Chronic Pain and HIV (eBook)

A Practical Approach

Jessica S. Merlin, Peter A. Selwyn, Glenn J. Treisman (Herausgeber)

Angela G. Giovanniello (Autor)

eBook Download: PDF

2016
John Wiley & Sons (Verlag)
9781118777404 (ISBN)

Infos

Patients suffering from HIV/AIDS often experience chronic pain due to the many diseases and infections they pick up as a result of a weakened immune system. It interferes with their quality of life and physical functioning, impacts adherence to antiretroviral therapy and HIV primary care, and is associated with significant psychological/social distress and substance use disorders.

Chronic Pain and HIV addresses all these complex issues that can influence pain care that can influence pain care for the patient with HIV and acts both as a primer and a comprehensive review to define the field of chronic pain management. Using a clear, clinical approach, key topics include the following:

• Musculoskeletal pain in individuals in HIV
• Headache in individuals with HIV
• Psychiatric comorbidities among individuals with HIV and chronic pain
• Potential benefit and harm of prescription opioids in HIV
• Pain at the end of life in individuals with AIDS
• Treatment of chronic pain syndromes in the HIV-infected person.

Edited by an outstanding team with extensive experience in HIV/AIDS and pain/palliative care, every chapter is written by a world-famous expert in their field who provides a thorough review of the relevant literature, including the very latest in management guidelines from the leading international societies.

Perfect for all those in primary care, as well as infectious disease specialists managing patients with HIV/AIDS, Chronic Pain and HIV provides sensible, straightforward clinical advice to ensure the best possible patient management.

Jessica S. Merlin, MD, MBA, Assistant Professor, Department of Medicine, Division of Infectious Diseases, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham.

Peter Selwyn, MD, MPH, Professor, Department of Family and Social Medicine, Albert Einstein College of Medicine.

Glenn Treisman, MD, PhD, Professor, Department of Psychiatry and Behavioral Sciences, Professor, Department of Internal Medicine, Johns Hopkins University School of Medicine.

Angela G. Giovanniello, PharmD, AAHIVP, Department of Family and Social Medicine, Albert Einstein College of Medicine.

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CHRONIC PAIN AND HIV: a practical approach Patients suffering from HIV/AIDS often experience chronic pain due to the many diseases and infections they pick up as a result of a weakened immune system. It interferes with their quality of life and physical functioning, impacts adherence to antiretroviral therapy and HIV primary care, and is associated with significant psychological/social distress and substance use disorders. Chronic Pain and HIV addresses all these complex issues that can influence pain care for the patient with HIV and acts both as a primer and a comprehensive review to define the field of chronic pain management. Using a clear, clinical approach, key topics include the following: Musculoskeletal pain in individuals with HIV Headache in individuals with HIV Psychiatric comorbidities among individuals with HIV and chronic pain Potential benefit and harm of prescription opioids in HIV Pain at the end of life in individuals with AIDS Treatment of chronic pain syndromes in the HIV-infected person. Edited by an outstanding team with extensive experience in HIV/AIDS and pain/palliative care, every chapter is written by a world-famous expert in their field who provides a thorough review of the relevant literature, including the very latest in management guidelines from the leading international societies. Perfect for all those in primary care, as well as infectious disease specialists managing patients with HIV/AIDS, Chronic Pain and HIV provides sensible, straightforward clinical advice to ensure the best possible patient management.

Inhalt

Cover 1
Title Page 5
Copyright 6
Contents 7
Foreword 9
About the editors 11
List of contributors 13
Chapter 1 Epidemiology of chronic pain in HIV-infected individuals 15
Introduction 15
A changing HIV epidemic 15
Chronic pain in the HAART era 16
Etiology of chronic pain in HIV 16
Impact of chronic pain on HIV health behavior 17
Conclusion 18
References 18
Chapter 2 Pathophysiology of chronic pain in individuals with HIV 21
Introduction 21
The pain sensory system 21
Pathophysiology of the normal acute pain response 22
Primary afferent neurons 22
Spinal neurons 23
Supraspinal neurons 24
Modulation 24
Pathophysiology of chronic pain 25
Peripheral sensitization 25
Central sensitization 25
Pathophysiology of chronic pain in patients with HIV 26
Implications for pain treatment 27
Conclusion 27
References 28
Chapter 3 Chronic pain assessment, diagnostic testing, and management, with an emphasis on communication about these topics to individuals with HIV 30
Introduction 41
Epidemiology 41
Underlying mechanisms 41
Clinical manifestations 42
Diagnostic and treatment approaches 43
Painful disorders of muscle 43
Painful disorders of joint and bone 44
Other chronic musculoskeletal pain syndromes 45
Conclusion 47
References 48
Chapter 4 HIV and chronic pain: musculoskeletal pain 41
Workup of a headache complaint 52
Secondary headaches 53
Headaches related to infections 53
Complications of infections 54
Headaches related to the cerebral vasculature 54
Reversible cerebral vasoconstriction syndrome (RCVS) 54
Ischemic and hemorrhagic stroke 54
Posterior reversible encephalopathy syndrome (PRES) 55
Iatrogenic headaches related to treatment and procedures 55
Medication side effects 55
Postdural puncture headache 55
Medication overuse headache (MOH) 55
Primary headaches 56
Tension type 56
Migraine 56
Other primary headaches and neuralgias 60
Trigeminal autonomic cephalalgias (TAC) 60
Trigeminal neuralgia 61
Pseudotumor cerebri/idiopathic intracranial hypertension (IIH) 61
Approach to a patient with daily headache 61
Tracking response to treatment 62
Resources for patients 62
Resources for clinicians 62
References 62
Chapter 5 Headache in HIV 52
Introduction 65
Epidemiology 65
Pathogenesis 66
Risk factors 67
Clinical features 67
Resource-limited settings 67
Children 68
Impact and comorbidities 68
Diagnosis 68
When to do which test? 69
Resource-limited settings 69
Management 70
Modifiable risk factors 70
Symptomatic treatment 70
Conclusion 73
References 73
Chapter 6 HIV and peripheral neuropathy 65
Background-the growing prevalence of multimorbidity in the HIV population 77
Factors contributing to multimorbidity and pain management complexity in HIV-infected individuals 78
HIV infection and chronic inflammation 78
Obesity 78
Aging 78
Cognitive impairment 78
Polypharmacy 79
Chronic pain management in the setting of multimorbidity 79
Case studies of chronic pain in the context of multimorbidity and HIV 80
Case examples 80
Summary of cases and conclusion 82
References 82
Chapter 7 Common medical comorbid conditions and chronic pain in HIV 77
Psychiatric diseases that exacerbate chronic pain 85
Co-occurrence of chronic pain and psychiatric comorbidities among individuals with HIV 86
The relationship between depression and chronic pain 86
Bipolar disorder and schizophrenia with chronic pain in HIV 87
Life experiences that exacerbate chronic pain conditions 87
Identifying and treating psychiatric illness in individuals with HIV 88
Summary 89
References 89
Chapter 8 Psychiatric comorbidities among individuals with HIV and chronic pain 85
Introduction 92
Understanding the language of substance use 92
Epidemiology of substance use in persons living with HIV in the United States 94
The experience of pain in persons with HIV and substance use disorders 94
Chronic pain management challenges for HIV clinicians caring for people who use drugs 95
Specific guidance for managing chronic pain in patients with HIV disease and current or prior substance use histories 96
Conclusion 103
Acknowledgments 104
References 104
Chapter 9 Comorbid substance use among persons with HIV and chronic pain 92
Introduction 111
Neurobiologic and behavioral rationales of chronic pain treatment 112
Establishing goals for treatment outcomes 113
Interventions and efficacy in selected chronic pain states 114
Pharmacological approaches: antidepressants, anticonvulsants, and other agents 114
Nonpharmacological approaches 115
Complementary and alternative therapies (CAM) 117
Mind-Body medicine 118
Manipulative body-based medicine 120
Biologically based CAM 121
Summary 122
References 122
Chapter 10 Pharmacologic and Non-Pharmacologic treatment approaches to chronic pain in individuals with HIV 111
Epidemiology of opioid prescribing to HIV-infected patients 127
Indications for opioids 127
Guideline-recommended indications for opioids 127
Mechanisms of opioid action and clinical pharmacology 128
Potential benefit of opioids 128
Potential harms of opioids 129
Unintentional overdose and death 129
Injury 129
Medical complications 130
HIV-specific concerns 131
Drug-drug interactions 131
Considerations in prescribing 131
References 132
Chapter 11 Potential benefits and harms of prescription opioids in HIV 127
Introduction 137
Judicious use of opioids for chronic pain 137
Risk assessment 138
Written treatment agreements 140
Urine drug testing (UDT) 141
Prescription monitoring programs 142
Responding to high-risk use 143
Putting these strategies into practice 144
References 144
Chapter 12 Safer opioid prescribing in HIV-infected patients with chronic pain 137
Introduction 137
Judicious use of opioids for chronic pain 137
Risk assessment 138
Written treatment agreements 140
Urine drug testing (UDT) 141
Prescription monitoring programs 142
Responding to high-risk use 143
Putting these strategies into practice 144
References 144
Chapter 13 The "difficult patient" with HIV and chronic pain 151
Introduction 151
Behavior, abnormal illness behavior, and chronic pain 151
Definitions 151
The role of personality in difficult patients 155
Models of personality traits 155
DSM personality clusters 157
Personality and behavior 158
The complicating role of other comorbid conditions in difficult patients 158
Behaviorally based approaches to "difficult" patients with chronic pain 159
Evaluation 159
Diagnosis, treatment plan, and role induction 159
Treat comorbid conditions 160
Assessment of progress 160
Goals of treatment 160
The behaviorally based treatment plan 161
It isn't working, now what? 161
Patient preference and patient satisfaction 161
Summary 162
References 162
Chapter 14 HIV-related pain in low- and middle-income countries with reference to sub-Saharan Africa 164
Epidemiology of HIV in low-resource regions 164
The concept of pain 164
Prevalence and correlates of pain 165
Public and patient pReferences for pain relief 166
Measurement of pain 166
Drug availability 167
Pain management and advocacy 167
Resources 167
Health Resources and Services Administration (HRSA) 167
References 168
Chapter 15 Pain at the end of life in individuals with AIDS 171
Introduction 171
Prevalence 171
Mortality rates 171
Barriers to effective pain management 172
Total pain management 172
Pain assessment 172
Medication history 173
Pharmacotherapy 173
Routes 173
Discontinuation of antiretroviral therapy and drug-drug interactions 175
Neurotoxicity 175
Palliative sedation for uncontrollable pain 177
Ethical issues 177
Summary 177
References 177
Chapter 16 Disparities and barriers in management of chronic pain among vulnerable populations with HIV infection 179
Introduction 179
Prevalence of HIV infection in vulnerable populations 179
Pain experience in HIV-infected vulnerable populations 179
Disparities and barriers in chronic pain and implications for pain assessment and management 180
Provider factors 180
Healthcare system factors 183
Strategies to improve pain assessment and management for vulnerable populations 183
Provider level interventions 183
Patient-level interventions: 185
System-level interventions 185
Conclusion 186
References 186
Index 177
EULA 195

Rezensionen

"This book provides an excellent summary of the current literature on advances in the
treatment of pain associated with HIV. Although a number of
books address HIV/AIDS or pain management, Chronic Pain
and HIV: A Practical Approach achieves the objective of addressing pain management in the context of patients with HIV...I believe this book should be required reading for every
pain physician, researcher, resident, certainly every medical
student, and even patients with HIV-related pain." (Anesthesia & Analgesia journal June 2017)

Produkt-Details

• Erscheint lt. Verlag: 22.1.2016
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Allgemeines / Lexika
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Schmerztherapie
• Themenwelt: Studium ► Querschnittsbereiche ► Infektiologie / Immunologie
• Schlagworte: Acquired Immune Deficiency Syndrome • AIDS • Allgemeinpraxis, hausärztliche Praxis • Allgemeinpraxis, hausärztliche Praxis • chronic pain • General Practice/Family Practice • HIV • Human immunodeficiency virus • immune system • infectious disease • Infektionskrankheiten • Medical Science • Medizin • Pain Medicine • pain relief • Schmerzmedizin
• ISBN-13: 9781118777404 / 9781118777404