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September 16–October 14, 2019 12 Working Nurse l WorkingNurse.com ON THE QUICK Nursing & Healthcare News Reconsidering Aspirin Therapy Patients should consult providers about aspirin use M illions of Americans regularly take aspirin in hopes of preventing heart attack or stroke. However, many do so without medical advice, which may be hazardous. Self Prescribing According to a recent study in the Annals of Internal Medicine, about one in four American adults over 40 and almost half of adults over 70 take daily aspirin to reduce their risk of cardio- vascular disease. The problem, say the authors, is that some 6.6 million of those users have never talked to their healthcare providers about aspirin use, which can be very dangerous for some patients. Bleeding Risks For patients who've already been diagnosed with cardiovascular disease, aspirin can be a vital tool in preventing heart attack or stroke. However, the same blood-thinning effects that make aspirin useful for that purpose can also cause or exacerbate bleeding or peptic ulcer disease. That's why the American Heart Association (AHA) revised its guidelines earlier this year. "Aspirin should be limited to people at the highest risk of car- diovascular disease and a very low risk of bleeding," says Johns Hopkins Medicine professor Roger Blumenthal, M.D., who co- chaired the committee responsible for the revised AHA guide- lines. The bottom line is that patients whose doctors have advised them to take aspirin should continue to do so. Otherwise, it's best to seek medical advice before deciding whether the poten- tial benefits of aspirin outweigh the risks. WN For direct links to the websites cited, find these articles at WorkingNurse.com Virtual Reality for Pain Relief Cedars-Sinai study shows the potential of drug-free alternatives I magine if instead of taking a pill or an injection for pain, you put on a virtual real- ity helmet for a 10-minute relaxation exercise. It sounds like science fiction, but a recent study at Cedars-Sinai finds VR thera- py can have significant benefits. Inpatient Study In 2016–17, a group of researchers at Cedars-Sinai recruited patients with mod- erate to severe pain (rated at least 3 on the 10-point pain scale) for an experiment to determine whether guided relaxation con- tent could reduce pain levels. About half of the participants tried relaxation-focused virtual reality experi- ences using a Samsung Gear Oculus VR helmet. The other half, who served as a control, instead watched relaxing video programs on the Health and Wellness channel on their in-room televisions. Each participant used this content for 10 min- utes at a time, at least three times a day. The results, recently published in the open access journal PLOS ONE, found that both groups showed some improvement in pain levels, but the benefits for VR users were significantly greater. Compared to simply watching videos, VR reduced report- ed pain levels by an average of 1.17 addi- tional points (pain levels) over the initial 48-hour period. A VR Future? Although the study's sample size was small and involved patients with many different diagnoses and types of pain, lead author Brennan Spiegel, M.D., MSHS, director of health service research at Cedars, says the study supports "previous research that VR can meaningfully reduce pain using a non- addictive, drug-free treatment." Some patients were reluctant to partici- pate in the VR study, and using a VR helmet or goggles can have some side effects, including dizziness or vertigo. However, several participants were so pleased with the results that they decided to continue using the VR technology at home after dis- charge. "I believe that one day soon, VR will be part of every doctor's tool kit for pain man- agement," says Spiegel. WN