Last week on Outlook on Outcomes we shared news about how innovative prosthetic technology is helping wounded warriors. Today, in part two of a three part series, we look at the complications of less visible wounds.
A new traumatic brain injury study by researchers at the University of Oklahoma found that the symptoms of brain injury could last for at least eight years after the injury. That’s a far cry from the prevailing wisdom that concussions and minor brain injuries heal in a short time with rest. The study found that traumatic brain injury symptoms, such as headaches, memory problems, dizziness, and depression, could last much longer than previously thought.
Brain Injuries Can Cause Lasting Symptoms
The study was presented at the yearly meeting of the American Headache Society. Researchers examined 500 U.S. military veterans who were diagnosed with traumatic brain injury during deployment. The research team administered tests to gauge severity and occurrence of post-concussion syndrome—the collection of brain injury symptoms that includes headaches, coordination problems, dizzy spells, depression, and judgment or memory problems.
The veterans who participated in the study were divided into two groups based on when their injury happened: those whose injuries occurred within four years of the testing date, or those that occurred five-to-eight years before the study. They found no improvement in symptoms for veterans whose injuries were older.
In the group whose injuries were more recent, about half the veterans reported mild-to-moderate headaches. The other half had persistent trouble with severe headaches. The percentages were almost the same for veterans with older injuries—45 percent reported mild headaches and 50 percent reported problems with severe headaches. That pattern continued for the other symptoms: dizziness, coordination, depression, and decision-making problems. Symptoms were worse for veterans who had multiple head injuries, suggesting a cumulative effect.
Treating Traumatic Brain Injury
Brain injuries result in both physical and psychological problems. “We have to recognize that people who may have head injuries may look the same, but they often are not going to act the same,” said Dr. James R. Couch, a professor of neurology at the University of Oklahoma medical school and the lead author. “You’ve got to stabilize the patient’s interaction with family and try to create the best milieu for the patient to be able to return to employment, stay with the family and return to self-respect.”
For more information about managing traumatic brain injuries, contact us via our website or call 888-621-6602. We also invite you to join our social communities on LinkedIn, Twitter, Facebook and YouTube.
Opioid addiction and misuse is a danger and a potential stumbling block in the recovery of injured workers suffering from chronic pain. In this three-part blog series, we’ll review the content of our in-depth webinar titled “Anatomy of Chronic Pain and Opioid Misuse.” Here, we’ll have a look at the importance of a proper diagnosis and ongoing pain management in the treatment of opioid addiction/misuse.
The Opioid Problem
According to a study in the 2009 Journal of the American Medical Association, pain medications are the top prescribed drugs in the United States. The 2011 DAWN report found that 300,000 Americans each year go to the emergency room after overdosing on opioid drugs. Prescription opioid addiction/misuse is a growing problem, and doctors must be aware of the dangers of opioid therapy to their patients.
When Diagnosis and Treatment Don’t Help
Patients who suffer chronic pain often receive an unclear diagnosis, which leads to untargeted treatment that can be highly ineffective. Physical diagnostic tests aren’t always as accurate as they should be, and often lead to an opioid prescription that’s not given in alignment with universal guidelines for opioid use. When incorrect diagnosis leads to incorrect treatment, the patient continues to suffer—and the treatment given in good faith can become a part of the problem.
Types of Opioid Misuse and Dependence
“Addiction” isn’t the only problem behavior associated with opioid use. The list of potential confounding factors related to drug therapy and pain management includes:
Tolerance. When a patient’s tolerance rises, the same dosage begins to have a reduced analgesic effect. The patient may seek higher doses of the drug, but increasing the dose may not be the correct therapeutic action on the part of the doctor.
Dependence. Physical dependence results when a patient’s body develops a tolerance to a drug such that it adjusts normal functioning to accommodate the drug’s effects. The result is that, when the drug is removed, the body experiences withdrawal symptoms.
Withdrawal. When a body has developed tolerance and become dependent upon a base dose of a drug for normal function, the body’s systems are thrown out of balance when the drug is removed. As the body readjusts to functioning without the drug, withdrawal symptoms such as sweating, restlessness, diarrhea, and pain can occur. In other words, increases in pain may actually be caused by opioid misuse and dependence, rather than the original problem for which the opioid was prescribed.
Hyperalgesia. Hyperalgesia, or increased pain due to a higher medication dosage, occurs when the body becomes more sensitized to pain as a side effect of opioids. That decreased pain threshold can be an increased risk factor for addiction.
Addiction. Addiction occurs when increased pain combined with decreased drug effectiveness leads patients to use more of the drug or to feel that they can’t function without the drug. At this point, psychosocial influences may become more important in the continuance of drug-seeking behavior than the pain for which the opioids were originally prescribed.
A proper and targeted diagnosis can make a significant difference in effective treatment for chronic pain. Vague diagnoses can yield dangerous, inaccurate prescription of high-risk medications that may or may not even be effective in a given instance. Often, weaning injured workers away from potential opioid misuse is the first step to improving their chances of recovery.
To listen to the full replay of this webinar go to www.paradigmcorp.com. Paradigm is always ready to assist with complex medical needs. You can also follow us on Facebook and LinkedIn.
Chronic pain is a chronic problem costing billions of dollars each year. Learn more about Paradigm’s approach to diagnosing chronic pain. Click here to watch our video.
Pill Mills, Part I of II: The Growing Problem
In part 1 of our pill mills series Stephen Colameco, MD, MEd, FASAM highlights the general problem of prescription drug abuse and the specific problem of pill mills. He then goes on to define what a pill mill is according to Florida’s Prescription Drug Diversion and Abuse Roadmap 2012-2015………read more.
Pill Mills, Part II of II: What Can Be Done?
In part 2 of our ongoing pill mills series Stephen Colameco, MD, MEd, FASAM explores what steps have been taken in other states, and what needs to be done going forward alleviated the pill mill epidemic…….read more.
Applying Predictive Analytics to Improve Risk Management, Part Three
In this third part of our series, we explore how applying predictive analytics to the claims process can improve risk management and care for the injured person. Since claims are the biggest single outlay for an insurer, and roughly 20 percent of claims drive 80 percent of losses and expenditures, identifying and properly managing those with the highest potential for loss can significantly benefit a company’s financial performance.
Identify Complex and Costly Claims
Predictive analytics combines data gleaned from various internal and third-party sources to find commonalities that indicate the likelihood that a claim will be elevated in severity, duration or cost. Proactively managing these commonalities will improve risk management efforts, and result in lower costs for the insurer as well as improved quality of care and service to the patient……..read more.
Paradigm Leaders: Meet a Director of Clinical Services
Paradigm has been the leader in complex medical management for over 20 years, thanks to experts like Julie Fawson. As a Director of Clinical Services, Julie works hard to help improve the lives of catastrophically injured people. So let’s take a look at what she does to make a difference on a daily basis.
Julie coordinates the experts that make up the unique Paradigm model. She selects the right physicians, network managers and specialists to drive the best clinical outcomes for each case. She ensures each injured person’s needs, and the client’s expectations, are met in accordance with the highest standards……..read more.
Paradigm’s Network Manager: Leveraging Years of Experience to Ensure the Best Care
A Paradigm Network Manager is far more than a typical nurse case manager (NCM). These field-based experts blend early, onsite intervention with specialized knowledge and act as an integral part of the medical care team. In contrast, most other NCMs are removed from onsite work and advise the patient telephonically. Paradigm’s Network Managers are backed with comprehensive data, tools and processes, and are a one-of-a-kind human resource that no other care management company offers.
The Role of the Network Manager
When managing a case, Paradigm immediately wraps a clinical team around each injured person to ensure the best level of care. The onsite Network Manager serves as the central hub and immediately starts supporting the patient and family, and communicating with the client, Paradigm team members, and treating medical staff. The Network Manager aligns all parties toward the outcome goal and remains involved with the case to collaborate with the medical team for the highest level of functional independence……….read more.
Effective risk management is an important factor in keeping insurance premiums and workers’ compensation claims in check. Yet, even with concerted effort, it’s no easy task to improve risk management. New advances in applied predictive analytics can help. In this two-part blog series, we’ll explore how and why you should invest time and resources into the use and analysis of predictive analytics—and then make changes based on the results.
What Are Predictive Analytics?
Predictive analytics applications use computer modeling designed to help predict future outcomes based on current choices. For some time, advanced and predictive analytics models have provided corporate leaders insight into the future of their business enterprises. Today, predictive analytics are branching out into the realm of safety professionals. If you specialize in corporate or industrial safety, you can now examine the possible outcomes of current safety choices.
Why Try Predictive Analytics to Improve Risk Management?
When you embed predictive analytics into your risk management equations, you can make better front-line decisions and direct attention appropriately to high-cost claims. Workplace accidents may also be predicted before they happen, thus greatly reducing your medical expenses.
The white paper “Predictive Analytics in Workplace Safety,” published by Predictive Solutions, encourages the use of predictive models, or leading indicators, over the use of existing safety data or lagging indicators. In other words, most existing data sets are based on the status quo. The predictive modeling offered by predictive analytics lets you examine future scenarios before you’re faced with the results of costly accidents.
Why Trust Predictive Analytics to Improve Risk Management?
The same Predictive Solutions publication reports that predictive modeling has produced accuracy levels between 80 percent and 97 percent in predicting future worksite injuries based on existing data. In addition, Risk & Insurance reports that the $12 billion Dallas-based Dean Foods Company reported “major success” in just one year of using predictive analytics to offset workers’ compensation claims.
Proactive safety inspections are better than reactive incident investigations.The use of predictive analytics introduces a corporate culture of safety and prevention. To use predictive analytics, you’ll build safety data collection procedures into daily operating procedures so that data mining occurs routinely and effortlessly—all while encouraging a climate of on-site safety. This results in organized, understandable data streams that are readily accessible to help you make important decisions regarding safety and workplace management.
Paradigm is always ready to assist with your complex medical needs. For more information on our full service offerings, contact us via our website or call 888-621-6602. We also invite you to join our social communities on LinkedIn, Twitter, Facebook and YouTube.
Paradigm is a different kind of company. More than just your average workers’ compensation case management company, Paradigm focuses on providing medical coordination and family support for people suffering from catastrophic injuries, and complex injuries.
Working in collaboration with families, medical providers, employers and insurers, Paradigm helps ensure the best patient care possible for catastrophic injuries and complex injuries. Here’s what makes them different.
Paradigm’s consulting doctors, nurses and specialists have extensive experience in catastrophic injuries, complex injuries, and traumatic brain injury management, and they work with both the patient and treating providers to ensure the best care for each person.
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