European Journal of Pain最新文献

{"title":"Oxycodone and Morphine Use in Hospitals and Primary Care in Norway 2010–2021: A Nationwide Study","authors":"Eirik Haarr, Marte Handal, Svetlana Skurtveit, Torgeir Gilje Lid","doi":"10.1002/ejp.70045","DOIUrl":"https://doi.org/10.1002/ejp.70045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Increasing oxycodone prescribing and its association with opioid-related harms have raised concerns. In Norway, nearly 90% of opioids are prescribed in primary care, making primary care decisions important to overall opioid exposure. In-hospital use may influence primary care practices through several mechanisms. This study analyses oxycodone and morphine use in Norwegian hospitals and its association with primary care prescribing from 2010 to 2021, alongside a review of tender agreements for these medications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Morphine and oxycodone, available in all relevant formulations, served as opioid proxies to compare covariation between hospitals and their catchment areas. We analyzed 2010–2021 procurement data from hospital pharmacies and primary care dispensing data from the Norwegian Prescription Database for all hospital trusts. Correlations between hospital and primary care morphine-to-oxycodone prescribing ratios were assessed using Pearson's <i>r</i>. Annual tender agreements were obtained from the national Hospital Procurement Organization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Hospital oxycodone use increased by 67.0% and primary care prescribing rose by 86.5%. Morphine use increased by 12.6% in hospitals but decreased by 23.2% in primary care. A moderate covariation (Pearson's <i>r</i> = 0.48) between hospital use and primary care prescribing was observed. Hospital tender agreements for morphine declined by 80%, while those for oxycodone remained stable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Oxycodone use substantially increased relative to morphine in Norwegian hospitals and primary care. Prescription patterns show moderate covariation, suggesting a potential link between hospital and primary care prescribing, though causality remains uncertain. Tender agreements may contribute to prescribing trends in hospitals, with possible associations in primary care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>This study is the first to provide quantitative evidence of covariation between in-hospital use and primary care opioid prescribing across a national healthcare system. Despite recommendations favoring morphine, oxycodone prescribing continues to rise in Norway, with marked geographical variation. By linking procurement data, prescription patterns and tender agreements, our findings highlight the need to consider hospital practices and structural factors when addressing opioid prescribing. These results offer new insights into potential lever","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144140354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Mediating Role of Psychological Flexibility and Inflexibility Between Impulsivity and Opioid Misuse in People With Chronic Noncancer Pain","authors":"Victoria Barrado-Moreno,&nbsp;Rosa Esteve,&nbsp;Lance M. McCracken,&nbsp;Carmen Ramírez-Maestre","doi":"10.1002/ejp.70048","DOIUrl":"https://doi.org/10.1002/ejp.70048","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The prescription of opioid medication is a frequent therapeutic approach in chronic noncancer pain, as is misuse of prescribed opioids. There is previous evidence for associations between personal variables such as impulsivity and opioid misuse. Psychological flexibility and inflexibility have also been associated with pain-related outcomes and opioid misuse. The aim of this cross-sectional study was to examine the combined role of a dispositional variable (impulsivity) along with psychological factors (Psychological Flexibility and Inflexibility) in pain outcomes and opioid misuse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The sample comprised 155 people with chronic noncancer pain. A hypothetical model was tested using correlation and structural equation modelling analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results show significant associations between impulsivity and Psychological Flexibility, Psychological Inflexibility and opioid misuse. Psychological Flexibility and Inflexibility were related to pain intensity, interference and opioid misuse. Structural equation modelling showed significant associations between impulsivity, Psychological Inflexibility and pain interference, and opioid misuse. Associations between Psychological Flexibility and pain interference and opioid misuse were nonsignificant. These results support the hypothesis that impulsivity and Psychological Inflexibility are factors that contribute to pain interference and opioid misuse, but do not support the hypothesis that Psychological Flexibility reduces opioid misuse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>It is recommended to assess these psychological aspects prior to the prescription of opioid medication, and, if necessary, offering Acceptance and Commitment and Mindfulness Based Therapies could be desirable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>The results of this study provide further evidence of the role of trait impulsivity as a transdiagnostic antecedent variable in opioid misuse, both by a direct association and through psychological inflexibility. It can be drawn from these results that psychological transdiagnostic variables, rather than pain outcomes alone, would be key factors influencing opioid misuse. These findings underscore the need for comprehensive psychological assessments prior to the prescription of opioids.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Astrocytic Inducible Nitric Oxide Synthase Upregulation Contributes to Chronic Below-Level Neuropathic Pain Following Spinal Cord Injury in Male Rats","authors":"Youngkyung Kim,&nbsp;Hyunggoo Kang,&nbsp;Young Wook Yoon","doi":"10.1002/ejp.70047","DOIUrl":"https://doi.org/10.1002/ejp.70047","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Spinal cord injury (SCI) leads to persistent inflammation, contributing to chronic neuropathic pain. However, current treatments show limited efficacy. Three types of nitric oxide synthase (NOS) play different roles in inflammation and neuronal hyperexcitation. Therefore, this study aimed to determine the predominant NOS subtype involved in neuropathic pain after spinal contusion.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We investigated the effects of intrathecal NOS inhibitors on mechanical sensitivity following a moderate spinal contusion injury in male Sprague-Dawley rats. These NOS inhibitors were N(G)-nitro-L-arginine methyl ester hydrochloride (L-NAME; non-selective NOS inhibitor), 1400W (iNOS inhibitor), Nω-propyl-L-arginine hydrochloride (NPLA; nNOS inhibitor) and N5-(1-iminoethyl)-L-ornithine (L-NIO; eNOS inhibitor). Additionally, we analysed protein expression and cellular localisation of spinal NOS subtypes in rats that underwent SCI or sham procedures.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Treatment with L-NAME significantly reduced paw withdrawal threshold in a dose-dependent manner, although motor deficits appeared at the highest dose (30 μM), while 1400W effectively alleviated mechanical hypersensitivity without motor side effects. NPLA showed limited efficacy, and L-NIO had no effect. Protein expression of iNOS increased two-fold in the L4-5 spinal segment of SCI rats compared with sham controls. After SCI, iNOS-immunoreactivity colocalized with GFAP in the superficial laminae of the L4-5 spinal segment. Treatment with 1400W reduced the hyper-reactivity of both iNOS and GFAP.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;These findings indicate that iNOS plays a significant role in below-level neuropathic pain following thoracic spinal cord contusion in rats. Specific blockade of iNOS activity may have potential as a therapeutic intervention for spinal-contusion-induced neuropathic pain with reduced risk of side effects.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Significance Statement&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;iNOS inhibition effectively alleviated pain without motor side effects, unlike non-selective NOS, nNOS and eNOS inhibitors. The colocalization of iNOS with astrocytes in the spinal cord suggests a key mechanism in pain maintenance. These findings highlight the potential of targeting iNOS as a therapeutic strategy for SCI-induced neuropathic pain with reduced risks of side effects.&lt;/p&gt;\u0000 ","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family-Related Factors in Children and Adolescents With Chronic Pain: A Systematic Review","authors":"Lorena Martí,&nbsp;Helena Garriga-Cazorla,&nbsp;Josep Roman-Juan,&nbsp;Jordi Miró","doi":"10.1002/ejp.70038","DOIUrl":"https://doi.org/10.1002/ejp.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The aim of this systematic review is to synthesise the findings about the role of family-related factors in chronic pain in children and adolescents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a search of the following electronic databases: PubMed/MedLine, CINHAL, PsychINFO, PubPsych, Scopus and Web of Science from inception to July 2024. We only included studies involving children and adolescents (up to 19 years old) with chronic pain and studies that involved the parents or families of these children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 24,049 articles were retrieved, of which 20,921 were screened for evaluation and 119 were included in the review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Most of the studies were cross-sectional with a moderate or high risk of bias, reporting on the parenting individual-, dyadic-, and contextual-related factors. In the included studies, significant associations emerged between a number of family-related factors and chronic pain and related disability in 16 of the 119 studies that had been judged to be of good methodological quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>The data from these studies showed significant associations between parental individual variables (e.g., parent's mental health), dyadic variables (e.g., parental responses towards their children's pain), and context-related variables (e.g., family functioning), and some key pain-related outcomes, including pain chronification, pain intensity, pain frequency, pain extent, pain-related interference, the ability to cope with chronic pain, and pain-related disability in children and adolescents. Therefore, these factors may be important targets for the prevention and management of chronic pain in children and adolescents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144117924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal Summation of Pain Unpleasantness Is Increased in Borderline Personality Disorder","authors":"Annette Löffler,&nbsp;Dieter Kleinböhl,&nbsp;Sylvia Steinmann,&nbsp;Sabine C. Herpertz,&nbsp;Ute Habel,&nbsp;Robin Bekrater-Bodmann,&nbsp;Herta Flor","doi":"10.1002/ejp.70042","DOIUrl":"https://doi.org/10.1002/ejp.70042","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Borderline personality disorder (BPD) is characterised by deficient regulation of emotions and is associated with reduced pain sensitivity, which has been related to self-injury and dissociation. BPD can therefore be used as a model to better understand pain-modulating mechanisms and their association with affective processing. However, studies assessing pain-modulating processes in BPD are sparse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study investigated temporal summation (TS) of pain intensity and unpleasantness, as well as TS of the RIII-reflex as a marker for spinal nociceptive processing in 24 participants with BPD compared to 24 non-clinical controls (NCC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our main result showed that TS of pain unpleasantness, but not TS of pain intensity, was significantly increased in BPD compared to NCC, whereas we replicated higher pain thresholds in BPD compared to NCC. There was no significant correlation between pain threshold and TS of pain intensity or TS of pain unpleasantness in BPD. Moreover, correlative findings suggest a mutual dependence of spinal processing, temporal summation of pain and stimulus intensity in NCC, but not in participants with BPD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The combination of reduced pain sensitivity in terms of heightened pain threshold and enhanced TS of pain unpleasantness might explain the so-called pain paradox, describing that individuals with BPD are both hyposensitive to acute pain and more prone to develop chronic pain. Different mechanisms might underlie heightened pain thresholds and increased TS of pain unpleasantness based on a complex interaction of altered ascending and descending mechanisms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>The results of this study provide evidence that temporal summation of pain unpleasantness is increased in individuals with borderline personality disorder compared to non-clinical controls. These data suggest that altered pain perception in BPD is composed of several processes, extending beyond well-known pain insensitivity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144108880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Smoking on Low Back Pain and Disability","authors":"Lukas Schönnagel,&nbsp;Bernhard U. Hoehl,&nbsp;Nima Taheri,&nbsp;Luis Becker,&nbsp;Phillip Suwalski,&nbsp;Friederike Schömig,&nbsp;Paul Köhli,&nbsp;Hendrik Schmidt,&nbsp;Matthias Pumberger","doi":"10.1002/ejp.70041","DOIUrl":"https://doi.org/10.1002/ejp.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Low back pain (LBP) is a predominant cause of disability, imposing a significant burden on healthcare systems and individuals' quality of life. The multifactorial nature of LBP encompasses various risk factors, but the association between smoking and LBP, particularly concerning severity and disability, has not been fully explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study utilised a cross-sectional design with propensity score matching to analyse the relationship between smoking and LBP severity and associated disability among adults aged 18 to 64. We prospectively recruited individuals from the general public, assessing LBP severity and disability using the von Korff questionnaire and the Roland Morris Disability Scale (RMDS). Smoking status was classified as ‘yes’ or ‘no’ and further stratified by pack years (PY). Adjustments were made for age, sex, body mass index (BMI), alcohol consumption, physical activity, and depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 430 patients with a median age of 41 (IQR 31–53) were included in the analysis, with 79 (18.4%) being active smokers. In the propensity score-matched analysis, individuals with 0 to &lt; 10 PY did not show a significant increase in pain-related outcomes, whereas those with ≥ 10 PY exhibited a significant increase in pain severity (<i>p</i> = 0.043), disability score (<i>p</i> = 0.001), and RMDS score (<i>p</i> = 0.015). Multivariable linear regression further confirmed a significant association between PY and LBP-related outcomes, whereas smoking status alone was not significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study shows an independent effect of smoking on disability and pain severity, underscoring the potential importance of smoking cessation in LBP management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>This study identified a dose–response relationship between smoking and increased low back pain (LBP) severity and disability, particularly among individuals with ≥ 10 pack years, strengthened by the robust propensity score-matched design. By highlighting the independent effect of smoking on pain and disability, these findings emphasise the role of Smoking in the development of LBP and the potential importance of smoking cessation as a critical component in managing LBP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144100707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropathic Pain in Nursing Homes","authors":"Gisèle Pickering,&nbsp;Marion Voute,&nbsp;Elise Sortais,&nbsp;Nicolas Macian,&nbsp;Leslie Goumy,&nbsp;Fatiha Giron,&nbsp;Bruno Pereira","doi":"10.1002/ejp.70035","DOIUrl":"https://doi.org/10.1002/ejp.70035","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In older persons, pain prevalence is estimated to range between 22% and 80%. In nursing home residents, underevaluated pain is common despite pain management quality indicators. This study aims to assess neuropathic pain (NP) prevalence, NP evaluation and treatment, and healthcare professionals’ practices and needs to optimise NP management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study received ethical approval [IRB number 2023-CF230]. In order to obtain data from healthcare professionals working in nursing homes, an online survey was conducted on REDCap software between 4 March 2024 and 28 June 2024. The survey was divided into 3 sections: (1) prevalence of NP, (2) assessment of the four steps of the NP management algorithm (detection, evaluation, treatment and re-evaluation), (3) awareness and needs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Responses to the survey came from nine nursing homes, for a total of 841 residents, half of them aged between 75 and 85 years The prevalence of NP was 8.5% [4.2; 12.7]. The clinical pertinence of each step of the algorithm showed good satisfaction (mean ± SD, 7.9 ± 1.5). A large majority of participants (96.8%) expressed the need to receive a specific training on NP management in their care setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The prevalence of NP is close to that described in the literature, but appears to be underestimated by the participants because of diagnostic issues. The decision-making algorithm proposed to the teams has shown good results in terms of its usefulness in current practice. The survey also highlighted the need for training in this field to optimise NP management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>This survey highlights the underestimated prevalence of neuropathic pain because of lack of diagnosis issues. A 4-step algorithm (detection, evaluation, treatment and re-evaluation) was proposed and validated by healthcare professionals for neuropathic pain management with good results in terms of its usefulness for current practice. Results unveils the still unmet needs for information and training of nursing homes healthcare professionals and medical/nursing students as regards neuropathic pain assessment and treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144100701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Assessment of Endometriosis Pain Over the Life Course: A Reliability Study Within the ComPaRe-Endometriosis Cohort","authors":"Solène Gouesbet,&nbsp;Sarah Lambert,&nbsp;Hélène Amazouz,&nbsp;Zélia Breton,&nbsp;Viet-Thi Tran,&nbsp;Stacey Missmer,&nbsp;Marina Kvaskoff","doi":"10.1002/ejp.70040","DOIUrl":"https://doi.org/10.1002/ejp.70040","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Endometriosis may manifest through various pain symptoms, such as dysmenorrhea, dyspareunia, dyschezia, dysuria and abdominal pain. While retrospective evaluation of these pain symptoms is less expensive and time-consuming compared to a prospective evaluation, there is potential for recall bias, and the reliability of such data needs to be assessed. We aimed to evaluate the reliability of questions on past endometriosis-related pain.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We conducted a reliability study within ComPaRe-Endometriosis, an ongoing prospective e-cohort including patients with endometriosis. We assessed past endometriosis-related pain over a lifetime using the WERF-EPHect Patient Questionnaire—Standard (EPQ-S). Participants rated the worst intensity of dysmenorrhea, dyspareunia, dyschezia, dysuria and abdominal pain that they experienced at ≤ 15, 16–20, 21–30, 31–40 and &gt; 40 years using a numeric-rating scale (NRS). We asked the same questions about 1 year later and measured the agreement between participant responses by calculating intraclass correlation coefficients (ICC) (continuous NRS level) and weighted kappa coefficients (&lt;i&gt;κ&lt;/i&gt;&lt;sub&gt;w&lt;/sub&gt;) (pain intensity categories).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 1752 participants completed both surveys. The global reliability was close to the ‘good’ and ‘substantial’ thresholds for dysmenorrhea (ICC = 0.74; &lt;i&gt;κ&lt;/i&gt;&lt;sub&gt;w&lt;/sub&gt; = 0.57) and dyspareunia (ICC = 0.72; &lt;i&gt;κ&lt;/i&gt;&lt;sub&gt;w&lt;/sub&gt; = 0.57), ‘moderate’ and close to the ‘substantial’ threshold for dysuria (ICC = 0.68; &lt;i&gt;κ&lt;/i&gt;&lt;sub&gt;w&lt;/sub&gt; = 0.59), and ‘moderate’ for dyschezia (ICC = 0.62; &lt;i&gt;κ&lt;/i&gt;&lt;sub&gt;w&lt;/sub&gt; = 0.54) and abdominal pain (ICC = 0.58; &lt;i&gt;κ&lt;/i&gt;&lt;sub&gt;w&lt;/sub&gt; = 0.49).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In this population, questions on worst pain intensity over the life course showed moderate-to-good reliability depending on the type of pain, with higher reliability when pain level was considered as a continuous variable.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Significance Statement&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;While prospective measures are the most robust approach in epidemiological research, longitudinal data with pain recorded since childhood or adolescence are scarce. This study shows that the worst level of pelvic and abdominal pain over the life course are reliably reported by endometriosis patients after a 1-year interval. These findings suggest that retrospecti","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143938874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author's Reply to the Comment by Meira E Cruz M","authors":"Cristina Rocha Exposto","doi":"10.1002/ejp.70036","DOIUrl":"https://doi.org/10.1002/ejp.70036","url":null,"abstract":"","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143944477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author's Reply to the Comment by Anjum et al.","authors":"Cristina Rocha Exposto","doi":"10.1002/ejp.70037","DOIUrl":"https://doi.org/10.1002/ejp.70037","url":null,"abstract":"","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143944478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}