Zambelli Zoe, Halstead Elizabeth J, Iles Ray, Fidalgo Antonio R, Dimitriou Dagmara
Sleep Education and Research Laboratory, Psychology and Human Development, University College London-Institute of Education, London, UK.
The National Institute for Stress, Anxiety, Depression and Behavioural Change (NISAD), Helsingborg, Sweden.
Br J Pain. 2022 Aug;16(4):439-449. doi: 10.1177/20494637221083837. Epub 2022 Apr 5.
To characterise the prevailing pharmacological and non-pharmacological pain management strategies among adults with chronic pain, comparing these against the newly published NICE guidelines NG-193, and examine these pre-NG-193 pain management strategies in relation to pain severity, pain interference, sleep quality and mental health outcomes.
This study was conducted using a cross-sectional online survey study design.
This study was conducted on a community-dwelling cohort.
Adults aged 18+, living in the UK, with diagnosis of chronic pain by a health care professional.
Primary outcomes were characterisation of the pain management strategies utilised. Secondary outcomes were related to pain severity, pain interference, sleep quality, depression and anxiety via validated self-report measures.
Several strategies were employed by respondents to manage their chronic pain condition including physical therapy, exercise, psychological therapy and pharmacological therapy. The data also indicated a high level of joint-care planning among patients and their clinicians. Some group differences were found in relation to pain, sleep and mental health outcomes.
This study set a comparative starting baseline to which the efficacy of the NG-193 may be compared in future years. There is evidence that NICE recommendations are being followed for the management of chronic primary pain conditions; however, pharmacological use of opioid drugs is still reported by 47%. Despite the confirmed evidence in this study of small efficacy of chronic pain by pharmacological agent, the reduction in the use of pain relief medications be it over the counter medications or prescription opioids, as recommended by NG-193, may be slow to be adopted. The data suggest that more care provision is needed to meet the recommendations around pharmacological management and review.
描述慢性疼痛成人中普遍采用的药物和非药物疼痛管理策略,与新发布的英国国家卫生与临床优化研究所(NICE)指南NG-193进行比较,并研究这些NG-193之前的疼痛管理策略与疼痛严重程度、疼痛干扰、睡眠质量和心理健康结果的关系。
本研究采用横断面在线调查研究设计。
本研究在一个社区居住队列中进行。
年龄在18岁及以上、居住在英国、由医疗保健专业人员诊断为慢性疼痛的成年人。
主要结局是对所采用的疼痛管理策略进行描述。次要结局通过有效的自我报告测量方法与疼痛严重程度、疼痛干扰、睡眠质量、抑郁和焦虑相关。
受访者采用了多种策略来管理他们的慢性疼痛状况,包括物理治疗、运动、心理治疗和药物治疗。数据还表明患者及其临床医生之间有高水平的联合护理计划。在疼痛、睡眠和心理健康结果方面发现了一些组间差异。
本研究设定了一个比较性的起始基线,未来几年可将NG-193的疗效与之进行比较。有证据表明,在慢性原发性疼痛状况的管理中遵循了NICE的建议;然而,仍有47%的人报告使用阿片类药物进行药物治疗。尽管本研究证实了药物治疗慢性疼痛的疗效较小,但按照NG-193的建议,减少止痛药物(无论是非处方药物还是处方阿片类药物)的使用可能会缓慢采用。数据表明,需要提供更多护理以满足围绕药物管理和审查的建议。