Canadian Journal of Pain-Revue Canadienne de la Douleur最新文献

{"title":"Validation of the Critical-Care Pain Observation Tool (CPOT) in pediatric patients undergoing orthopedic surgery.","authors":"Mandy M J Li,&nbsp;Don Daniel Ocay,&nbsp;Cynthia L Larche,&nbsp;Kelsey Vickers,&nbsp;Neil Saran,&nbsp;Jean A Ouellet,&nbsp;Céline Gélinas,&nbsp;Catherine E Ferland","doi":"10.1080/24740527.2022.2156332","DOIUrl":"https://doi.org/10.1080/24740527.2022.2156332","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pain cannot be measured accurately among many children with intellectual and developmental disabilities, resulting in underrecognition or delay in recognition of pain. The Critical-Care Pain Observation Tool (CPOT) is a pain assessment tool that has been widely validated in critically ill and postoperative adults.</p><p><strong>Aims: </strong>The objective of this study was to validate the CPOT for use with pediatric patients able to self-report and undergoing posterior spinal fusion surgery.</p><p><strong>Methods: </strong>Twenty-four patients (10-18 years old) scheduled to undergo surgery were consented to this repeated-measure, within-subject study. To examine discriminative and criterion validation, CPOT scores and patients' self-reports of pain intensity were collected prospectively by a bedside rater before, during, and after a nonnociceptive and nociceptive procedure on the day following surgery. Patients' behavioral reactions were video recorded at the bedside and retrospectively viewed by two independent video raters to examine interrater and intrarater reliability of CPOT scores.</p><p><strong>Results: </strong>Discriminative validation was supported with higher CPOT scores during the nociceptive procedure than during the nonnociceptive procedure. Criterion validation was supported with a moderate positive correlation between the CPOT scores and the patients' self-reported pain intensity during the nociceptive procedure. A CPOT cutoff score of ≥2 was associated with the maximum sensitivity (61.3%) and specificity (94.1%). Reliability analyses revealed poor to moderate agreement between bedside and video raters and moderate to excellent consistency within video raters.</p><p><strong>Conclusions: </strong>These findings suggest that the CPOT may be a valid tool to detect pain in pediatric patients in the acute postoperative inpatient care unit after posterior spinal fusion.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"7 1","pages":"2156332"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9980602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10848874","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":"Ultrasound-guided repetitive pulsed peripheral magnetic stimulation provides pain relief in refractory glossopharyngeal neuralgia: A case report.","authors":"James S Khan,&nbsp;Duncan Westwood,&nbsp;Massieh Moayedi","doi":"10.1080/24740527.2022.2157250","DOIUrl":"https://doi.org/10.1080/24740527.2022.2157250","url":null,"abstract":"<p><strong>Aims: </strong>Repetitive peripheral magnetic stimulation (rPMS) is a novel nonpharmacological treatment modality. This noninvasive approach can stimulate peripheral nerves to provide analgesia through neuromodulation. We report the first case of ultrasound-guided rPMS to treat a case of severe refractory glossopharyngeal neuralgia.</p><p><strong>Methods: </strong>A 70-year-old female with an 8-year history of glossopharyngeal neuralgia reported refractory pain unresponsive to pharmacological and interventional treatments. After consenting to treatment, the patient received high-frequency rPMS in three different sessions using intermittent theta burst stimulation below motor thresholds. rPMS was applied over the skin directed at the glossopharyngeal nerve identified using ultrasound guidance. Session 1 included 20 min of continuous treatment, session 2 included 40 min of treatment (two 20-min treatments separated by a 10-min break), session 3 included 40 min of treatment (similar to Session 2) repeated daily for 5 days. Pre- and postintervention pain levels were collected with a daily 1-week pain diary and pain questionnaires.</p><p><strong>Results: </strong>Session 1 led to an immediate 30% decrease in pain after treatment. Session 2 led to a 75% decrease in pain immediately after treatment that remained reduced for approximately 2 days. Session 3 produced complete pain relief immediately after treatment and remained lower for 5 days after treatment and returned to baseline levels at 1 week.</p><p><strong>Conclusion: </strong>rPMS provided immense but temporary relief in a severe case of refractory glossopharyngeal neuralgia. Further work is needed to determine the most effective regimen to treat complex pain disorders in the head and neck.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"7 1","pages":"2157250"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9888447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9198009","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":"Views on and experiences with medicinal cannabis among Canadian veterans who live with pain: A qualitative study.","authors":"David P Storey,&nbsp;Natalie R Keeler-Villa,&nbsp;Nick Harris,&nbsp;Jennifer Anthonypillai,&nbsp;Gregory K Tippin,&nbsp;Vikas Parihar,&nbsp;Joshua A Rash","doi":"10.1080/24740527.2023.2232838","DOIUrl":"https://doi.org/10.1080/24740527.2023.2232838","url":null,"abstract":"<p><strong>Background: </strong>During fiscal year 2021-2022, Veterans Affairs Canada (VAC) reimbursed 18,388 veterans for medicinal cannabis at a cost of $153 million. Yet, it is not known whether the reimbursement program is producing a net benefit for veterans.</p><p><strong>Aims: </strong>This study investigated the views and experiences Canadian that veterans who live with pain have about medicinal cannabis use, including its use for the management of chronic pain, poor sleep, and emotional distress.</p><p><strong>Methods: </strong>Twelve Canadian veterans who live with pain-eight men, four women; split across four focus groups-were recruited to participate in a semistructured discussion around their experiences with medicinal cannabis use.</p><p><strong>Results: </strong>Using inductive thematic analysis, seven broad categories were identified: (1) cannabis use behaviors, (2) reasons for cannabis use, (3) outcomes from cannabis use, (4) facilitators of cannabis use, (5) barriers to cannabis use, (6) stigma around cannabis use, and (7) questions and concerns about cannabis use.</p><p><strong>Conclusions: </strong>Most veterans initiated cannabis use to manage the symptoms of preexisting medical and/or mental health conditions. Despite some negative side effects, most veterans reported improvements in their overall quality of life, sleep, relationships, mood, and pain. Concern remains around the discrepancy between veterans' qualitative reports of beneficial outcomes from medicinal cannabis use and equivocal findings around the benefit-to-harm ratio in the wider literature. Currently, the VAC reimbursement program remains challenged by unclear indication for which veterans, with what condition(s), at what dose, and in what form medical cannabis is most beneficial.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"7 1","pages":"2232838"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10494725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10244515","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":"Experiences of Veteran and Civilian Patients in Exploratory Yoga Sessions for Chronic Pain: A Qualitative Study.","authors":"Amy Huang,&nbsp;Jennifer Anthonypillai,&nbsp;Eleni G Hapidou","doi":"10.1080/24740527.2023.2244025","DOIUrl":"https://doi.org/10.1080/24740527.2023.2244025","url":null,"abstract":"<p><strong>Background: </strong>Yoga integrates all aspects of self, with biological, mental, intellectual, and spiritual elements. The practice of yoga aligns with the biopsychosocial model of health and, as such, it can be instrumental in pain treatment.</p><p><strong>Aims: </strong>The purpose of this qualitative study was to explore perceptions regarding the yoga sessions for chronic pain through thematic content analysis with comparison of gender, veteran or civilian status, and delivery methods.</p><p><strong>Methods: </strong>Patients with chronic pain attended a 5-week intensive interdisciplinary chronic pain management program at the Michael G. DeGroote Pain Clinic. Participants were asked to complete six open-ended questions following four weekly 1-h yoga classes, through in-person or virtual delivery. Survey responses were thematically and separately analyzed by reviewers.</p><p><strong>Results: </strong>Forty-one (<i>N</i> = 41) participants (56% males, 71% veterans) with an average age of 50.87 (SD 10.10) years provided comments. Nine themes emerged: (1) mind and body are one through yoga practices; (2) meaningful practice of yoga basics is productive for range of motion/movement, tension in joints, and chronic pain; (3) yoga classes provide an enjoyable process of learning; (4) yoga reminds patients of their physical capabilities; (5) routine practices lead to improvements; (6) yoga improved on strategies for chronic pain; (7) yoga can be adapted for each patient; (8) mindset improves to include positive thinking, better focus, and willingness to try new things; and (9) improvements exist for the current yoga programming.</p><p><strong>Conclusion: </strong>Findings of the current study were nine qualitative themes that present the experience of patients with chronic pain in the yoga sessions.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"7 2","pages":"2244025"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f9/79/UCJP_7_2244025.PMC10503449.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10311095","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":"Evaluating the efficacy of oxytocin for pain management: An updated systematic review and meta-analysis of randomized clinical trials and observational studies.","authors":"Anastasia A Mekhael,&nbsp;Jennifer E Bent,&nbsp;Jonathan M Fawcett,&nbsp;Tavis S Campbell,&nbsp;Aldo Aguirre-Camacho,&nbsp;Alison Farrell,&nbsp;Joshua A Rash","doi":"10.1080/24740527.2023.2191114","DOIUrl":"https://doi.org/10.1080/24740527.2023.2191114","url":null,"abstract":"<p><strong>Background: </strong>There is a need for novel analgesics with favorable risk to benefit profiles. Oxytocin has recently gained attention for its potential analgesic properties.</p><p><strong>Aim: </strong>The aim of this study was to perform an updated systematic review and meta-analysis evaluating the effect of oxytocin for pain management.</p><p><strong>Method: </strong>Ovid MEDLINE, Embase, PsycINFO, CINAHL, and Clinicaltrials.gov were searched for articles reporting on associations between oxytocin and chronic pain management from January 2012 to February 2022. Studies published before 2012 that were identified in our previous systematic review were also eligible. Risk of bias of included studies was assessed. Synthesis of results was performed using meta-analysis and narrative synthesis.</p><p><strong>Results: </strong>Searches returned 2087 unique citations. In total, 14 articles were included that reported on 1504 people living with pain. Results from meta-analysis and narrative review were mixed. Meta-analysis of three studies indicated that exogenous oxytocin administration did not result in a significant reduction in pain intensity relative to placebo (<i>N</i> = 3; <i>n</i> = 95; <i>g</i> = 0.31; 95% confidence interval [CI] -0.10, 0.73). Narrative review provided encouraging evidence that exogenous oxytocin administration reduced pain sensitivity among individuals with back pain, abdominal pain, and migraines. Results suggested that individual difference factors (e.g., sex and chronic pain condition) may influence oxytocin-induced nociception, but the heterogeneity and limited number of studies identified precluded further investigation.</p><p><strong>Discussion: </strong>There is equipoise for the benefit of oxytocin for pain management. Future studies are imperative and should undertake more precise exploration of potential confounds and mechanisms of analgesic action to clarify inconsistency in the literature.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"7 1","pages":"2191114"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10187080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10544657","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 systematic review of the efficacy of ketamine for craniofacial pain.","authors":"Yasmine Hoydonckx,&nbsp;Tyler McKechnie,&nbsp;Miki Peer,&nbsp;Marina Englesakis,&nbsp;Pranab Kumar","doi":"10.1080/24740527.2023.2210167","DOIUrl":"https://doi.org/10.1080/24740527.2023.2210167","url":null,"abstract":"<p><strong>Background: </strong>Craniofacial pain (CFP) poses a burden on patients and health care systems. It is hypothesized that ketamine, an <i>N</i>-methyl-d-aspartate (NMDA) receptor antagonist, can reverse central sensitization associated with causation and propagation of CFP. This systematic review aims to assess the role of ketamine for CFP.</p><p><strong>Methods: </strong>Databases were searched for studies published up to September 26, 2022, investigating the efficacy of ketamine for adults with CFP. Primary outcome was the change in pain intensity at 60 min postintervention. Two reviewers screened and extracted data. Registration with PROSPERO was performed (CRD42020178649).</p><p><strong>Results: </strong>Twenty papers (six randomized controlled trials [RCTs], 14 observational studies) including 670 patients were identified. Substantial heterogeneity in terms of study design, population, dose, route of administration, treatment duration, and follow-up was noted. Bolus dose ranged from 0.2-0.3 mg/kg (intravenous) to 0.4 mg/kg (intramuscular) to 0.25-0.75 mg/kg (intranasal). Ketamine infusions (0.1-1 mg/kg/h) were given over various durations. Follow-up was short in RCTs (from 60 min to 72 h) but longer in observational studies (up to 18 months). Ketamine by bolus treatment failed to reduce migraine intensity but had an effect by reducing intensity of aura, cluster headache (CH), and trigeminal neuralgia. Prolonged ketamine infusions showed sustainable reduction of migraine intensity and frequency of CH attacks, but the quality of the evidence is low.</p><p><strong>Conclusion: </strong>Current evidence remains conflicting on the efficacy of ketamine for CFP owing to low quality and heterogeneity across studies. Ketamine infusions are suggested to provide sustained improvement, possibly because of prolonged duration and higher dosage of administration. RCTs should focus on the dose-response relationship of prolonged ketamine infusions on CFP.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"7 1","pages":"2210167"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10294769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10564335","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":"Ultrasound-guided axial facet joint interventions for chronic spinal pain: A narrative review.","authors":"Michael J Wong,&nbsp;Manikandan Rajarathinam","doi":"10.1080/24740527.2023.2193617","DOIUrl":"https://doi.org/10.1080/24740527.2023.2193617","url":null,"abstract":"<p><strong>Background: </strong>Axial facet joint interventions (e.g., medial branch block and radiofrequency ablation, facet joint intra-articular injection) are commonly performed for managing chronic spinal pain. Although traditionally performed with fluoroscopy or computed tomography (CT) guidance, ultrasound-guided techniques have also been developed for these interventions.</p><p><strong>Aims: </strong>The aim of this study is to present contemporary ultrasound-guided techniques for facet joint interventions and synthesize data addressing their accuracy, safety, and efficacy.</p><p><strong>Methods: </strong>The PubMed, MEDLINE, CINAHL, Embase, and Cochrane Central Register of Controlled Trials databases were systematically searched for studies of ultrasound-guided facet joint interventions with human subjects from November 1, 1992, to November 1, 2022. Additional sources were drawn from reference lists and citations of relevant studies.</p><p><strong>Results: </strong>We found 48 studies assessing ultrasound-guided facet joint interventions. Ultrasound guidance for injection of the cervical facet joints and their innervating nerves had favorable accuracy (78%-100%), with lower procedural time compared to fluoroscopy or CT guidance and comparable pain relief. Accuracy with ultrasound-guided lumbar facet joint intra-articular injection (86%-100%) was more reliable than medial branch block (72%-97%); analgesia was comparable to fluoroscopy and CT guidance. In general, these procedures were more challenging for patients with obesity, and deeper structures were more difficult to accurately target (e.g., lower cervical levels, L5 dorsal ramus).</p><p><strong>Conclusions: </strong>Ultrasound-guided facet joint interventions continue to evolve. Some technically challenging interventions may be impractical for widespread usage or require further technical refinement. The utility of ultrasound guidance with obesity and abnormal anatomy may be reduced.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"7 2","pages":"2193617"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10193888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10194077","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":"Cost-Effectiveness and Cost-Utility Analyses in Thailand of Continuous Intrathecal Morphine Infusion Compared with Conventional Therapy in Cancer Pain: A 10-year Multicenter Retrospective Study.","authors":"Arpawan Thepsuwan,&nbsp;Nuj Tontisirin,&nbsp;Pramote Euasobhon,&nbsp;Patt Pannangpetch,&nbsp;Borwornsom Leerapan,&nbsp;Oraluck Pattanaprateep,&nbsp;Steven P Cohen","doi":"10.1080/24740527.2023.2225564","DOIUrl":"https://doi.org/10.1080/24740527.2023.2225564","url":null,"abstract":"<p><strong>Background: </strong>Because of the high initial cost of intrathecal drug delivery (ITDD) therapy, this study investigated the cost-effectiveness and cost-utility of ITDD therapy in refractory cancer pain management in Thailand over the past 10 years.</p><p><strong>Methods: </strong>The retrospective study was conducted in patients with cancer pain who underwent ITDD therapy from January 2011 to 2021 at three university hospitals. Clinical outcomes included the numerical rating scale (NRS), Palliative Performance Scale, and the EQ-5D. The direct medical and nonmedical as well as indirect costs were also recorded. Cost-effectiveness and cost-utility analyses were performed comparing ITDD therapy with conventional therapy (extrapolated from costs of the same patient before ITDD therapy) from a societally oriented economic evaluation.</p><p><strong>Results: </strong>Twenty patients (F:M: 10:10) aged 60 ± 15 years who underwent implantation of an intrathecal percutaneous port (IT port; <i>n</i> = 15) or programmable intrathecal pump (IT pump; <i>n</i> = 5) were included. The median survival time was 78 (interquartile range = 121-54) days after ITDD therapy. At 2-month follow-up, the incremental cost-effectiveness ratio (ICER)/pain reduction of an IT port (US$2065.36 (CA$2829.54)/2-point NRS reduction/lifetime) was lower than for patients with an IT pump (US$5479.26 (CA$7506.58)/2-point NRS reduction/lifetime) compared with continued conventional therapy. The ICER/quality-adjusted life years (QALYs) gained for an IT port compared with conventional treatment was US$93,999.31(CA$128,799.06)/QALY gained, which is above the cost-effectiveness threshold for Thailand.</p><p><strong>Conclusion: </strong>The cost-effectiveness and cost-utility of IT port therapy for cancer pain was high relative to the cost of living in Thailand, above the cost-effectiveness threshold. Prospective cost analysis studies enrolling more patients with diverse cancers that investigate the benefit of early ITDD therapy with devices over a range of prices are warranted.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"7 1","pages":"2225564"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/59/3f/UCJP_7_2225564.PMC10392764.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10196193","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 Association between COVID-19 and Changes in Opioid Prescribing Patterns and Opioid-Related Overdoses: A Retrospective Cohort Study.","authors":"Alexandra Robins,&nbsp;Alan Dimitriev,&nbsp;Cameron MacKay,&nbsp;Hayden Wang,&nbsp;Abigail Kearney,&nbsp;Daniel P Borschneck,&nbsp;Amber Simpson","doi":"10.1080/24740527.2023.2176297","DOIUrl":"https://doi.org/10.1080/24740527.2023.2176297","url":null,"abstract":"<p><strong>Background: </strong>Recent data suggest that restrictions related to COVID-19 resulted in changes in the prescribing patterns of opioids.</p><p><strong>Aims: </strong>We sought to analyze Ontario health data for changes in frequencies among new and continuing users for the following opioid prescription characteristics: the type of opioid, the average daily dose, and the prescriber's specialty.</p><p><strong>Methods: </strong>Utilizing data on the Ontario Health Data Platform, we defined two 149-day windows as \"before\" and \"after\" based on the initial COVID-19 provincial lockdown. A total of 882,268 individuals met our inclusion criteria and were classified as either \"new\" or \"continuing\" users. Chi-square tests and Fisher's exact tests were applied for each level of our primary outcomes to determine whether there were significant changes in prescription proportions before and after the lockdown.</p><p><strong>Results: </strong>A decline of 28% was observed for the number of new users after the lockdown. Statistically significant changes were observed for new users across almost all opioid prescription characteristics between the before and after windows. The proportion of new users who received at least one dispensing event from a pharmacist increased by 26.32%, whereas continuing users increased by 378.61%. There were no statistically significant shifts in opioid prescriptions among individuals with a reported toxicity event during the study period.</p><p><strong>Conclusions: </strong>In terms of opioid prescribing patterns, new users experienced greater change following the onset of the pandemic lockdown than continuing users. Our findings potentially showcase the unintended impacts that COVID-19-related restrictions had on non-COVID-19-related health services, which can inform future policy decisions.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"7 1","pages":"2176297"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10081074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9637394","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":"Understand me: Youth with chronic pain on how knowledge gaps influence their pain experience.","authors":"Cara L Brown,&nbsp;Gayle Restall,&nbsp;Francis Austin S Diaz,&nbsp;Polina Anang,&nbsp;Kerstin Gerhold,&nbsp;Heidi Pylypjuk,&nbsp;Kristy Wittmeier","doi":"10.1080/24740527.2022.2146489","DOIUrl":"https://doi.org/10.1080/24740527.2022.2146489","url":null,"abstract":"<p><strong>Background: </strong>There is a perceived lack of readily available resources to support self-management skills in youth living with chronic pain. The perspectives of youth regarding information gaps may improve the effectiveness of resources developed for them.</p><p><strong>Aim: </strong>The aim of this study was to explore the perspectives of youth living with chronic pain on the interactions among their pain experiences, chronic pain resources and research.</p><p><strong>Methods: </strong>Using an interpretive paradigm, we interviewed seven participants (age range 12-19 years) diagnosed with chronic pain. Two frameworks for meaningful engagement of citizens in research and policy informed the interview guide. Data were analyzed inductively using content analysis approaches to examine patterns and develop themes.</p><p><strong>Results: </strong>The participants' perceptions were captured by the overarching theme of \"understand me.\" Four subthemes elaborate on the relationship between the participants' experiences and how their lives could be enhanced through research and knowledge mobilization. In the subtheme \"my unique pain experience,\" the participants help us understand them by chronicling the variation in presentation of their chronic pain. The subtheme \"people don't know it's a thing\" emphasizes that there is general misunderstanding of chronic pain by the public and in the participants' support systems. The first two subthemes influence the third, which describes how the pain \"kind of stops you from living.\" The fourth subtheme, \"knowledge offers hope,\" offers a solution to dismantling misunderstanding of youth living with chronic pain.</p><p><strong>Conclusion: </strong>Future work needs to focus on embedding health literacy and knowledge mobilization into health and education structures to promote developmentally relevant self-management skills.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"7 1","pages":"2146489"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9888456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9198013","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}