Doctors Should Give Greater Weight To The Effects Of Low Back Pain On Patients’ Social Lives

A team of researchers led by Warwick Medical School found that that low back pain often leads to damaged relationships, people withdrawing from society, and becoming isolated and depressed. Publishing their findings in the online journal BMC Musculoskeletal Disorders, they suggest that clinicians should in future give greater weight to the broader impact of low back pain including social factors rather than concentrating on pain and disability. This may be crucial in improving patients’ experiences of health care, they add. They also say the way that the outcome measures currently used to capture and quantify back pain need to be more relevant and to take these social factors into account. In their review of existing research 49 papers describing 42 studies, the team found a whole range of social concerns among people with low back pain, including fear of loss of employment, not being believed that there was anything wrong with them because the pain had no apparent cause, and loss of control over their lives. “Patients with low back pain seek diagnosis, treatment and cure, but also reassurance about lack of a cause of their pain,” explained lead researcher Dr Rob Froud. “They also want to be believed as having their experiences as someone ‘doing battle’ with pain validated. Some people struggle to meet social expectations and obligations but when they do they fear their credibility of the pain and disability can be jeopardised. Others withdraw, fearful of disapproval, or unable or unwilling to meet social demands. “Pain and disability are the most commonly measured outcomes in trials of back pain treatments, but the development of the next generation of outcomes for research and clinical use needs to take a broader perspective, with emphasis on what is important to patients.” Professor Alan Silman, medical director of Arthritis Research UK said: “Chronic back pain is one of the most significant causes of morbidity in the UK, causing pain, distress and loss of function for millions. One of the issues is its persistence over in many patients several years or even decades.
Doctors should give greater weight to the effects of low back pain on patients’ social lives

Clinical trial delays leave UK vulnerable to epidemics, say senior doctors

But doctors hoping to test drugs or other interventions in patients can face delays of more than a year before they can recruit a single case. The delays mean that doctors have almost no hope of learning which treatments might save lives during an outbreak because patients will have recovered or died before a trial can start. Farrar said the system needed a radical overhaul so emergency trials could launch within 24 hours of an epidemic emerging. “Getting this information early on is critical to inform what we do and how we treat patients. Without it we are completely in the dark,” he said. Pandemic influenza is considered the most serious civil emergency risk that Britain faces, but other infections, such as novel coronaviruses and the alarming rise of drug-resistant pathogens, are also a serious threat. Clinical trials need formal approval from the NHS and other bodies before doctors can recruit patients, but the process is held up at almost every stage. Researchers must apply for grants, submit study protocols and patient consent forms, gain ethical approval, find hospitals with the right facilities, equipment, supplies, staff and patients, and then sign legal contracts with them all. The process is necessarily thorough to protect patients and hospitals from litigation. Trials can go spectacularly wrong, as happened in 2006 when six young men were nearly killed by an experimental drug in a trial at Northwick Park hospital in north London. The 2002 Sars pandemic killed 774 people and infected more than 8,000. Had the virus not been contained it could have killed far more. The reason the death toll was not higher was that patients were most infectious when they were most sick, so isolating the ill stopped the virus spreading.
Clinical trial delays leave UK vulnerable to epidemics, say senior doctors

‘Urgent’ action needed over weekend doctor numbers

Hospital ward

The hospital said it had 12 consultants on call who could come in. Blood tests The NHS published its last figures about patient mortality in 2011. The survey of 14 million admissions showed that a patient is 11% more likely to die if admitted on a Saturday and 16% more likely to die if admitted on a Sunday than during the week. The NHS also reports on patient outcomes. Continue reading the main story Start Quote There are not enough trainees in the system to deliver the kind of seven day service that we would all like to see End Quote Dr Peter Williams Royal Liverpool Hospital Overall, patients stay longer in hospital when they are admitted at weekends. They wait longer for a diagnosis and part of the reason for that is that there are not the senior doctors around in the departments that do the blood tests, X-rays and scans. Prof Sir Bruce Keogh has set out a 10-point plan to achieve 24-hour, seven day a week staffing in hospitals. He wants to see it in place by 2017. He told You and Yours: “It’s a bold plan because the NHS, like other parts of society, has not functioned the same at the weekend as it has in the week – but we need to do it with urgency. “The rest of society has moved on, all other service industries are starting to address how they provide more routine services at the weekend and it’s time we did so in health”. But Sir Richard Thompson of the Royal College of Physicians thinks it will take longer. “I think we’re heading in the right direction but I think the plan is optimistic. Without getting a large extra number of staff of all grades and all types I cannot see how we can get a full equal service on Monday, Tuesday, Wednesday, Thursday, Friday, Saturday and Sunday”. ‘Bit of a rest’ According to the research the Royal Liverpool Hospital has 7% of the level of staffing for doctors at the weekend compared to a Wednesday afternoon. Sharon Duffy has been a patient on the haematology ward at the hospital for six weeks.
‘Urgent’ action needed over weekend doctor numbers

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