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BACKGROUND AND OBJECTIVES: Arthralgia, myalgia, and neuropathic pain are the most common side effects observed due to paclitaxel chemotherapy. The aim of this study was to investigate the prophylactic role, maintenance, remission, and re-occurrence of arthralgia, myalgia, and neuropathic pain post-gabapentin therapy. METHODOLOGY: This study was conducted in the Department of Oncology, Dhiraj Hospital, Vadodara with a sample of 51 patients. Newly detected cancer patients who observed arthralgia, myalgia, and neuropathic pain due to paclitaxel were taken and a baseline pain assessment was done using the Common Terminology Criteria for Adverse Events (CTCAE) and painDETECT questionnaire. Gabapentin was given in the first cycle after symptoms appeared and prophylactic treatment was given in the subsequent three cycles and evaluation of pain was done post-gabapentin therapy to assess the symptomatic as well as prophylactic effect. RESULTS: At baseline, neuropathic pain score was 22.7 ± 3.6 which reduced to 0.01 ± 0.14 on subsequent follow-ups. Grade 2 arthralgia, myalgia, and neuropathic pain were more observed at baseline which reduces to Grade 0 in the third cycle. The difference in baseline and post-gabapentin therapy was statistically analyzed by conducting t-test which showed p-value <0.00001 and t-value was less than -2 which indicated a statistically significant result. CONCLUSION: This study shows that gabapentin reduces neuropathic pain. Prophylactic usage of gabapentin was highly effective at bringing about quick pain relief when compared to symptomatic treatment. In further follow-ups, it was noted that gabapentin maintained the impact throughout the cycles.
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OBJECTIVE: This study aims to evaluate the impact of several organisational initiatives implemented as part of a physician engagement, wellness and excellence strategy at a large mental health hospital. Interventions that were examined include: communities of practice, peer support programme, mentorship programme and leadership and management programme for physicians. METHODS: A cross-sectional study, guided by the Reach, Effectiveness/Efficacy, Adoption, Implementation and Maintenance evaluation framework, was conducted with physicians at a large academic mental health hospital in Toronto, Canada. Physicians were invited to complete an online survey in April 2021, which composed of questions on the awareness, use and perceived impact of the organisational wellness initiatives and the two-item Maslach Burnout Inventory tool. The survey was analysed using descriptive statistics and a thematic analysis. RESULTS: 103 survey responses (40.9% response rate) were gathered from physicians, with 39.8% of respondents reporting experiences of burn-out. Overall, there was variable reach and suboptimal use of the organisational interventions reported by physicians. Themes emerging from open-ended questions included the importance of addressing: workload and resource related factors; leadership and culture related factors; and factors related to the electronic medical record and virtual care. CONCLUSIONS: Organisational strategies to address physician burn-out and support physician wellness require repeated evaluation of the impact and relevance of initiatives with physicians, taking into account organisational culture, external variables, emerging barriers to access and participation, and physician needs and interest over time. These findings will be embedded as part of ongoing review of our organisational framework to guide changes to our physician engagement, wellness and excellence strategy.