Pain Medicine最新文献

{"title":"Cancer patients quality of life after intrathecal drug delivery for advanced pain management: a patient-reported outcome analysis.","authors":"Vasudha Goel, Alexander Kaizer, David Darrow, Drew Rosielle, Benjamin Owens, Anne Blaes","doi":"10.1093/pm/pnaf012","DOIUrl":"10.1093/pm/pnaf012","url":null,"abstract":"<p><strong>Objectives: </strong>Cancer-related pain (CRP) is a common, most feared symptom experienced by cancer patients, adversely affecting quality of life and cancer outcomes. Patient-reported outcomes (PRO) measures are a patient's report of their health condition without interpretation of the response by a health care provider. This study assesses PRO measures after therapy using an intrathecal drug delivery system (IDDS) for cancer pain management.</p><p><strong>Design, setting, subjects, and methods: </strong>The retrospective study included adult patients undergoing IDDS implantation from January 2022 to January 2023 at the University of Minnesota Medical Center. Patients with moderate to severe CRP (VAS > 4) who had failed conventional medical therapy for pain control or had severe opioid-related side effects were considered for IDDS therapy. PRO measures were evaluated by the Patient Reported Outcomes Measurement Information System (PROMIS). The measurements were collected weekly during the first month after implantation and then during monthly follow-up. Linear mixed effects models with a random intercept for each participant are fit to the PROMIS outcomes to compare the change in scores.</p><p><strong>Results: </strong>During the study period, 23 patients received IDDS treatment for CRP, and 20 patients (age 57.2 ± 17.1 years, female sex 65%, Caucasian ethnicity 90%, stage IV cancer 90%) were included in the final analysis. The mean oral morphine equivalent consumption at implantation was 237 ± 309. The patients started with severely reduced physical function, mobility, self-efficacy, social activity, social role, and satisfaction with roles. They also presented with mild-moderate sleep disturbance, anxiety, and depression symptoms. Of all the domains, pain interference and sleep disturbance consistently improved throughout the study period.</p><p><strong>Conclusions: </strong>Pain interference and Sleep disturbance as measured by PRO measures improved with IDDS therapy among patients with refractory pain and advanced metastatic cancer.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"261-268"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebrospinal fluid metabolomics of pain in patients with spinal muscle atrophy.","authors":"Abby Pei-Ting Chiu, G A Nagana Gowda, Wentao Zhu, Lars Arendt-Nielsen, Daniel Raftery, Michele Curatolo","doi":"10.1093/pm/pnae129","DOIUrl":"10.1093/pm/pnae129","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"283-286"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep brain stimulation and motor cortex stimulation for central post-stroke pain: a systematic review and meta-analysis.","authors":"Siddarth Kannan, Conor S Gillespie, Jeremy Hanemaaijer, John Eraifej, Andrew F Alalade, Alex Green","doi":"10.1093/pm/pnaf001","DOIUrl":"10.1093/pm/pnaf001","url":null,"abstract":"<p><strong>Introduction: </strong>Deep brain stimulation (DBS) and motor cortex stimulation (MCS) are invasive interventions in order to treat various neuropathic pain syndromes such as central post-stroke pain (CPSP). While each treatment has varying degree of success, comparative analysis has not yet been performed, and the success rates of these techniques using validated, objective pain scores have not been synthesized.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. Three databases were searched, and articles published from January 2000 to October 2024 were included (last search date October 25, 2024). Meta-Analysis was performed using random effects models. We evaluated the performance of DBS or MCS by assessing studies that reported pain relief using visual analogue scale (VAS) or numerical rating scale (NRS) scores.</p><p><strong>Results: </strong>Of the 478 articles identified, 32 were included in the analysis (330 patients-139 DBS and 191 MCS). The improvement in mean VAS score for patients that underwent DBS post-surgery was 48.6% compared to a score of 53.1% for patients that had MCS. The pooled number of patients who improved after DBS was 0.62 (95% CI, 0.51-0.71, I2 = 16%). The pooled number of patients who improved after MCS was 0.64 (95% CI, 0.53-0.74, I2 = 40%).</p><p><strong>Conclusion: </strong>The use of neurosurgical interventions such as DBS and MCS are last-resort treatments for CPSP, with limited studies exploring and comparing these two techniques. While our study shows that MCS might be a slightly better treatment option, further research would need to be done to determine the appropriate surgical intervention in the treatment of CPSP.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"269-278"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-expressed goals in chronic pain management: a qualitative analysis of primary care visits.","authors":"Cameron L Clerkley, Biftu M Mume, Ebere I Sonoiki, Stephen G Henry","doi":"10.1093/pm/pnaf005","DOIUrl":"10.1093/pm/pnaf005","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"287-289"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of cognitive functional therapy for chronic spinal pain: a systematic review with meta-analysis.","authors":"Michele Marelli, Matteo Cioeta, Leonardo Pellicciari, Fabio Rossi, Stefania Guida, Silvia Bargeri","doi":"10.1093/pm/pnaf002","DOIUrl":"10.1093/pm/pnaf002","url":null,"abstract":"<p><strong>Objective: </strong>To assess the effectiveness of cognitive functional therapy (CFT) in reducing disability and pain compared to other interventions in chronic spinal pain patients.</p><p><strong>Methods: </strong>Five databases were queried to October 2023 for retrieving randomized controlled trials (RCTs), including patients with chronic spinal pain and administering CFT. Primary outcomes were disability and pain. Secondary outcomes included psychological factors, quality of life, patient satisfaction, and adverse events. Two independent reviewers performed study selection, data extraction, risk of bias assessment (Cochrane RoB 2.0), and evidence certainty (GRADE approach). Random-effect models were used for meta-analyses. Clinical relevance was assessed with the smallest worthwhile effect.</p><p><strong>Results: </strong>Eight RCTs (N = 1228) for chronic low back pain (CLBP), one (N = 72) for chronic neck pain (CNP) were included. Compared to other conservative interventions, CFT may reduce disability (MD: -9.41; 95%CI: -12.56, -6.27) and pain (MD: -1.59; 95%CI: -2.33, -0.85 for CLBP) at short-term follow-up with probable to possible clinical relevance in CLBP and with low and very low evidence certainty, respectively. Similar results, with larger effect sizes, were observed for CFT compared to any unstructured or unsupervised minimal care treatments. Efficacy persisted in longer-term follow-ups, except for comparison with other conservative interventions. The CNP study showed positive results for CFT. Evidence certainty was low to very low. Sparse evidence was found for secondary outcomes.</p><p><strong>Conclusion: </strong>CFT may offer clinically relevant benefits for CLBP, although the evidence remains mainly of low to very low certainty. Well-conducted studies, particularly in CNP and other spinal pain conditions are needed to strengthen these findings.</p><p><strong>Registration: </strong>PROSPERO CRD42023482667.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"248-260"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the commentary on psychosocial interventions and neural mechanisms in chronic pain.","authors":"Yan Yuan, Kristin Schreiber, K Mikayla Flowers, Robert Edwards, Desiree Azizoddin, LauraEllen Ashcraft, Christina E Newhill, Valerie Hruschak","doi":"10.1093/pm/pnaf031","DOIUrl":"10.1093/pm/pnaf031","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"292-293"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and mental health characteristics among patients receiving medications for opioid use disorder treatment versus patients receiving low- and high-dose opioids when referred for pain management.","authors":"Jie Yang, Melita Giummarra, Louisa Picco, Carolyn Arnold, Suzanne Nielsen","doi":"10.1093/pm/pnaf011","DOIUrl":"10.1093/pm/pnaf011","url":null,"abstract":"<p><strong>Objective: </strong>To examine the demographic and clinical characteristics of patients attending pain management services who were receiving opioid agonist treatment (ie, methadone or buprenorphine for the treatment of opioid use disorder) in comparison with those taking prescription opioid analgesics in oral morphine equivalent daily doses at low (<40 mg) and high doses (>100 mg) in a national database from the electronic Persistent Pain Outcomes Collaboration (ePPOC) in Australia.</p><p><strong>Design: </strong>A cross-sectional study.</p><p><strong>Setting: </strong>Australian pain services.</p><p><strong>Subjects: </strong>Adult patients referred to Australian pain service clinics between 2016 and 2021.</p><p><strong>Methods: </strong>Multinomial and bivariate logistic regression models were conducted to compare the demographic and clinical characteristics of patients on opioid agonist treatment and those taking other prescription opioid analgesics.</p><p><strong>Results: </strong>Among 42 182 participants, most were female (56.8%), with a mean age of 51.7 years. People on opioid agonist treatment (n = 1016) and high-dose opioids (n = 7122) were similar in that they both had more severe mental health symptoms and longer pain duration than the low-dose group (n = 20 517). Compared with the high-dose group, people on opioid agonist treatment had reduced odds of reporting more severe pain intensity but increased odds of having multimorbidity, more severe anxiety, and pain catastrophizing thoughts.</p><p><strong>Conclusions: </strong>These findings highlight the need for mental health treatment and the necessity of tailored multidisciplinary pain management for people in opioid agonist treatment.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"237-247"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-based patient-centered pain management and the American Academy of Pain Medicine.","authors":"Charles E Argoff","doi":"10.1093/pm/pnaf021","DOIUrl":"10.1093/pm/pnaf021","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"229-230"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transforming pain medicine: the power of collaboration, entrepreneurship, and innovation.","authors":"Salman Hirani, Peter Vu, Mali Halac, Siri Bohacek, Barlas Benkli, David Jevotovsky, Julio Vega, Aliza Hirani, Vwaire Orhurhu, Charles Odonkor, Jesse Ehrenfeld, Iskander Shadid, Amanda Azadian, Brian Mayrsohn, Albert Kwon, Zishan Hirani, Uzondu Osuagwu, Justin Bird, Christopher Gilligan, Beth D Darnall, Kayode Williams, W Michael Hooten, Shriya Srinivasan","doi":"10.1093/pm/pnae130","DOIUrl":"10.1093/pm/pnae130","url":null,"abstract":"","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":"231-236"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the first prescription: Clinical and demographic drivers of strong opioid use in primary care.","authors":"Bishaal Tej Gurung, Louisa Picco, Grant Russell, Christopher Pearce, Suzanne Nielsen, Ting Xia","doi":"10.1093/pm/pnaf053","DOIUrl":"https://doi.org/10.1093/pm/pnaf053","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the demographic and clinical factors which influence the initiation of weak versus strong opioids amongst opioid-naïve patients in Australian primary care settings.</p><p><strong>Methods: </strong>This retrospective cohort study focuses on opioid-naïve patients, defined as those receiving an eligible opioid prescription with no prior opioid prescriptions in the past year, using general practice data extracted in partnership with Primary Health Networks via the POpulation Level Analysis and Reporting (POLAR) platform. Opioid prescriptions at time of initiation were categorised as weak or strong. We used multivariate probit model analysis to identify the demographic and clinical factors associated with type of opioid at initiation of prescribing.</p><p><strong>Results: </strong>We identified 415,098 opioid-naïve patients in primary care between January 1, 2018, and July 31, 2023, with 17% initiated on strong opioids. The probability of initiation with a strong opioid increased in patients over 80 years old by 25.0% (95%CI 0.244 to 0.257) compared to patients aged 20-29 years old. Patients with diagnoses of pain related to injury procedures (9.7% increase; 95%CI 0.093 to 0.101), or with prior antipsychotic prescriptions (6.2% increase; 95%CI 0.055 to 0.067), had higher probabilities of being prescribed strong opioids at the initiation compared to those without these conditions.</p><p><strong>Conclusion: </strong>One in six patients initiated on opioids in primary care were prescribed a strong opioid. This study highlights key factors associated with initiation of strong opioids among opioid-naïve patients. Further assessment of clinical suitability and outcomes associated with strong opioid prescribing can inform our understanding of opioid use in primary care.</p>","PeriodicalId":19744,"journal":{"name":"Pain Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}