the use of the CAMs as part of management for back pain. That would allow him to have a clear understanding of the success rate expected for each of the CAMs used while enabling him to establish a clear outcome focusing on the expected performance when using the CAMs. The ultimate result is that this would serve as a critical determinant of efficiency in advancing his ability to manage the pain that he has been experiencing effectively.
Changes in Prescribed Drugs
Based on the medication that Mr. NX has been using, it is clear that the prescribed medication, as have been identified above, seek to promote a change in the type of drugs used. That means that Mr. NX would be expected to make changes to the medication that he has been using with the sole focus being towards ensuring that he can achieve positive results in maximizing on the expected outcomes.
Follow-Up Evaluations
One of the key aspects to note is that Mr. NX will be expected to visit the health care facility regularly to help in determining whether the treatment approaches taken are sufficient or whether the treatment plans need to be changed. The follow-up will be essential to aid in the practical evaluation of the impacts that the CAMs and prescribed medications are having on the patient towards promoting overall treatment. Additionally, the follow-up will also seek to engage in an in-depth evaluation of Mr. NX as part of advancing possible advancements in meeting the expected outcomes. The following are the evaluations for the follow-up plan that has been set out in ensuring that indeed Mr. NX can achieve the anticipated results in promoting favorable treatment and effective management of the chronic pain.
Time-Frame
The time-frame for the follow-up will depend on a wide array of factors including the complexity of the back pain and the impacts that the medication is having on the patient, as this would serve as a critical determinant towards ensuring that the patient is expected to make a follow-up. In the case of Mr. NX, it would be advisable for him to come back to the facility after one week during which time it would be much easier to determine the frequency of the follow-ups. Mr. NX will be expected to use the prescribed medication, as well as, engage the CAMSs, as have been presented, for seven days after which an effective assessment will be conducted to determine the efficiency of the approaches.
Strategies for Evaluating Side/Adverse Effects
The primary approach that would be considered in an evaluation of side/adverse effects associated with the prescribed approaches is the regular use of the plain lumbosacral spine radiograph. The radiograph will be able to make a graph focusing on the possibilities of efficiency in the expected treatment outcomes while ensuring that indeed the health practitioner can make the necessary changes as part of treatment. The results from the radiograph present both the lateral and the anteroposterior positioning of the spinal cord, which is essential towards identifying some of the key aspects that would contribute to possibilities of pain. If the radiograph results show abnormal readings, that would serve as one of the ways through which to determine the occurrence of side/adverse effects.
Strategies for Evaluation Effectiveness
The ability achieve effectiveness as part of effective treatment is one of the key expectations for Mr. NX in his bid towards seeking treatment; thus, highlighting the need for having to find strategies that would help in the evaluation of effectiveness. The crucial first strategy would involve constant reports from Mr. NX himself concerning whether he believes that the chronic pain that he was experiencing is reducing. The reports from Mr. NX will help in determining whether indeed the treatment approaches and medication that has been considered are effective. The second strategy would involve a medical examination of Mr. NX, which would serve as one of the ways through which to establish the overall possibilities for improvement. Through the medical examination, it will be much easier to determine whether indeed Mr. NX is improving from a health perspective or whether he is worsening.
References
Lee, S. G., Glass, M. D., Harris, J. S., Bernard, R., Blais, M., & Genovese, E. (2008). Occupational medicine practice guidelines: evaluation and management of common health problems and functional recovery in workers . American College of Occupational and Environmental Medicine.
Smith, C., & Grimmer ‐ Somers, K. (2010). The treatment effect of exercise programmes for chronic low back pain. Journal of evaluation in clinical practice , 16 (3), 484-491.
Williams, C. M., Henschke, N., Maher, C. G., van Tulder, M. W., Koes, B. W., Macaskill, P., & Irwig, L. (2013). Red flags to screen for vertebral fracture in patients presenting with low-back pain. Cochrane Database Syst Rev , 1 .
