Selected Health Conditions and Likelihood of Improvement with Treatment (2020) / Chapter Skim
Currently Skimming:
2 Cross-Cutting Issues
2 Cross-Cutting Issues
Pages 33-44
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From page 33... ...
APPROACH TO PAIN AND PAIN TREATMENT Chronic pain has been linked to numerous physical and mental health conditions and contributes to high health care costs and lost productivity. It is one of the most common reasons that adults seek medical care and has been linked to restrictions in mobility and daily activities, dependence on opioids, anxiety and depression, and poor perceived health.
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In common musculoskeletal conditions, including chronic primary back pain and chronic secondary musculoskeletal pain due to inflammatory disease or structural abnormalities, chronic pain is the major driver of functional impairment and disability. In cancer, chronic pain arising from the disease process or from the adverse effects of cancer treatment contributes substantially to the functional impairment and disability experienced by cancer survivors.
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Specifically, in chronic pain, opioid analgesics lack demonstrated advantages over other treatments and are associated with increased disability and reduced functional recovery; although they are commonly prescribed, opioids are not recommended by chronic pain guidelines. Current guidelines for common chronic pain conditions (e.g., low back pain)
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Thus, interactions between comorbidities complicate recovery. While mental health disorders exacerbate other conditions, physical comorbid conditions will increase both the likelihood of mental health-related disability and the extent of the work impairment.
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The identification and treatment of coand multimorbidities along with primary diagnoses may improve functional outcomes and the ability to return to work in patients receiving disability compensation. VARIATION IN AVAILABILITY AND USE OF EFFECTIVE TREATMENT While the committee understands that the Social Security Administration (SSA)
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. Among the population of individuals who would qualify for Social Security Disability Insurance on the basis of a cancer diagnosis, there is known variation in the availability of evidence-based and effective cancer treatments (Jacobsen et al., 2017; Mougalian et al., 2015; Murphy et al., 2016; Shalowitz et al., 2015; Shugarman et al., 2009)
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, a broad array of mental health provider specialty types, the fragmentation in care, the lack of high-quality monitoring systems and decision support tools, and other individual, organizational, and system level factors all contribute to the problem of ineffective care for mental health disorders (Aarons et al., 2012; IOM, 2006, 2015)
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. However, experts on this committee believe that there may be instances when the use of certain treatments for select cancers, musculoskeletal disorders, or mental health disorders might serve as an indicator of severity.
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2018. Common psychosocial fac tors predicting return to work after common mental disorders, cardiovascular diseases, and cancers: A review of reviews supporting a cross-disease approach.
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2017. Timeliness of access to lung cancer diagnosis and treatment: A scoping literature review.
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2009. Race and sex differences in the receipt of timely and appropriate lung cancer treatment.
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2010. Do racial or socioeconomic disparities exist in lung cancer treatment?
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