Patient Outcomes for Fibromyalgia Treatments

Patient Outcomes for Fibromyalgia treatmentsBusch et al. (2011) describes fibromyalgia as chronic condition that exhibits symptoms that include widespread pain, non-recuperative sleep and fatigue. Fibromyalgia can affect anyone of any age tho is most prevalent in women aged 50 or older (Traska, Rutledge, Mouttapa, Weiss, Aquino, 2010). Currently, the etiology of fibromyalgia is not understood. Fibromyalgia also has no specific diagnostic tests or cures (Becker, Stuifbergen, Taxis, Beal, Pierini, 2009). diagnosis is established with guidelines set by the American College of Rheumatology (Gore, Sadosky, Zlateva, Clauw, 2009). Gore, et al. (2009) states that the guidelines stress the incidence of pain and tenderness at least 11 of the 18 defined tender points. Treatment for fibromyalgia, according to Zhao, Sun, Watson, Mitchell, and Swindle (2011), is palliative measures that include pharmacological treatment, behavioral modifications, physical and exercise therapy, and alternativ e medicines.This literature review is an examination of both pharmacologic and non-pharmacologic treatments for fibromyalgia and the forcefulness of the treatments. The following text will review and analyze several pieces of literature that provide information and statistics regarding the different methods of controlling the symptoms of fibromyalgia. The conclusion of this review will inclose suggestions and recommendations for enhancing and expanding the current body of research.Literature ReviewPharmacologic TreatmentPharmacologic treatment for fibromyalgia includes many classes of medications. Medications include analgesics, antidepressants, anticonvulsants, opioids, and dopamine agonists (Zhao, Sun, Watson, Mitchell, Swindle, 2011). The pathophysiology of fibromyalgia is not well understood, but is believed to be the go of an increase in pain signal transmission of the central nervous system (Gore, et al. 2009). Gore, et al. (2009) foc apply attention on the medications gab apentin and pregabalin. A commercial database was used to playing area identifying traits among patients newly prescribed gabapentin and pregabalin that included clinical characteristics, healthcare resource use, and pharmacologic therapy (Gore, et al. 2009). Statistics were limited to those with at least one healthcare encounter during 2006 and 2007 with a diagnosis of fibromyalgia and naive to both gabapentin and pregabalin. The sample was majority female (85%) and greater than 70% over the age of 45 (Gore, et al. 2009).Results indicated that pregabalin users in the cohort study proverb statistically significant reduction (p values A arrogant literature review of 14 studies revealed a decrease in healthcare admission among Latinos in the US as compared to Caucasian Americans (Timmins, 2002). Fifty-five percent of these studies indicated significant veto dos to healthcare access for Latino individuals with LEP (Timmins, 2002). Cancer screenings, mental health evaluations, a nd generative care among Latino populations were advantageously lower (Timmins, 2002). The reason for this decline was primarily linked to poor health education and promotion as a result of linguistic barriers (Timmins, 2002). Communication barriers also hindered therapeutic rapport that potentially contributed to decreased access to care (Timmins, 2002).Shi, Lebrun, and Tsai (2009) conducted descriptive and comparative research on a field of study health survey that involved 29,868 participants. The purpose of this research was to determine the influence of LEP on healthcare access (Shi et al., 2009). Analysis showed that respondents with LEP were more inclined to waive needed medical care and less inclined to have healthcare visits (Shi et al., 2009). In particular, unadjusted analysis showed 58% of respondents with LEP and adjusted analysis revealed 34% of those respondents were more in all probability to have reduced healthcare visits (Shi et al., 2009). This study revealed multivariable impacts upon healthcare access however, strategic analysis allowed for variable isolation in order to fully appreciate the effect of language barriers alone upon healthcare access.In a descriptive study, DuBard and Gizlice (2008) examined responses from 45,076 Hispanics in a randomized national health survey. The study indicated that healthcare access was substantially limited for Hispanics with LEP than Hispanics with incline improvement. The results showed 55% of Hispanics with LEP had no health insurance whereas, 23% of Hispanics who spoke English were uninsured (DuBard Gizlice, 2008). An additional comparison revealed that 58% of Hispanics with LEP had not obtained a primary doctor, while 29% of English-speaking Hispanics were under primary physician care (DuBard Gizlice, 2008). Hispanics with LEP were also less likely to have annual health visits and tour of duty services, such as immunization, dental, and screening care (DuBard Gizlice, 2008). These resul ts have implied a prominent influence of language barriers upon access to healthcare. Multivariate analysis disclosed limitations to healthcare access for all Hispanics, but a substantial decrease in access to health services was observed for Hispanics with LEP (DuBard Gizlice, 2008).Safety and Quality of CareIn his systematic review, Timmins (2002) reported that 86% of studies indicated a definite negative effect of linguistic barriers upon the quality of care for Hispanics with LEP. In comparison to Hispanics that were proficient in English, one study revealed Hispanics with LEP were significantly (P Masland, Kang, and Ma (2011) conducted a study that assessed medication prescription comprehension in the following five ethnic minority groups (a) Mexican, (b) Central American, (c) Chinese, (d) Korean, and (e) Vietnamese. Limited English attainment inhibited communicating and judgment of prescriptions in all ethnicities except Vietnamese (Masland et al., 2011). In particular, lim ited English proficiency in the Mexican, Central American, and Korean groups tripled the chance of misinterpretation and quadrupled the chance for the Chinese group (Masland et al., 2011). Poor communication and unavailability of prescription labels in native languages were associative reasons that inhibited prescription understanding and ultimately compromised client safety (Masland et al., 2011). However, most all ethnicities greatly benefitted from having language concordant physicians (Masland et al., 2011).As a result of physician/patient communication barriers, patients with LEP had an increase probability of undergoing more diagnostic testing (Pares-Avila et al., 2011). Studies reported physicians unnecessarily ordering an array of tests to determine or rule out health problems (Pares-Avila et al., 2011). This action not only potentially contributed to poor patient satisfaction but also promoted delays in care services (Pares-Avila et al., 2011).Health Status and ManagementAc cording to DuBard and Gizlice (2008), 39% of Hispanics with LEP reported fair or poor health status whereas, 17% of Hispanics who were English proficient conveyed fair or poor health condition. Timmins (2002) added that negative health status and outcomes could be attributed to language barriers. Misdiagnosing and prescription errors were found in one study to have contributed to negative health outcomes, yet limited English proficiency was not clearly isolated as a specific cause (Timmins 2002). Another study alluded to a casual association between language barriers and negative health outcomes, which potentially promoted declines in health status (Timmins, 2002).Wisnivesky et al. (2009) conducted a cohort study to analyze asthma control and quality of life. Upon comparing English proficiency levels, Wisnivesky et al. (2009) discovered major language barrier impacts. Latinos with LEP had statistically significant (P Fernandez et al. (2010) examined data from the 2005-2006 Diabetes Study of Northern California, a well-designed cohort of insured clients, to determine diabetes management of Hispanic individuals with LEP. Although this studys multivariate analysis examined other variables that could have contributed to ineffective glycemic control, limited English proficiency was identified as the primary independent prognosticator (Fernandez et al., 2010, p. 170) of poor glycemic management among US Hispanics. Analysis further revealed statistically significant improvement (P Future Research and Practice RecommendationsLiterature has confirmed the existence of multivariable elements that compound, exacerbate, and/or lead to healthcare disparities among minority populations. Ongoing research is needed to explore all potential variables, to analyze the impact each variable has upon healthcare, and to discover take up methods to improve healthcare for minority groups. A substantial amount of literature has corroborated language barriers as a major source contribu ting to negative healthcare management therefore, this appraiser has considered this evidence indicative of poor professional practice that insufficiently bridges language barrier divisions and compromises patient healthcare. Nurses should be proactive in employing interpreter services and finding best practice measures to effectively communicate with patients. Pares-Avila et al. (2011) reported that patients with LEP are often not informed of their legal rights to have interpreters hence, nurses essential be client advocates and inform patients of this entitlement. Furthermore, quality improvement measures and future research should be implemented to continually evaluate interpreter service use and effectiveness.In the US, rapid expansion in language diversity has not mirrored the available diversity among healthcare encounterers (Pares-Avila et al., 2011). Literature has reflected improvements in healthcare directly relate to having language concordant physicians, yet accessibi lity of language concordant providers has not adequately complemented the increasing number of patients with linguistic diversities. This literature review lacked studies that addressed or assessed the impact of nurse language concordance. However, this appraiser values language agreement between nurse and patient, perceiving it a powerful measure to ensure affective communication and promote health. More research is needed to analyze the effect of language unity between nurses and clients. With a growing diverse nation and competitive work arena, nurses should envision secondary language acquisition as the edge toward professional success and patient satisfaction.ReferencesBecker, H., Stuifbergen, A., Taxis, C., Beal, C. C., Pierini, D. M. (2009). The use of goal attainment scaling to facilitate and assess individualized change in a wellness intervention for women with fibromyalgia syndrome.Journal of Holistic Nursing,27, 232-240. doi 10.1111/j.1365-2702.2010.03501Busch, A. J., We bber, S. C., Brachaniec, M., Bidonde, J., Bello-Haas, V. D., Danyliw, A. D., . . . Schacter, C.L. (2011).Exercise therapy for fibromyalgia.Current Pain Headache Reports, 15, 358-367.Gore, M., Sadosky, A. B., Zlateva, G., Clauw, D. J. (2009).Clinical Characteristics, Pharmacotherapy and Healthcare Resource Use among Patients with Fibromyalgia Newly bring down Gabapentin or Pregabalin.Pain Practice,9, 363-374. doi 10.1111/j.1533-2500.2009.00292Traska, T. K., Rutledge, D. N., Mouttapa, M., Weiss, J., Aquino, J. (2010). Strategies used for managing symptoms by women with fibromyalgia.Journal of Clinical Nursing,21, 626-635. doi 10.1177/0898010109339525Zhao, Y., Sun, P., Watson, P., Mitchell, B., Swindle, R.(2010). Comparison of medication adherence and healthcare costs between duloxetine and pregabalin initiators among patients with fibromyalgia.Pain Practice,11, 204-216.