Chronic pain as a topic for epidemiology and public health

Croft, Peter; Blyth, Fiona; Windt, Daniëlle van der

doi:10.1093/acprof:oso/9780199235766.003.0001

Cited by 56 publications

(79 citation statements)

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“…Our findings indicate that despite the evidence for better access to information, increase in physical activity, and weight loss advice, such approaches in an opportunistic consultation cannot be implemented until OA pain is directly addressed. Chronic pain, such as that experienced by people with OA, has a major impact on both the mental and physical capacity to function (27). The results of this study support this as all groups emphasize that until unmanaged pain is addressed, the patient is unlikely to be concordant with any conservative advice or treatment.…”

Section: Finney Et Alsupporting

confidence: 59%

Defining the Content of an Opportunistic Osteoarthritis Consultation With Primary Health Care Professionals: A Delphi Consensus Study

Finney

Porcheret

Grime

et al. 2013

Arthritis Care & Research

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Objective. To define the core content for an opportunistic consultation between a health care professional (HCP) and a patient with osteoarthritis (OA) in primary care.Methods. An ideas generation round and a 2-round Delphi postal consensus study allowed participants to rank the importance of tasks for an opportunistic consultation. The study was conducted with a lay group (n ‫؍‬ 18) and 3 groups of HCPs (n ‫؍‬ 30 for general practitioners, n ‫؍‬ 19 for practice nurses, and n ‫؍‬ 37 for allied health professionals). Results. The ideas generation round formulated 35 consultation tasks. There was a 50% response rate to the 2-round postal exercise (n ‫؍‬ 52). Consensus was reached on 12 tasks for an opportunistic OA consultation using a >80% level of agreement across all groups. Three of these consultation tasks were defined at 100%. The 3 tasks were questions asked by the HCP about how things are going with the condition, the type and amount of pain the patient has, and whether the patient is taking regular analgesia. Conclusion. In a Delphi study to define the content of an opportunistic primary care OA consultation, 12 consultation tasks provided the content of a comprehensive consultation. Three of these tasks with 100% agreement could be adopted in any multidisciplinary consultation for OA in primary care. Inquiring about the condition, the type and amount of pain the patient has, and whether analgesia is being taken forms a core set of questions that are considered important by both lay and health professional groups in an opportunistic consultation.

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Section: Finney Et Alsupporting

confidence: 59%

Defining the Content of an Opportunistic Osteoarthritis Consultation With Primary Health Care Professionals: A Delphi Consensus Study

Finney

Porcheret

Grime

et al. 2013

Arthritis Care & Research

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“…2 Around 25% of adults suffer with moderate or severe pain, [3][4][5][6][7] and for 6-14% of these the pain is severe and disabling. 2,8 Musculoskeletal (MSK) pain is one of the most predominant types of pain and accounts for a large portion of the primary care workload.…”

Section: Introductionmentioning

confidence: 99%

Patients’ experiences of chronic non-malignant musculoskeletal pain: a qualitative systematic review

Toye¹,

Seers²,

Allcock³

et al. 2013

Br J Gen Pract

122

128

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“…While there are no published standardized measures of the individual financial consequences of pain, 59 there are measures of meaningful clinical improvement to pain and disability. Retrospective reports of interference with daily activities show internal consistency and convergent validity 59, 60 and 11-point numerical rating scales provide sufficient levels of discrimination with similar sensitivity to 101-point scales.…”

Section: Discussionmentioning

confidence: 99%

“…Retrospective reports of interference with daily activities show internal consistency and convergent validity 59, 60 and 11-point numerical rating scales provide sufficient levels of discrimination with similar sensitivity to 101-point scales. 59,61 Using first-return-to-work as an indicator of recovery is challenging because it is frequently followed by recurrences of work absence. 62 It is difficult to measure work disability outside the usual measures of absence from/presence at work and the number of days of work absence.…”

Section: Discussionmentioning

confidence: 99%

Cost-Analysis Related to Dose-Response for Spinal Manipulative Therapy for Chronic Low Back Pain: Outcomes from a Randomized Controlled Trial

VavrekDarcy

SharmaRajiv

HaasMitchell

2014

The Journal of Alternative and Complementary Medicine

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Objective-The purpose of this analysis is to report the incremental costs and benefits of different doses of spinal manipulative therapy (SMT) in patients with chronic low back pain (LBP).Methods-We randomized 400 patients with chronic LBP to receive a dose of 0, 6, 12, or 18 sessions of SMT. Participants were scheduled for 18 visits over 6 weeks and received SMT or light massage control from a doctor of chiropractic. Societal costs in the year following study enrollment were estimated using patient reports of healthcare utilization and lost productivity. The main health outcomes were the number of pain-free days and disability-free days. Multiple regression was performed on outcomes and log-transformed cost data.Results-Lost productivity accounts for a majority of societal costs of chronic LBP. Cost of treatment and lost productivity ranged from $3398 for 12 SMT sessions to $3815 for 0 SMT sessions with no statistically significant differences between groups. Baseline patient characteristics related to increase in costs were greater age (P=0.03), greater disability (P=0.01), lower QALY scores (P=0.01), and higher costs in the period preceding enrollment (P<0.01). Painfree and disability-free days were greater for all SMT doses compared to control, but only SMT 12 yielded a statistically significant benefit of 22.9 pain-free days (P=0.03) and 19.8 disability-free days (P=0.04). No statistically significant group differences in QALYs were noted. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusions-A dose of 12 SMT sessions yielded a modest benefit in pain-free and disabilityfree days. Care of chronic LBP with SMT did not increase the costs of treatment plus lost productivity. NIH Public Access

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Chronic pain as a topic for epidemiology and public health

Cited by 56 publications

References 0 publications

Defining the Content of an Opportunistic Osteoarthritis Consultation With Primary Health Care Professionals: A Delphi Consensus Study

Defining the Content of an Opportunistic Osteoarthritis Consultation With Primary Health Care Professionals: A Delphi Consensus Study

Patients’ experiences of chronic non-malignant musculoskeletal pain: a qualitative systematic review

Cost-Analysis Related to Dose-Response for Spinal Manipulative Therapy for Chronic Low Back Pain: Outcomes from a Randomized Controlled Trial

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