Pain practice : the official journal of World Institute of Pain
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The present study represents the next stage in the development of a psychometrically sound, self-report screening tool used for assessing the potential pain-medication-misuse risk. A revised Pain Medication Questionnaire (PMQ) was initially designed to successfully evaluate such risk. A subsequent series of two additional studies further documented the clinical utility of the PMQ. ⋯ Results revealed that the new version maintained the strong psychometric properties of the original PMQ. Moreover, its predictive accuracy was found to be high (85.5% accuracy). Thus, this revised, shortened PMQ can aid physicians in assessing for potential medication misuse, allowing them to more closely monitor at-risk patients during pain management treatment.
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The aim of this study was to develop and psychometrically evaluate an instrument for measuring the impact of chronic pain on daily life. ⋯ The initial tests showed that the PII seems to be a psychometrically sound instrument for measuring the impact of pain on daily life from a multidimensional perspective.
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A major issue in pain literature is whether an etiological association between pain, sleep, and vitality exists. We utilized data from clinical trials of duloxetine for management of diabetic peripheral neuropathic pain (DPNP) to investigate these associations. Data were pooled from 3 double-blind, randomized, placebo-controlled, 12-week trials of patients without mood disorder (N = 1,139). ⋯ Path analyses suggested vitality improvement in patients with chronic pain may be secondary to improvement in pain by duloxetine. Results do not prove pain causes fatigue, but indicate in DPNP patients with fatigue that treatment of pain can improve perception of improvement in fatigue. Thus, improvement of pain may be important in the context of trying to improve fatigue in DPNP patients.
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Randomized Controlled Trial Clinical Trial
Pain responder analysis: use of area under the curve to enhance interpretation of clinical trial results.
Interpretation of results on patient-reported pain outcomes from clinical trials should be meaningful to patients and healthcare providers. This study applied an area-under-the-curve (AUC) analysis to responder profiles in a clinical trial of pregabalin for the treatment of fibromyalgia (FM). Data were from a 14-week, randomized, placebo-controlled trial of pregabalin (300, 450, or 600 mg/day) for the treatment of FM in patients meeting American College of Rheumatology criteria for FM and with a baseline pain score of at least 40 mm on the 100-mm pain visual analogue scale. ⋯ The AUCs (2,100 for placebo, and 2,944, 3,170, and 3,349 for pregabalin 300, 450, and 600 mg, respectively) can be considered as if every responder improved by 21, 29, 31, and 33.5% in the responder's respective treatment group. Pain improvement was significantly better with pregabalin (P < 0.05), with pregabalin responders improving by 8.4% (300 mg/day), 10.7% (450 mg/day), and 12.5% (600 mg/day) more than placebo responders. This novel approach demonstrates that responder profiles can provide an enhanced interpretation of pain outcomes for patient care and symptom management.