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The patient’s response should be assessed after 2-3 weeks of analgesic treatment4, 5. The reasons for poor response should be explored with the patient e.g. unrealistic expectations, or not taking the medication as instructed (due to side effects, forgetfulness or other concerns). Before moving to the next step (refer to “WHO Analgesic ladder”), clinicians should ensure the patient has taken maximal doses of analgesics at regular dosing intervals rather than taking medications “as required”4, 5.
Relapse prevention
It is prudent to anticipate setbacks and disappointments that interrupt the progress of treatment and maintenance of improvements1, 7.
To reduce flare-ups/setbacks patients can learn1, 2, 34.
- Pacing of physical activity
- To recognise the early warning signs
- To take time before reacting i.e. don’t panic
- To stay positive/develop positive responses
- To rest and relax, but don’t just go to bed
- To implement pain-coping strategies
- Be flexible and realistic
- Consider accepting help from others.
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