The Clinical journal of pain
-
The main aim of the study was to generate initial convergent validity evidence for the Pain and Discomfort Scale (PADS) for use with nonverbal adults with intellectual disabilities. ⋯ FACS is an objective coding platform for facial expression. It requires intensive training and resources for scoring. As such it may be limited for clinical application. PADS was designed for clinical application. PADS scores were comparable with FACS scores under controlled evaluation conditions providing partial convergent validity evidence for its use.
-
Observational Study
Breakthrough Pain in Patients with Abdominal Cancer Pain.
Characterization of breakthrough cancer pain (BTcP) in patients with abdominal cancer is lacking. The aim of this study was to assess the characteristics of BTcP in patients with abdominal cancer pain. ⋯ This preliminary study provides new insights on the characteristics of BTcP in a subclass of patients with abdominal disease. It has been estimated that about 55% of patients with well-controlled background pain will develop BTcP episodes. This percentage was higher (about 90%) in patients who presented with uncontrolled background pain, underlying the need to better characterize patients with BTcP, only after a careful optimization of basal pain, as considered by the definition of BTcP.
-
Randomized Controlled Trial Multicenter Study
Pregabalin in Patients With Inadequately Treated Painful Diabetic Peripheral Neuropathy: A Randomized Withdrawal Trial.
This study used a randomized withdrawal design to evaluate the efficacy of pregabalin versus placebo for pain relief in patients with painful diabetic peripheral neuropathy inadequately treated by other therapies. ⋯ This is the first reported placebo-controlled trial of pregabalin in patients with inadequately treated painful diabetic peripheral neuropathy. Although the primary endpoint was not met, pregabalin was associated with clinically relevant improvements versus placebo in this difficult-to-treat population.
-
Cultural differences in pain perception exist. Although chronic whiplash-associated disorder (WAD) is well investigated in western countries, little is known about its presentation in Singapore. We studied the neck motion and pain sensitivity in people with chronic WAD in Singapore. ⋯ These findings of sensory hypersensitivity and decreased neck motion in Singaporeans with chronic WAD are consistent with physical impairments reported in western populations.
-
Systematic reviews have consistently shown that multidisciplinary interventions are more effective than waitlist and other unimodal active treatments for a range of chronic pain conditions. However, these group-based statistics fail to inform us whether these programs result in clinically meaningful improvement at the individual level. The current study examines group changes and individual responsiveness to a CBT-informed multidisciplinary chronic pain management program. ⋯ The results of our study are consistent with previous research, and highlight the potential for multidisciplinary programs to improve the well-being of individuals with chronic pain. Clinically important change analyses underscore the variability that exists in chronic pain patients and allows for a more fine grained evaluation of individual responsiveness to treatment. Considering the strengths and limitations of each methodological approach for assessing clinically important change, guidelines are offered for future research and program development.