Chronic pain: a review of its epidemiology and associated factors in population-based studies

Mills, Sarah; Nicolson, Karen P.; Smith, Blair H.

doi:10.1016/j.bja.2019.03.023

Cited by 1,095 publications

(948 citation statements)

References 143 publications

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“…The majority of persons interviewed attained up to primary or secondary level of education with only 15.2% acquiring tertiary level. Although reports have shown the prevalence of chronic pain to be inversely related to socio-economic status (20) the American Pain Society in 2017 reported that prevalence differences according to education were insigni cant (21). It is important to note that in countries with generally easily accessible healthcare systems, educational background does not directly impact disease activity but patients with a higher educational level may have slightly less pain and less functional disability.…”

Section: Discussionmentioning

confidence: 99%

Arthritis and Health Related Quality of Life in Adult Outpatients in Trinidad: A Cross Sectional Study

Motilal

Dawar

Mankee

et al. 2020

Preprint

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Abstract BACKGROUND Arthritis is a public health concern because of the high prevalence reported in various settings as well as its impact on health-related quality of life (HRQOL). The main objective of this study was to determine the prevalence of self-reported joint pain, arthritis and its associations with quality of life in a Trinidadian primary care population. METHODS A cross-sectional study was conducted on adult outpatients from 16 randomly selected primary care centres. An interviewer administered questionnaire was used to collect data on arthritis and HRQOL domains. Data was analysed using Statistical Package for the Social Sciences (SPSS, version 21) using Fisher’s exact, Chi-square testing, correlation and t-tests. Regression analysis was also done for predictors of HRQOL. RESULTS Of 421 subjects approached, 392 (93%) completed this survey. The average age was 46 ± 17.8 years with 60.5% of respondents being female and 75% being of either East Indian or African descent. Joint pain in the past 6 months, reported by 57.9% of participants, was associated with female gender (P = 0.016), East Indian descent (P = 0.001), unemployment (P < 0.001) and primary school education level (P < 0.001). There was significant (P < 0.005) upset in all domains of quality of life in those with joint pain. Severity and duration of joint pain was also positively correlated with worse HRQOL scores (P < 0.05). CONCLUSION This study highlighted the high prevalence of self-reported joint pain in Trinidad and its negative effects on HRQOL. There is an urgent need to address arthritis and the resulting morbidity in this setting.

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Section: Discussionmentioning

confidence: 99%

Arthritis and Health Related Quality of Life in Adult Outpatients in Trinidad: A Cross Sectional Study

Motilal

Dawar

Mankee

et al. 2020

Preprint

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“…It is estimated the prevalence of chronic pain is 20.6% of the world population. The total number of pain prevalence has never been studied in Indonesia, but it is estimated that the cancer pain is experienced by around 12.7 million people (5% of the population), rheumatic pain occurs in 23.6-31.3%, and lower back pain is suffered by as much as 40% of the population 6,7 .…”

Section: Introductionmentioning

confidence: 99%

A pain management specialist

Santosa

2020

medisians

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Pain management must be done systematically according to the type of pain and its severity level in order to obtain optimal results. Therefore it is necessary to have an expert in pain management, who is equipped with a variety of pain management knowledge. In Indonesia there is no specific profession or license to become a pain management specialist. In this article the author tries to explain what is pain management specialist from various references abroad.

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“…For example, neuroinflammation appears to play a role in both depression and chronic pain [23]. Chronic pain has also been associated with anxiety, negative thought patterns, and problems sleeping (which may be due to mental or physical problems) [24], any of which may lead a clinician to consider the use of a benzodiazepine. However, benzodiazepines are habit-forming drugs that produce side effects and may interfere with the patient's ability to participate in healthpromoting, pain-fighting activities such as daily exercise, psychological therapy, social activities, and so on.…”

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confidence: 99%

Reappraising the use of benzodiazepines in chronic pain patients

Pergolizzi

LeQuang

2020

Postgraduate Medicine

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Benzodiazepines are not indicated for pain control, but they are frequently taken by pain patients. Indeed, benzodiazepines are among the most widely prescribed drugs on earth despite the fact that they are known to cause tolerance, dependence, and be associated with side effects [1,2]. Their unfortunate popularity among pain patients is troubling as many pain patients take concomitant opioids and the benzodiazepine-opioid combination can lead to potentially life-threatening respiratory depression. The Centers for Disease Control and Prevention (CDC) in their 12point guidelines to primary care physicians who prescribe opioids specifically advised against the concurrent use of a benzodiazepine with an opioid [3]. About 30% of opioid-associated overdose deaths involve the use of a benzodiazepine. [4] A cohort study found that the risk of death was increased 10-fold for opioid patients who took a benzodiazepine at the same time (7.0 per 10,000 person-years, 95% confidence interval, 6.3-7.8 versus 0.7 per 10,000 person years, 95% confidence interval, 0.6-0-.9) [5]. Benzodiazepines, which first came to market to replace carbamate drugs and the useful but extremely habit-forming drug class of barbiturates, act as positive allosteric modulators of the gamma-aminobutyric acid (GABA) receptor A, producing sedative, anxiolytic, hypnotic, anticonvulsant, and muscle-relaxing effects [6]. GABA is the single most common neurotransmitter in the body and it has an inhibitory effect on excitable neurons, which can result in a calming or dampening effect on cerebral activity [6]. Benzodiazepines are indicated for short-term use to treat acute anxiety and acute insomnia, both of which can occur with acute and chronic painful conditions [7-11]. In addition, benzodiazepines are widely prescribed off-label for a variety of mental health conditions, including depression, posttraumatic stress disorder, schizophrenia, obsessive-compulsive disorder, and others [12-15]. In the case of posttraumatic stress disorder, the use of benzodiazepines is not only contraindicated but it may exacerbate symptoms [12,16]. There is a paucity of evidence in the literature as to why pain patients are prescribed benzodiazepines. One may surmise that many people struggling with pain, particularly chronic pain syndromes, may report distressing symptoms of stress, anxiety, fearfulness, and disordered sleep patterns, any of which might be considered a reasonable indication for a benzodiazepine. Nevertheless, benzodiazepines are intended for short-term use only, typically defined as under four weeks,

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Chronic pain: a review of its epidemiology and associated factors in population-based studies

Cited by 1,095 publications

References 143 publications

Arthritis and Health Related Quality of Life in Adult Outpatients in Trinidad: A Cross Sectional Study

Arthritis and Health Related Quality of Life in Adult Outpatients in Trinidad: A Cross Sectional Study

A pain management specialist

Reappraising the use of benzodiazepines in chronic pain patients

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