The journal of pain : official journal of the American Pain Society
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Review Meta Analysis
Racial-Ethnic Differences in Osteoarthritis Pain and Disability: A Meta-Analysis.
Osteoarthritis (OA), a leading cause of disability and pain, affects 32.5 million Americans, producing tremendous economic burden. Although some findings suggest that racial/ethnic minorities experience increased OA pain severity, other studies have shown conflicting results. This meta-analysis examined differences in clinical pain severity between African Americans (AAs) and non-Hispanic whites with OA. ⋯ Clinical pain severity and disability in OA is higher among AAs and future studies should explore the reasons for these differences to improve pain management. PERSPECTIVE: This meta-analysis shows that differences exist in clinical pain severity, functional limitations, and poor performance between AAs and non-Hispanic whites with OA. This research may lead to a better understanding of racial/ethnic differences in OA-related pain.
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Multicenter Study Observational Study
Effectiveness of Opioids for Chronic Noncancer Pain: A Two-Year Multicenter, Prospective Cohort Study With Propensity Score Matching.
Opioid use in chronic non cancer pain (CNCP) is still controversial regarding their effectiveness and safety. We conducted a 2-year prospective cohort study in 4 multidisciplinary chronic pain clinics to assess long-term opioid effectiveness in CNCP patients. All adult CNCP patients consecutively admitted to their first consultation were recruited. ⋯ PERSPECTIVE: This study adds important additional evidence concerning the controversial use of opioids in CNCP management. Opioid users presented no improvement regarding pain relief, functional outcomes and quality of life over 2 years of follow-up. Therefore, our results support and highlight the limited effectiveness of opioids in long-term CNCP management.
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Comparative Study
Comparative Responsiveness of the PROMIS Pain Interference Short Forms With Legacy Pain Measures: Results From Three Randomized Clinical Trials.
The Patient-Reported Outcomes Measurement Information System Pain Interference (PROMIS-PI) scales are reliable and publicly accessible; however, little is known about how responsive they are to detect change in clinical trials and how their responsiveness compares with legacy measures. The study purpose was to evaluate responsiveness for the PROMIS-PI scales and to compare their responsiveness with legacy pain measures. We used data from 3 clinical trials totaling 759 participants. ⋯ For all pain questionnaires, responsiveness varied based on the study population and whether pain improved or worsened. PERSPECTIVE: This article presents 1) how responsive the PROMIS-PI scales were to detect change over time in the context of 3 clinical trials and 2) how their responsiveness compared with legacy pain measures. The findings can help researchers and clinicians choose between different patient-reported pain outcome measures.
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Fibromyalgia (FM) is a common chronic pain disorder that presents diagnostic challenges for clinicians. Several classification, diagnostic and screening criteria have been developed over the years, but there continues to be a need to develop criteria that reflect the current understanding of FM and are practical for use by clinicians and researchers. The Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks (ACTTION) public-private partnership with the U. ⋯ PERSPECTIVE: The ACTTION-APS FM taxonomy provides an evidence-based diagnostic system for FM. The taxonomy includes diagnostic criteria, common features, comorbidities, consequences, and putative mechanisms. This approach might improve the recognition of FM in clinical practice.
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Mindfulness-based training reduces pain in clinical and experimental settings. Evidence suggests that these beneficial effects are facilitated via an increased focus on the present moment and a reduced emotional enhancement of pain. Most of the existing literature has focused on mindfulness as a learned skill and on the neural mechanisms that underlie the acquisition of this skill. ⋯ PERSPECTIVE: Mindfulness research mostly focuses on mindfulness as a trained skill rather than a trait. Consistent with trained-mindfulness studies, we demonstrate that mindfulness is associated with variations in neural connectivity linked to sensory and evaluative processes. These findings indicate that trait mindfulness serves as a marker for individual differences in pain coping.