A review of chronic pain impact on patients, their social environment and the health care system

Dueñas, María; Ojeda, Begoña Siles; Salazar, Alejandro; Micó, J.A.; Failde, Inmaculada

doi:10.2147/jpr.s105892

Cited by 709 publications

(601 citation statements)

References 76 publications

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“…Such negative associations also have been found in previous research 47. Our regression models accounted for 35%–70% of the total variance of QoL, indicating that pain intensity and depression play an important role in the variation of QoL.…”

Section: Discussionsupporting

confidence: 88%

Quality of life during early radiotherapy in patients with head and neck cancer and pain

Schaller¹,

Dragioti²,

Liedberg³

et al. 2017

JPR

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BackgroundPatients with head and neck cancer (HNC) have a potentially severe diagnosis and often suffer from tumor-related pain as well as from adverse side effects of treatment such as radiotherapy (RT). Knowledge about quality of life (QoL) during early RT in this group is limited and should be assessed in relation to diagnosis and treatment.PurposeThe purpose of this cross-sectional study was to identify potential factors that may influence QoL in patients with HNC during the early stages of RT (no later than two weeks of ongoing RT). We hypothesized that pain intensity, pain interference, catastrophizing, and mood disturbances are associated with QoL during early RT.Patients and methodsIn this study, 54 patients (53% of eligible patients) diagnosed with HNC were consecutively recruited from the regular flow to the Pain and Rehabilitation Center at Linköping University. The patients completed self-reported questionnaires on sociodemographics, pain intensity, pain interference, anxiety, depression, pain catastrophizing, and QoL.ResultsThe patients in this study scored high for QoL, low for pain intensity, and low for pain interference. The patients reported minor depressive symptoms and anxiety symptoms. Regression analyses showed that pain intensity and depressive symptoms negatively influenced QoL.ConclusionNo later than two weeks of RT, pain intensity and depression negatively influenced QoL in patients with HNC. Early screening for pain and depression in a targeted preventive strategy might maintain QoL during the course of the RT for patients with HNC. This assumption needs to be further investigated.

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Section: Discussionsupporting

confidence: 88%

Quality of life during early radiotherapy in patients with head and neck cancer and pain

Schaller¹,

Dragioti²,

Liedberg³

et al. 2017

JPR

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“…Chronic pain is common, disabling, has limited effective treatment options and is costly to healthcare systems and society. 64 This challenging field is also currently immersed in one of the worst iatrogenic crises to date and is struggling to find new, non-opioid, therapeutic options. 65 …”

Section: An Illustrative Examplementioning

confidence: 99%

Challenges of differential placebo effects in contemporary medicine: The example of brain stimulation

Burke

Kaptchuk

Pascual‐Leone

2019

Annals of Neurology

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‘Differential placebo effects’ is the concept that different types of placebos (e.g. inert pill versus sham device) may yield different magnitudes of placebo effects. This issue has been pushed into the spotlight by recent clinical trials of new technologies reporting unexpectedly large placebo effects from sham devices/procedures needed to maintain blinding integrity. In this Neurology Grand Rounds, we use transcranial magnetic stimulation as a model to explore the principles and implications of differential placebo effects. We highlight emerging research on the neurobiology of placebo effects and analyze fundamental questions of measuring efficacy in contemporary medicine.

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“…Research suggests that CWP is often unsuccessfully identified and managed within primary care and that consequently there is a tendency for overuse of healthcare appointments and thus health service utilisation [11, 12]. …”

Section: Introductionmentioning

confidence: 99%

A qualitative study of professional stakeholders’ perceptions about the implementation of a stepped care pain platform for people experiencing chronic widespread pain

Gellatly

Pelikan²,

Wilson

et al. 2018

BMC Fam Pract

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BackgroundChronic widespread pain (CWP) is a major public health problem. Many people experiencing CWP experience mental health problems such as anxiety or depression. Complete relief of skeletal and body pain symptoms is unlikely but with appropriate treatment the impact upon quality of life, functioning and mental health symptoms can be reduced. Cognitive behavioural therapy (CBT) is widely used for a range of health conditions and can have short and long-term improvements in patients with CWP. This research aimed to explore, from a professional stakeholder perspective, the implementation of a local Pain Platform offering a stepped care approach for interventions including telephone delivered CBT (T-CBT).MethodsFourteen professional stakeholders holding various roles across primary and secondary care services within the Pain Platform took part in semi-structured interviews. Their views and experiences of the implementation of the Pain Platform were explored. Interviews were recorded, transcribed verbatim and analysed according to Normalisation Process Theory (NPT).ResultsProfessional stakeholders were positive about the Pain Platform and its potential to overcome previously identified existing access issues to psychological interventions for CWP patients. It was considered a valuable part of ensuring that patients’ preferences and needs are more readily addressed. In some circumstances, however, introducing psychological interventions to patients was considered challenging and the introduction of new referral processes was raised concerns. To ensure sustainability more work is required to reduce professional isolation and ensure efficient referral procedures between primary and secondary care services are established to reduce concerns over issues related to clinical governance and potential risk to patient.ConclusionsThe findings provide professional insight into the key challenges of introducing a Pain Platform incorporating psychological support across primary and secondary care services within a local service. These included development of sustainable procedures and closer working relationships. Areas requiring future development are identified.

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A review of chronic pain impact on patients, their social environment and the health care system

Cited by 709 publications

References 76 publications

Quality of life during early radiotherapy in patients with head and neck cancer and pain

Quality of life during early radiotherapy in patients with head and neck cancer and pain

Challenges of differential placebo effects in contemporary medicine: The example of brain stimulation

A qualitative study of professional stakeholders’ perceptions about the implementation of a stepped care pain platform for people experiencing chronic widespread pain

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