The Impact of Enrollment in a Specialized Interdisciplinary Neuropathic Pain Clinic

Garven, Alexandra; Brady, Shauna; Wood, Susan; Hatfield, Melinda; Bestard, Jennifer; Toth, Cory

doi:10.1155/2011/518710

Cited by 15 publications

(20 citation statements)

References 62 publications

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“…We prospectively evaluated patients with NeP at a tertiary care NeP clinic in Calgary, AB, Canada 36. This investigation was designed as a prospective cohort assessment as part of the patients’ regular clinical care.…”

Section: Methodsmentioning

confidence: 99%

The importance of catastrophizing for successful pharmacological treatment of peripheral neuropathic pain

Toth

Brady

Hatfield

2014

JPR

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ObjectiveCatastrophizing may be a negative predictor of pain-related outcomes. We evaluated the impact of catastrophizing upon success of first-line pharmacotherapy in the management of neuropathic pain (NeP) due to peripheral polyneuropathy.MethodsPatients with confirmed NeP with NeP Visual Analog Scale (VAS) pain severity score ≥4 (0–10 scale) completed the Coping Strategies Questionnaire (CSQ) catastrophizing subscale at baseline. Pharmacological therapy consisting of first-line agents gabapentin, pregabalin, or a tricyclic antidepressant was initiated. Other measures examined included the Karnofsky Performance Scale, Beck Depression Inventory, EuroQol Quality of Life Health Questionnaire, and Modified Brief Pain Inventory. At 3 and 6 months, questionnaires were repeated and adverse effect reporting was completed. Outcome measures assessed were pharmacotherapy success (≥30% relief of NeP) and tolerability over 6 months of follow-up. Bivariate relationships using Pearson product-moment correlations were examined for baseline CSQ catastrophizing subscale score and the change in the NeP VAS scores and medication discontinuation.ResultsSixty-six patients were screened, 62 subjects participated, and 58 subjects (94%) completed the final follow-up visit. Greater catastrophizing was associated with poor pain relief response and greater likelihood of discontinuation of pharmacotherapy, reports of greater disability, and impaired quality of life. Duration of pain was negatively associated with likelihood of pharmacotherapy success.ConclusionCatastrophizing exerts maladaptive effects on outcomes with pharmacotherapy in NeP patients. Detection of catastrophizing during clinical visits when pharmacological therapy is being considered can be a predictive factor for patient outcomes.

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Section: Methodsmentioning

confidence: 99%

The importance of catastrophizing for successful pharmacological treatment of peripheral neuropathic pain

Toth

Brady

Hatfield

2014

JPR

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“…Regarding the use of QL parameters to evaluate chronic neuropathic pain individuals, the literature is scarce. Other authors refer in their studies that pain intensity has only decreased after one year of follow up, while QL indices and anxiety have improved after 6 months 15 . They concluded that educational activities and thorough interdisciplinary evaluation lead to better QL, thus confirming our study.…”

Section: Discussionmentioning

confidence: 96%

Melhora da qualidade de vida de pacientes com dor neuropática utilizando de monitorização ambulatorial contínua

et al. 2011

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“…One obvious parameter could be the change in waiting list time for pain clinics, although this might not necessarily reflect on the quality of care given in the community. We recommend the following parameters that would give evidence of a change in the bio-psycho-social aspects of the chronic pain phenomena: 1) in the biological aspect we could follow such parameters as VAS and the use of pain medication 28 , 29 ; 2) on the psychological aspect one could examine quality of life measures such as patient satisfaction, stress, anxiety, and anger 30 , 31 ; and 3) such social parameters as days off work and physician visitation rates. …”

Section: Practical Implicationsmentioning

confidence: 99%

Pain Medicine in Crisis—A Possible Model toward a Solution: Empowering Community Medicine to Treat Chronic Pain

Minerbi¹,

Vulfsons²

2013

Rambam Maimonides Med J

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Pain medicine in Israel and in the world has reached a crisis. The lack of available pain medicine services is resulting in the unsatisfactory treatment for chronic pain sufferers. The main causes of this crisis are: 1) the high prevalence of chronic pain, reaching levels of 17% in the adult population;2) the lack of appropriate training of primary care physicians in the field of chronic pain management; and 3) the paucity of consultation services in the field of chronic pain. In this journal article, we propose a possible model for the solution of the problem, based upon levels of treatment according to the severity of the disease and upon training of primary and secondary care physicians in the treatment of pain. According to the model, the vast majority of treatment and management will take place in the community after appropriate training of primary care physicians. More complex cases will be referred to secondary care community-based pain clinics manned by physicians with further in-depth training. Only the most complex of patients, or those needing specialized treatment such as invasive analgesic therapy, will be referred to tertiary pain centers manned by specialists in pain medicine. Implementation of this model will necessitate training of primary care physicians and the establishment of secondary care facilities and can, in our opinion, pose a pragmatic solution for the hundreds of thousands of patients suffering from chronic pain.

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The Impact of Enrollment in a Specialized Interdisciplinary Neuropathic Pain Clinic

Cited by 15 publications

References 62 publications

The importance of catastrophizing for successful pharmacological treatment of peripheral neuropathic pain

The importance of catastrophizing for successful pharmacological treatment of peripheral neuropathic pain

Melhora da qualidade de vida de pacientes com dor neuropática utilizando de monitorização ambulatorial contínua

Pain Medicine in Crisis—A Possible Model toward a Solution: Empowering Community Medicine to Treat Chronic Pain

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