Frank suffers from chronic pain and PTSD which has significantly affected his ability to continue working and living a normal life. Recently he has also been diagnosed with the major depressive disorder which has reduced his ability to keep working in a local nursery counter. This paper will establish an evidence-based treatment plan for Frank's chronic pain, PTSD and MDD.
Evidence-Based Treatment Plan
Frank's condition of PTSD and chronic pain require a multidimensional and interdisciplinary approach to treatment. Effective treatment of Frank's problems should begin with a correct diagnosis which helps determine the best treatment approach to improve the patient function. Chronic pain is a disorder that results after the patient injury has been completely cured. Chronic pain patients cannot be cured, but it should be managed to reduce the patient suffering and help regain the ability to continue with normal daily activities.1 On the other hand, PTSD leads to the abrupt change in mood and depression which is a psychological problem mainly affecting the function of an individual general function.
From the diagnosis, Frank's pain intensity is severe with a score of 9/10 which has reduced his enjoyment to 6/10, depression and PTSD measures of PHQ-9=10 and PCL-5=40 which has significantly interfered with his general function and quality of life. Frank's pain has led to PTSD which is aggravated by his past abuse as a child and witnessing the death of a colleague.
Treating Frank's PTSD and MDD is very important because they determine the quality of life and the ability to manage pain. Currently, Vicodin pills which Frank is using should be discontinued due to their potential harm and a non-drug multimodal analgesia through cognitive therapy and patient education initiated due to PTSD and MDD which were positively diagnosed. Dr. Tauben argues that cognitive therapy and mindfulness has been found to have high effectivity of 40-50% compared to Vicodin which is an opioid which has 30% effectiveness.1 Cognitive behavioral therapy will significantly help Frank based on the treatment low harm percentage compared to Vicodin pills. Frank has purposefulness which is essential in chronic pain management because he would like to support his family through improved function. There is a need to discontinue the use of Vicodin pills (5/300) which exposes Frank to various risks, and his PTSD and MDD increases the potential of opioid misuse in case of continued use.
Non-drug multimodal analgesia using cognitive behavioral therapy and patient education are the best treatment approaches for Frank's chronic back pain, PTSD and MDD. The use of Vicodin should be discontinued gradually with decreasing doses as cognitive behavioral therapy and mindfulness have proved to be more effective compared to the use of opioids.
Dr. Tauben. (2016, June 27). Pain Talk: Dr. Tauben. Retrieved January 29, 2019, from https://mediasite.hs.washington.edu/Mediasite/Play/e9ee726d306b4082beba9cf6a1314ad61d
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