British Journal of Pain最新文献

{"title":"BPS ASM 2023 abstract supplement","authors":"","doi":"10.1177/20494637231177771","DOIUrl":"https://doi.org/10.1177/20494637231177771","url":null,"abstract":"","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":"17 1","pages":"1 - 63"},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46499612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Yarning about pain: Evaluating communication training for health professionals at persistent pain services in Queensland, Australia.","authors":"Christina M Bernardes, Stuart Ekberg, Stephen Birch, Andrew Claus, Matthew Bryant, Renata Meuter, Jermaine Isua, Paul Gray, Joseph P Kluver, Eva Malacova, Corey Jones, Kushla Houkamau, Marayah Taylor, Ivan Lin, Gregory Pratt","doi":"10.1177/20494637221149831","DOIUrl":"10.1177/20494637221149831","url":null,"abstract":"<p><strong>Background: </strong>Providing cultural education to health professionals is essential in improving the quality of care and outcomes for Aboriginal and Torres Strait Islander patients. This study reports the evaluation of a novel training workshop used as an intervention to improve communication with Aboriginal and Torres Strait Islander patients of persistent pain services.</p><p><strong>Methods: </strong>In this single-arm intervention study, health professionals undertook a one-day workshop, which included cultural capability and communication skills training based on a clinical yarning framework. The workshop was delivered across three adult persistent pain clinics in Queensland. At the end of the training, participants completed a retrospective pre/post evaluation questionnaire (5 points Likert scale<i>, 1 = very low to 5 = very high)</i>, to rate their perceived importance of communication training, their knowledge, ability and confidence to communicate effectively. Participants also rated their satisfaction with the training and suggested improvements for future trainings.</p><p><strong>Results: </strong>Fifty-seven health professionals were trained (<i>N</i> = 57/111; 51% participation rate), 51 completed an evaluation questionnaire (<i>n</i> = 51/57; 90% response rate). Significant improvements in the perceived importance of communication training, knowledge, ability and confidence to effectively communicate with Aboriginal and Torres Strait Islander patients were identified (<i>p < 0.001</i>). The greatest increase was in the perceived confidence pre-training mean of 2.96 (SE = 0.11) to the post-training mean of 4.02 (SE = 0.09).</p><p><strong>Conclusion: </strong>This patient-centred communication training, delivered through a novel model that combines cultural capability and the clinical yarning framework applied to the pain management setting, was highly acceptable and significantly improved participants' perceived competence. This method is transferrable to other health system sectors seeking to train their clinical workforce with culturally sensitive communication skills.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":"17 3","pages":"306-319"},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10278454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10664074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"All Change at the BJP.","authors":"Felicia Cox, Roger Knaggs","doi":"10.1177/20494637231167722","DOIUrl":"10.1177/20494637231167722","url":null,"abstract":"","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":"17 2","pages":"116"},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10088423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9294484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of sensory neural entrainment on acute and chronic pain: A systematic review and meta-analysis.","authors":"Rhys Maddison,&nbsp;Hamde Nazar,&nbsp;Ilona Obara,&nbsp;Quoc C Vuong","doi":"10.1177/20494637221139472","DOIUrl":"https://doi.org/10.1177/20494637221139472","url":null,"abstract":"<p><strong>Background: </strong>Changes to the power of neural oscillations in cortical and sub-cortical structures can change pain perception. Rhythmic sensory stimulation is a non-invasive method that can increase power in specific frequencies of neural oscillations. If the stimulation frequency targets those frequencies related to pain perception, such as alpha or theta frequencies, there can be a reduction in perceived pain intensity. Thus, sensory neural entrainment may provide an alternative to pharmacological intervention for acute and chronic pain. This review aimed to identify and critically appraise the evidence on the effectiveness of sensory entrainment methods for pain perception.</p><p><strong>Methods: </strong>We undertook a systematic search across Medline, Embase, PsycInfo, Web of Science and Scopus in November 2020 to identify studies investigating the efficacy of sensory entrainment on adults. We assessed studies for their quality using the PRISMA checklist. A random-effects model was used in a meta-analysis to measure the effect of entrainment on pain perception.</p><p><strong>Results: </strong>Our systematic review yielded nine studies fitting the search criteria. Studies investigated the effect of visual and auditory entrainment on pain intensity rating, electrophysiological markers of pain and amount of analgesia needed during surgery. The meta-analysis suggests that alpha (8-13 Hz) sensory entrainment is effective for acute pain perception, whereas theta (4-7 Hz) entrainment is effective for chronic pain.</p><p><strong>Conclusions: </strong>Although there is heterogeneity in the current evidence, our review highlights the potential use of sensory entrainment to affect acute and chronic pain. Further research is required regarding the timing, duration and frequency of the stimulation to determine the best application for maximum efficacy.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":"17 2","pages":"126-141"},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10088425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9360027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficiency of pain inhibition and facilitation of fibromyalgia patients is not different from healthy controls: Relevance of sensitivity-adjusted test stimuli.","authors":"Roland Staud, Melyssa M Godfrey, Joseph L Riley, Roger B Fillingim","doi":"10.1177/20494637221138318","DOIUrl":"10.1177/20494637221138318","url":null,"abstract":"<p><strong>Background: </strong>Pain is a dynamic phenomenon dependent on the balance of endogenous excitatory and inhibitory systems, which can be characterized by quantitative sensory testing. Many previous studies of pain modulatory capacity of patients with fibromyalgia syndrome (FM) have reported decreased pain inhibition or increased pain facilitation. This is the first study to assess pain modulation, including conditioned pain modulation (CPM) and temporal pain summation, in the same healthy control (HC) and FM participants.</p><p><strong>Methods: </strong>Only sensitivity-adjusted stimuli were utilized for testing of conditioned pain modulation (CPM) and temporal pain summation in 23 FM patients and 28 HC. All subjects received sensitivity-adjusted ramp-hold (sRH) during testing of pain facilitation (temporal summation) and pain inhibition (CPM). CPM efficacy was evaluated with test stimuli applied either concurrently or after application of the conditioning stimulus. Finally, the effects of CPM on pressure pain thresholds were tested.</p><p><strong>Results: </strong>FM subjects required significantly less intense test and conditioning stimuli than HC participants to achieve standardized pain ratings of 50 ± 10 numerical rating scale (NRS) (<i>p</i> = 0.03). Using such stimuli, FM subjects' temporal pain summation and CPM efficacy was not significantly different from HC (all <i>p</i> > 0.05), suggesting similar pain facilitation and inhibition. Furthermore, the CPM efficacy of FM and HC participants was similar regardless of whether the test stimuli were applied during or after the conditioning stimulus (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>Similar to previous studies, FM participants demonstrated hyperalgesia to heat, cold, and mechanical stimuli. However, using only sensitivity-adjusted stimuli during CPM and temporal summation testing, FM patients demonstrated similarly effective pain inhibition and facilitation than HC, suggesting that their pain modulation is not abnormal.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":"17 2","pages":"182-194"},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10088420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9306167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medicinal cannabis for Australian patients with chronic refractory pain including arthritis.","authors":"Elise A Schubert, Masego T Johnstone, Melissa J Benson, Johannes C Alffenaar, Nial J Wheate","doi":"10.1177/20494637221147115","DOIUrl":"10.1177/20494637221147115","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the tolerability and effectiveness of medicinal cannabis prescribed to patients for chronic, refractory pain, with a subset analysis on arthritis.</p><p><strong>Methods: </strong>This was an interim analysis of the CA Clinics Observational Study investigating self-reported adverse events (AEs) and changes in health-related quality of life (HRQoL) outcomes over time after commencing medicinal cannabis. Patients were prescribed medicinal cannabis by a medical practitioner, containing various ratios of Δ⁹-tetrahydrocannabinol (THC) and/or cannabidiol (CBD).</p><p><strong>Results: </strong>The overall chronic pain cohort, and specifically the balanced CBD:THC products, were associated with significantly reduced pain intensity scores (<i>p</i> = 0.003, <i>p</i> = 0.025), with 22% of patients reporting a clinically meaningful reduction in pain intensity. Patients in the arthritis subset (<i>n</i> = 199) reported significantly reduced pain intensity scores (<i>p</i> = 0.005) overall, and specifically for those taking CBD-only (<i>p</i> = 0.018) and balanced products (<i>p</i> = 0.005). Other HRQoL outcomes, including pain interference and pain impact scores were significantly improved depending on the CBD:THC ratio. Products that contained a balanced ratio of CBD:THC were associated with improvements in the most number of PROMIS-29 domains. Approximately half (<i>n</i> = 364; 51%) of the chronic pain cohort experienced at least one AE, the most common being dry mouth (24%), somnolence (19%) or fatigue (12%). These findings were similar in the arthritis subset.</p><p><strong>Discussion: </strong>Medicinal cannabis was observed to improve pain intensity scores and HRQoL outcomes in patients with chronic, refractory pain, providing real-world insights into medicinal cannabis' therapeutic potential.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":"17 2","pages":"206-217"},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10088421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9360029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A service evaluation to examine the effectiveness of chronic pain management programmes delivered using video conferencing technology compared to in-person.","authors":"Deborah Joy, Annie Caddle","doi":"10.1177/20494637221135125","DOIUrl":"10.1177/20494637221135125","url":null,"abstract":"<p><strong>Introduction: </strong>The Covid-19 pandemic required rapid substitution of in-person Pain Management Programmes (PMP) delivery with delivery via videoconferencing technologies (VCT). No prior published VCT-PMP effectiveness findings were found, so an evaluation was conducted to explore effectiveness of this method and to compare psychometric outcomes with pre-pandemic, in-person- PMPs, delivered in routine clinical settings.</p><p><strong>Methods: </strong>Participants were routinely attending PMPs. A consecutive series of six in-person-PMPs (<i>n</i> = 61) immediately prior to the pandemic were compared with the first series of six VCT-PMPs (<i>n</i> = 64) delivered in the same services. A within-subjects comparison of clinical outcomes (pre-post for VCT-PMP and in-person PMP) and a between-subjects comparison of delivery type was conducted (two-way mixed ANOVA). Reliable change indices examined reliable improvements and deteriorations by delivery type.</p><p><strong>Results: </strong>Both PMP delivery format groups made significant improvements in anxiety, depression, pain self-efficacy, chronic pain acceptance and pain catastrophising. No significant difference was found between VCT-PMP and in-person-PMP on each of the measures. Reliable change indices indicated similar levels of improvement and deterioration with each delivery format with improvements far outweighing deteriorations. Attrition was greater in the VCT format (33%) versus in-person-PMP (18%).</p><p><strong>Conclusion: </strong>This study indicates that meaningful change as measured by standard psychometric questionnaires can occur in PMPs delivered via VCT and appear broadly equivalent to that achieved through in-person delivery. Physical performance outcomes such as quality and amount of movement were not measured or explored.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":"17 2","pages":"142-151"},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10088418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9306168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Readability of online health information pertaining to migraine and headache in the UK.","authors":"Kate Atherton,&nbsp;Mark J Forshaw,&nbsp;Tara M Kidd","doi":"10.1177/20494637221134461","DOIUrl":"https://doi.org/10.1177/20494637221134461","url":null,"abstract":"<p><p>An estimated 46% of the worldwide adult population live with an active headache disorder, and it is thought that there is a proportion of headache and migraine sufferers who do not attend for medical care, instead choosing to manage their symptoms at home. The internet continues to act as a source of online health information for self-management, however, it is important that this information can be understood by the user. Research indicates that most health information online is written at a level too difficult for much of the UK population to understand. The aim of this study was to investigate the readability of online health information pertaining to headache and migraine for a UK-based internet user accessing the top four search engines. Searches for 'headache' and 'migraine' were performed on each search engine and results from the first page were selected for analysis. Five validated readability tests were used to analyse readability; Flesch-Kincaid Grade Level, Flesch Reading Ease, Gunning Fog Index, Coleman-Liau Index and Simple Measure of Gobbledygook Index. We found that the majority of online health information about migraine and headache is too difficult for the UK adult population to read. Findings highlight work is required to ensure that information from a wider variety of sources is easier to comprehend for much of the population in order for individuals to make informed decisions about health seeking and self-management of headache and migraine. Health information providers should weave readability analysis into their content design process, incorporating shorter sentences and simpler words in their description of conditions and treatment.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":"17 2","pages":"117-125"},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10088424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9360025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What influences physician opioid prescribing for children with acute pain?","authors":"George Slim, Michael van Manen, Megan Fowler, Naveen Poonai, Samina Ali","doi":"10.1177/20494637221146421","DOIUrl":"10.1177/20494637221146421","url":null,"abstract":"<p><strong>Background: </strong>Pain is one of the most common symptoms encountered in the healthcare system, and opioids are among the top three medications used to treat it. Understanding the reasoning behind physicians' opioid prescribing practices is vital to safe practice. The primary objective of our study was to describe pediatric emergency physicians' decision-making process when prescribing opioids for children's acute pain management.</p><p><strong>Methods: </strong>This study employed qualitative methodology, using one-on-one semi-structured interviews within a grounded theory analytic framework. We employed purposeful sampling to recruit pediatric emergency physicians from across Canada. Interviews were conducted by telephone (December 2019-January 2021). Transcript analysis occurred concurrently with data collection, supporting data saturation and theory development considerations.</p><p><strong>Results: </strong>Eleven interviews were completed with participants representing each of Canada's geographic regions. Nine major themes emerged: (1) practice setting and outpatient opioid use, (2) condition-specific considerations, (3) physician confidence in medical evidence, (4) pain assessment challenges, (5) patient and family perspectives, (6) opioid safety concerns, (7) personal biases and experiences, (8) personal practice context, and (9) the Opioid Crisis/media influence. Most clinicians felt that they limited opioid use to those who needed it most; all participants described challenges managing acute pain, emphasizing the need for accurate pain measurement and better guidelines, evidence-based data, and knowledge translation. Clinicians were more comfortable treating pain in the emergency department, compared to discharge prescribing. They recognized the importance of co-therapy with non-opioids and the need for opioid risk assessment when prescribing. A family centered approach was recognized as the goal of practice.</p><p><strong>Conclusion: </strong>Clinicians are less comfortable prescribing opioids to children for at-home use and find pain assessment and lack of clear guidelines to be barriers to pain care. Knowledge translation strategies for safer practice and optimal acute pain management could support responsible and judicious opioid use.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":"17 2","pages":"195-205"},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10088422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9660730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caregiving for older people living with chronic pain: analysis of the English longitudinal study of ageing and health survey for England.","authors":"Toby Smith,&nbsp;Michael Mansfield,&nbsp;Sarah Hanson,&nbsp;Allie Welsh,&nbsp;Reema Khoury,&nbsp;Allan Clark,&nbsp;Emma Dures,&nbsp;Jo Adams","doi":"10.1177/20494637221144250","DOIUrl":"https://doi.org/10.1177/20494637221144250","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain is a disabling condition. Many people with chronic pain seek informal support for everyday activities of daily living (ADL). However, there remains uncertainty on the type of people with chronic pain who access this support, what types of support they need and who provides such support. The purpose of this analysis was to answer these uncertainties.</p><p><strong>Methods: </strong>Data from the Health Survey for England (HSE) and English Longitudinal Study of Ageing (ELSA) were accessed. People who reported chronic pain (moderate or above for minimum of 12 months) were identified. From these cohorts, we determined if individuals self-reported receiving informal care. Data on caregiver profiles and caregiving activities were reported through descriptive statistics. Logistic regression analyses were performed to compare health status outcomes between people with pain who received and who did not receive informal care.</p><p><strong>Results: </strong>2178 people with chronic pain from the ELSA cohort and 571 from the HSE cohort were analysed. People who received care were frequently female, older aged with several medical morbidities including musculoskeletal diseases such as arthritis. People with chronic pain received informal care for several diverse tasks. Most frequently these related to instrumental activities of daily living (IADL) such as shopping and housework. They were most frequently provided by partners or their children. Although they reported greater disability and symptoms (<i>p</i> < 0.001), people who received care did not report differences in health status, loneliness or wellbeing (<i>p</i> = 0.27; <i>p</i> = 0.46).</p><p><strong>Conclusions: </strong>Whilst it may be possible to characterise people living in chronic pain who receive informal care, there is some uncertainty on the impact of informal caregiving on their health and wellbeing. Consideration should now be made on how best to support both care recipients and informal caregivers, to ensure their health and quality of life is promoted whilst living with chronic pain.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":"17 2","pages":"166-181"},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/87/f0/10.1177_20494637221144250.PMC10088417.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9660734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}