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Tieppo Francio V, Alm J, Leavitt L, Mok D, Yoon BV, Nazir N, Lam C, Latif U, Sowder T, Braun E, Sack A, Khan T, Sayed D. Variables associated with nonresponders to high-frequency (10 kHz) spinal cord stimulation. Pain Pract 2024; 24:584-599. [PMID: 38078593 DOI: 10.1111/papr.13328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
INTRODUCTION The use of spinal cord stimulation (SCS) therapy to treat chronic pain continues to rise. Optimal patient selection remains one of the most important factors for SCS success. However, despite increased utilization and the existence of general indications, predicting which patients will benefit from neuromodulation remains one of the main challenges for this therapy. Therefore, this study aims to identify the variables that may correlate with nonresponders to high-frequency (10 kHz) SCS to distinguish the subset of patients less likely to benefit from this intervention. MATERIALS AND METHODS This was a retrospective single-center observational study of patients who underwent 10 kHz SCS implant. Patients were divided into nonresponders and responders groups. Demographic data and clinical outcomes were collected at baseline and statistical analysis was performed for all continuous and categorical variables between the two groups to calculate statistically significant differences. RESULTS The study population comprised of 237 patients, of which 67.51% were responders and 32.49% were nonresponders. There was a statistically significant difference of high levels of kinesiophobia, high self-perceived disability, greater pain intensity, and clinically relevant pain catastrophizing at baseline in the nonresponders compared to the responders. A few variables deemed potentially relevant, such as age, gender, history of spinal surgery, diabetes, alcohol use, tobacco use, psychiatric illness, and opioid utilization at baseline were not statistically significant. CONCLUSION Our study is the first in the neuromodulation literature to raise awareness to the association of high levels of kinesiophobia preoperatively in nonresponders to 10 kHz SCS therapy. We also found statistically significant differences with greater pain intensity, higher self-perceived disability, and clinically relevant pain catastrophizing at baseline in the nonresponders relative to responders. It may be appropriate to screen for these factors preoperatively to identify patients who are less likely to respond to SCS. If these modifiable risk factors are present, it might be prudent to consider a pre-rehabilitation program with pain neuroscience education to address these factors prior to SCS therapy, to enhance successful outcomes in neuromodulation.
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Affiliation(s)
- Vinicius Tieppo Francio
- Department of Physical Medicine and Rehabilitation, The University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - John Alm
- Department of Physical Medicine and Rehabilitation, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Logan Leavitt
- Department of Physical Medicine and Rehabilitation, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Daniel Mok
- Department of Physical Medicine and Rehabilitation, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - B Victor Yoon
- Department of Physical Medicine and Rehabilitation, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Niaman Nazir
- Department of Population Health, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Christopher Lam
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Usman Latif
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Timothy Sowder
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Edward Braun
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Andrew Sack
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Talal Khan
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Dawood Sayed
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
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Pedreira EDM, Mineiro VBP, Knop LMPB, Lins-Kusterer LEF, Kraychete DC. Medication adherence in treating non-oncologic chronic pain: a problem to solve? BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ELSEVIER) 2023; 73:827-828. [PMID: 37516355 PMCID: PMC10625146 DOI: 10.1016/j.bjane.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/13/2023] [Accepted: 07/16/2023] [Indexed: 07/31/2023]
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Satisfaction with Medications Prescribed for Osteoarthritis: A Cross-Sectional Survey of Patients and Their Physicians in the United States. Pain Ther 2022; 11:191-208. [PMID: 35028917 PMCID: PMC8861239 DOI: 10.1007/s40122-021-00350-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 12/17/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction Satisfaction with medications prescribed for osteoarthritis (OA) varies; this study aimed to determine the factors associated with satisfaction in US patients and their physicians. Methods This point-in-time study used the Adelphi OA Disease Specific Programme (physicians identified from public lists reported on nine consecutive patients diagnosed with OA [any joint]: physicians and patients completed questionnaires). Patient’s demographic, clinical, and treatment characteristics associated with patient-reported and physician-rated overall satisfaction with, and expectations of effectiveness of, medication for OA were assessed using multivariate linear regression. Results Responses from 572 patients (mean age 64.9 years, 60.5% female) currently prescribed medication for OA and 153 physicians (81 primary care, 35 rheumatologists, 37 orthopedic surgeons) were analyzed. Pain intensity was moderate or severe for 59.4% of patients. Greater patient-reported overall satisfaction with medication was significantly associated with (standardized beta, 95% confidence interval) exercise (0.12, 0.03–0.20), comorbid other musculoskeletal or painful conditions (vs none) (0.15, 0.06–0.24), and physicians’ report that the best control had been achieved (0.12, 0.03–0.20); lack of efficacy was among factors associated with worse satisfaction. Greater patient-reported expectation of effectiveness was significantly associated with exercise (0.12, 0.03–0.21) and the most troublesome joint not being a knee, hip, or their back (0.08, 0.01–0.14). Greater physician-rated overall satisfaction with medication was significantly associated with their report that the best control had been achieved (0.18, 0.11–0.26), the most troublesome joint being a knee (0.08, 0.01–0.14), comorbid other musculoskeletal or painful conditions (0.07, 0.01–0.12), obesity (0.06, 0.00–0.11), and female patients (0.06, 0.00–0.11); lack of efficacy and adverse events/tolerability issues were among factors associated with worse satisfaction. For physicians, their report that the best control had been achieved (0.19, 0.11–0.27), the most troublesome joint being a knee (0.08, 0.00–0.15), improving (vs stable) OA (0.15, 0.07–0.24), and uncertain duration of OA (0.11, 0.02–0.21) were associated with greater perception that the medication was meeting patients’ efficacy expectations. Conclusion Although efficacy was strongly associated with both patients’ and physicians’ satisfaction with medication, other factors were also important, including exercise (for patients), tolerability (for physicians), and knee OA (for physicians). Supplementary Information The online version contains supplementary material available at 10.1007/s40122-021-00350-0.
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Liu H, Huang L, Yang Z, Li H, Wang Z, Peng L. Fear of Movement/(Re)Injury: An Update to Descriptive Review of the Related Measures. Front Psychol 2021; 12:696762. [PMID: 34305755 PMCID: PMC8292789 DOI: 10.3389/fpsyg.2021.696762] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 06/14/2021] [Indexed: 11/15/2022] Open
Abstract
The prevalence of fear of movement (kinesiophobia) in persistent pain ranges from 50 to 70%, and it may hinder the subsequent rehabilitation interventions. Therefore, the evaluation of fear of movement/(re)injury plays a crucial role in making clinical treatment decisions conducive to the promotion of rehabilitation and prognosis. In the decision-making process of pain treatment, the assessment of fear of movement/(re)injury is mainly completed by scale/questionnaire. Scale/questionnaire is the most widely used instrument for measuring fear of movement/(re)injury in the decision-making process of pain treatment. At present, the most commonly used scale/questionnaire are the Tampa Scale for Kinesiophobia (TSK), the Fear-Avoidance Beliefs Questionnaire (FABQ), the Kinesiophobia Causes Scale (KCS), the Athlete Fear-Avoidance Questionnaire (AFAQ), and the Fear-Avoidance Components Scale (FACS). In order to provide necessary tools and references for related research and rehabilitation treatment, this descriptive review is designed as an introduction to the background and content, score system, available language versions, variants of the original questionnaire, and psychometric properties of these scales/questionnaries.
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Affiliation(s)
- Haowei Liu
- College of Physical Education, Southwest University, Chongqing, China
| | - Li Huang
- College of Physical Education, Southwest University, Chongqing, China
| | - Zongqian Yang
- College of Physical Education, Southwest University, Chongqing, China
| | - Hansen Li
- College of Physical Education, Southwest University, Chongqing, China
| | - Zhenhuan Wang
- College of Physical Education, Southwest University, Chongqing, China
| | - Li Peng
- College of Physical Education, Southwest University, Chongqing, China.,Key Lab of Physical Fitness Evaluation and Motor Function Monitoring, Southwest University, Chongqing, China
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Turčáni P, Mašková J, Húska J. Real-World Treatment Patterns of Disease Modifying Therapy (DMT) for Patients with Relapse-Remitting Multiple Sclerosis and Patient Satisfaction with Therapy: Results of the Non-Interventional SKARLET Study in Slovakia. Patient Prefer Adherence 2020; 14:1129-1135. [PMID: 32753853 PMCID: PMC7354948 DOI: 10.2147/ppa.s254427] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 06/20/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND During long-term multiple sclerosis therapy, patient satisfaction with received treatment has considerable impact on treatment outcomes. Here we report the results of a non-interventional real-world study that mapped the treatment patterns of disease-modifying therapy (DMT) and assessed treatment satisfaction with DMT. PATIENTS AND METHODS The SKARLET study was a non-interventional, cross-sectional study in Slovakia running from May 2016 to March 2017. Patients with relapsing-remitting multiple sclerosis on DMT for ≥3 months and ≤2 years (per local labelling) from 10 multiple sclerosis centers across Slovakia were included. The primary objective was to collect the Treatment Satisfaction Questionnaire for Medication version 9 (TSQM 9) score regarding perceived effectiveness, convenience and overall satisfaction with DMT. RESULTS The following TSQM 9 scores (mean; 95% confidence interval) were reported from 415 patients: convenience (75.05; 73.49-76.61), effectiveness (68.15; 66.56-69.75) and global satisfaction scale (66.94; 65.26-68.62). All three parameters of the TSQM 9 were analyzed by the route of DMT administration, with infusions best rated for effectiveness and global satisfaction in comparison to oral dosage and injections. For convenience, however, oral dosage forms were appraised highly (82.66; 80.59-84.73) followed by infusions (74.40; 70.12-78.69), while injections were rated as the worst (66.92; 64.81-69.04). The difference of TSQM 9 scores according to the route of DMT administration is statistically significant for convenience (p < 0.001) and global satisfaction (p = 0.004), but not for effectiveness (p = 0.185). CONCLUSION In the present study, it was confirmed that patients find oral DMTs as most convenient; however, the infusion form of treatment outweighs oral DMTs in global satisfaction and effectiveness. The differences of TSQM 9 scores among DMT dosage forms were significant for convenience and global satisfaction. In conclusion, the results of this detailed survey increase our understanding of RRMS patient population characteristics and patient satisfaction with DMT treatment.
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Affiliation(s)
- Peter Turčáni
- First Department of Neurology, Faculty of Medicine, Comenius University, Bratislava81369, Slovak Republic
| | - Jana Mašková
- NEOX Clinical Research, Prague 1110 00, Czech Republic
| | - Jozef Húska
- Sanofi-Aventis Slovakia, Bratislava851 01, Slovak Republic
- Correspondence: Jozef Húska Email
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Morillo Verdugo R, Ramírez Herráiz E, Fernández-Del Olmo R, Roig Bonet M, Valdivia García M. Adherence to disease-modifying treatments in patients with multiple sclerosis in Spain. Patient Prefer Adherence 2019; 13:261-272. [PMID: 30863016 PMCID: PMC6388740 DOI: 10.2147/ppa.s187983] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Adherence to disease-modifying treatments is essential in order to maximize the beneficial effects of treatment for multiple sclerosis (MS). There are numerous treatments that have been approved. Treatment selection is essential in patient adherence. In addition, patient preference plays an increasingly significant role in treatment decision-making. This study aims to evaluate the degree of adherence, along with other variables that may influence this adherence, in Spain. METHODS A cross-sectional study was conducted with 157 MS patients with disease-modifying treatments. Adherence was assessed using the Morisky Green scale, and other related factors were measured using a questionnaire that addressed demographics, disease characteristics, global perception of pathology, impact of medication on patient's life, and treatment decision-making. RESULTS The adherence rate was 71% and was associated with the following variables: older age, more treatments received, time to diagnosis 5-10 years, absence of exacerbations, better cognitive status, being married/in a union, clear information about the disease, and higher treatment satisfaction. The main cause for non-compliance was forgetfulness (27%). CONCLUSION The adherence rate is acceptable. It is widely known that treatment satisfaction is related to adherence. In our study, patients' level of satisfaction was higher with oral treatments. However, oral administration showed a greater lack of adherence. The main cause of lack of adherence was forgetfulness. In relation to other variables, cognitive status and family support showed a correlation with treatment adherence.
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Affiliation(s)
| | | | | | - Montserrat Roig Bonet
- Project Department, Technical Advisory of Projects and Innovation "Esclerosis Múltiple España", Madrid, Spain
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Sidani S, Epstein DR, Fox M, Collins L. The contribution of participant, treatment, and outcome factors to treatment satisfaction. Res Nurs Health 2018; 41:572-582. [PMID: 30221779 DOI: 10.1002/nur.21909] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 08/22/2018] [Indexed: 11/09/2022]
Abstract
Treatment satisfaction, which refers to the positive appraisal of process and outcome attributes of a treatment, is a prominent indicator of quality care. Although it is known that participant, treatment, and outcome factors influence treatment satisfaction, it remains unclear which factors contribute to satisfaction with each process and outcome attribute. In this study, we examined the extent to which participant (age, gender, education, race, employment), treatment (type of therapy, method of assignment to therapy), and outcome (self-reported improvement in outcome) factors contribute to satisfaction with the process and outcome attributes of therapies for insomnia. This study consists of a secondary analysis of data obtained from a partially randomized preference trial in which persons with chronic insomnia (N = 517) were assigned to treatment randomly or by preference. Four types of behavioral therapies were included: sleep hygiene, stimulus control therapy, sleep restriction therapy, and multi-component therapy. Self-reported improvement in insomnia and satisfaction were assessed with validated measures at post-test. Multiple regression analysis was used to examine which factors influenced satisfaction with each treatment attribute. The findings showed that treatment and outcome, more so than participant, factors influenced satisfaction with the process and outcome attributes of the behavioral therapies for insomnia. Future research on satisfaction should explore the contribution of treatment (type and preference-matching) and outcome factors on satisfaction to build a better understanding of treatment attributes viewed favorably. Such understanding has the potential to inform modifying or tailoring treatments to improve their acceptance to participants and optimize their effectiveness.
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Affiliation(s)
- Souraya Sidani
- School of Nursing, Ryerson University, Toronto, Ontario, Canada
| | - Dana R Epstein
- College of Health Solutions, Arizona State University, Phoenix, Arizona.,Phoenix Veterans Affairs Health Care System, Phoenix, Arizona
| | - Mary Fox
- School of Nursing, York University, Toronto, Ontario, Canada
| | - Laura Collins
- School of Nursing, Ryerson University, Toronto, Ontario, Canada
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Satisfaction With an Intensive Interdisciplinary Pain Treatment for Children and Adolescents. Clin J Pain 2018; 34:795-803. [DOI: 10.1097/ajp.0000000000000600] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Luque-Suarez A, Martinez-Calderon J, Falla D. Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review. Br J Sports Med 2018; 53:554-559. [DOI: 10.1136/bjsports-2017-098673] [Citation(s) in RCA: 126] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2018] [Indexed: 11/04/2022]
Abstract
Objective(1) To explore the level of association between kinesiophobia and pain, disability and quality of life in people with chronic musculoskeletal pain (CMP) detected via cross-sectional analysis and (2) to analyse the prognostic value of kinesiophobia on pain, disability and quality of life in this population detected via longitudinal analyses.DesignA systematic review of the literature including an appraisal of the risk of bias using the adapted Newcastle Ottawa Scale. A synthesis of the evidence was carried out.Data sourcesAn electronic search of PubMed, AMED, CINAHL, PsycINFO, PubPsych and grey literature was undertaken from inception to July 2017.Eligibility criteria for selecting studiesObservational studies exploring the role of kinesiophobia (measured with the Tampa Scale for Kinesiophobia) on pain, disability and quality of life in people with CMP.ResultsSixty-three articles (mostly cross-sectional) (total sample=10 726) were included. We found strong evidence for an association between a greater degree of kinesiophobia and greater levels of pain intensity and disability and moderate evidence between a greater degree of kinesiophobia and higher levels of pain severity and low quality of life. A greater degree of kinesiophobia predicts the progression of disability overtime, with moderate evidence. A greater degree of kinesiophobia also predicts greater levels of pain severity and low levels of quality of life at 6 months, but with limited evidence. Kinesiophobia does not predict changes in pain intensity.Summary/conclusionsThe results of this review encourage clinicians to consider kinesiophobia in their preliminary assessment. More longitudinal studies are needed, as most of the included studies were cross-sectional in nature.Trial registration numberCRD42016042641.
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Sidani S, Epstein DR, Fox M. Psychometric evaluation of a multi-dimensional measure of satisfaction with behavioral interventions. Res Nurs Health 2017; 40:459-469. [PMID: 28857205 DOI: 10.1002/nur.21808] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 06/07/2017] [Indexed: 01/15/2023]
Abstract
Treatment satisfaction is recognized as an essential aspect in the evaluation of an intervention's effectiveness, but there is no measure that provides for its comprehensive assessment with regard to behavioral interventions. Informed by a conceptualization generated from a literature review, we developed a measure that covers several domains of satisfaction with behavioral interventions. In this paper, we briefly review its conceptualization and describe the Multi-Dimensional Treatment Satisfaction Measure (MDTSM) subscales. Satisfaction refers to the appraisal of the treatment's process and outcome attributes. The MDTSM has 11 subscales assessing treatment process and outcome attributes: treatment components' suitability and utility, attitude toward treatment, desire for continued treatment use, therapist competence and interpersonal style, format and dose, perceived benefits of the health problem and everyday functioning, discomfort, and attribution of outcomes to treatment. The MDTSM was completed by persons (N = 213) in the intervention group in a large trial of a multi-component behavioral intervention for insomnia within 1 week following treatment completion. The MDTSM's subscales demonstrated internal consistency reliability (α: .65 - .93) and validity (correlated with self-reported adherence and perceived insomnia severity at post-test). The MDTSM subscales can be used to assess satisfaction with behavioral interventions and point to aspects of treatments that are viewed favorably or unfavorably.
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Affiliation(s)
- Souraya Sidani
- Professor and Research Chair, School of Nursing, Ryerson University, Toronto, Ontario, Canada
| | - Dana R Epstein
- Research Professor, College of Health Solutions, Arizona State University, Research Associate, Phoenix Veterans Affairs Health Care System, Phoenix, Arizona
| | - Mary Fox
- Associate Professor, School of Nursing, York University, Toronto, Ontario, Canada
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Dhingra L, Schiller R, Teets R, Nosal S, Rodriguez S, Cruciani G, Barrett M, Ginzburg R, Ahmed E, Wasser T, Chen J, Shuman S, Crump C, Portenoy R. Race and Ethnicity Do Not Clinically Associate with Quality of Life Among Patients with Chronic Severe Pain in a Federally Qualified Health Center. PAIN MEDICINE 2017; 19:1408-1418. [DOI: 10.1093/pm/pnx040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Lara Dhingra
- MJHS Institute for Innovation in Palliative Care, New York, New York
- Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Robert Schiller
- The Institute for Family Health, New York, NY
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Raymond Teets
- The Institute for Family Health, New York, NY
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Sarah Nosal
- The Institute for Family Health, New York, NY
| | - Sandra Rodriguez
- MJHS Institute for Innovation in Palliative Care, New York, New York
| | - Gabriel Cruciani
- MJHS Institute for Innovation in Palliative Care, New York, New York
| | - Malcolm Barrett
- MJHS Institute for Innovation in Palliative Care, New York, New York
| | - Regina Ginzburg
- The Institute for Family Health, New York, NY
- Department of Clinical Health Professions, St. John’s University, Queens, New York
| | - Ebtesam Ahmed
- MJHS Institute for Innovation in Palliative Care, New York, New York
- Department of Clinical Health Professions, St. John’s University, Queens, New York
| | - Thomas Wasser
- Consult-Stat: Complete Statistical Services, Macungie, Pennsylvania
| | - Jack Chen
- MJHS Institute for Innovation in Palliative Care, New York, New York
| | | | - Casey Crump
- The Institute for Family Health, New York, NY
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Russell Portenoy
- MJHS Institute for Innovation in Palliative Care, New York, New York
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
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Conaghan PG, Serpell M, McSkimming P, Junor R, Dickerson S. Satisfaction, Adherence and Health-Related Quality of Life with Transdermal Buprenorphine Compared with Oral Opioid Medications in the Usual Care of Osteoarthritis Pain. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2017; 9:359-71. [PMID: 27314487 PMCID: PMC4925685 DOI: 10.1007/s40271-016-0181-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background Osteoarthritis (OA) causes substantial pain and reduced health-related quality of life (HRQL). Although opioid analgesics are commonly used, the relative benefits of different opioids are poorly studied. Transdermal buprenorphine (TDB) offers an alternative to oral opioids for the treatment of moderate-to-severe chronic pain. This observational study of people with OA pain assessed satisfaction, HRQL and medication adherence. Methods Patients in the UK with self-reported knee and/or hip OA who had been receiving one or more of TDB, co-codamol (an oral paracetamol/codeine combination) and tramadol for at least 1 month completed an online or telephone questionnaire. Medication satisfaction scores, HRQL scores (Short-Form 36 [SF-36]), medication adherence (Morisky Medication Adherence Scale [MMAS™]), adverse events and treatment discontinuations were recorded. Linear and logistic regression models were used to compare the treatment effect of TDB with co-codamol or tramadol. Results Overall, 966 patients met the inclusion criteria; 701 were taking only one of the target medications (TDB: 85; co-codamol: 373; tramadol: 243). The largest age group was 50–59 years and 76.0 % of patients were female. The TDB group was younger, with more male patients, therefore the statistical models were adjusted for age and sex. Medication satisfaction scores were significantly higher in the TDB group than the other two groups (TDB vs. co-codamol: 3.56, 95 % confidence interval [CI] 1.90–6.68, p < 0.0001; TDB vs. tramadol: 3.22, 95 % CI 1.67–6.20, p = 0.0005). Physical Component Summary scores for HRQL and mean adherence were also higher in the TDB group, while Mental Component Summary HRQL scores were similar across the three groups. Conclusions Patients with knee and/or hip OA pain treated with TDB were more satisfied and more adherent with their medication, and reported higher Physical Component Summary HRQL scores than those treated with co-codamol or tramadol, although demographic differences were observed between groups. Electronic supplementary material The online version of this article (doi:10.1007/s40271-016-0181-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine and National Institute of Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, University of Leeds, Leeds, UK
| | - Michael Serpell
- University Department of Anaesthesia, Gartnavel General Hospital, Glasgow, UK
| | - Paula McSkimming
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - Rod Junor
- Napp Pharmaceuticals Limited, Cambridge, UK
| | - Sara Dickerson
- Napp Pharmaceuticals Limited, Cambridge, UK. .,Mundipharma International Limited, Cambridge Science Park, Milton Road, Cambridge, CB4 0GW, UK.
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de Sola H, Salazar A, Dueñas M, Ojeda B, Failde I. Nationwide cross-sectional study of the impact of chronic pain on an individual's employment: relationship with the family and the social support. BMJ Open 2016; 6:e012246. [PMID: 28011806 PMCID: PMC5223634 DOI: 10.1136/bmjopen-2016-012246] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES To determine the prevalence and the factors related to sick leave and job loss among individuals suffering from chronic pain (CP), and to analyse specifically the effect of family and social support on the individual's employment. DESIGN Observational cross-sectional study. SETTING Data were collected using structured computer-assisted telephone interviews between February and June 2011. PARTICIPANTS A nationwide study of 1543 Spanish adults of working age (<65), 213 of whom suffered from CP (pain suffered at least 4 or 5 days a week during the past 3 months, according to the criteria of the International Association for the Study of Pain (IASP)). MAIN OUTCOME MEASURE Information was collected regarding the individual's sociodemographic status, pain characteristics, healthcare use and satisfaction, limitations in daily activities, mood status, perception of the impact of pain on their families, and their satisfaction with the family and social support. To identify factors associated with sick leave and job loss among those suffering CP, 2 logistic regression models were generated. RESULTS The prevalence of sick leave due to CP in the general Spanish population was 4.21% (95% CI 3.2% to 5.2%). Sick leave were more likely for individuals who considered their family were affected by their pain (OR=2.18), needed help to dressing and grooming (OR=2.98), taking medication (OR=2.18), had a shorter pain duration (OR=0.99) and higher educational level. The prevalence of job loss due to CP was 1.8% (95% CI 1.1% to 2.5%). It was related to feelings of sadness (OR=4.25), being unsatisfied with the care provided by health professionals (OR=2.60) and consulting a doctor more often due to CP (OR=1.09). CONCLUSIONS CP is negatively associated with an individual's employment. This detrimental effect could be ameliorated if the factors related to sick leave and job loss provoked by CP are identified, especially those related to the effect of CP on the family and social environment.
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Affiliation(s)
- Helena de Sola
- Preventive Medicine and Public Health Area, University of Cadiz, Observatory of Pain Grünenthal Fundation-University of Cadiz, Cadiz, Spain
| | - Alejandro Salazar
- Preventive Medicine and Public Health Area, University of Cadiz, Observatory of Pain Grünenthal Fundation-University of Cadiz, Cadiz, Spain
| | - María Dueñas
- Salus Infirmorum Faculty of Nursing, University of Cadiz, Cadiz, Spain
| | - Begoña Ojeda
- Preventive Medicine and Public Health Area, University of Cadiz, Observatory of Pain Grünenthal Fundation-University of Cadiz, Cadiz, Spain
| | - Inmaculada Failde
- Preventive Medicine and Public Health Area, University of Cadiz, Observatory of Pain Grünenthal Fundation-University of Cadiz, Cadiz, Spain
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14
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Abstract
Objective Experiencing pain not only affects patients' biopsychosocial functioning but also the existential domain. Attention to the existential, in addition to the biopsychosocial domains, might thus be important in chronic pain care. Therefore, we investigated: (a) how satisfied patients were with the attention of their practitioners to the impact of pain on biological, psychological, social, and existential life domains, and (b) how satisfaction with each domain was related to patient functioning. Method Pain patients ( N = 163) were questioned on their satisfaction with the attention of their practitioners to biological, psychological, social, and existential life domains, and on pain intensity, pain disability, life satisfaction, and depressive symptoms. Results Patients reported low satisfaction with the attention of their practitioners to the social and existential domains. Satisfaction with each domain was negatively related with pain intensity, pain disability, and depressive symptoms and positively related with life satisfaction. Only satisfaction with the existential domain was able to predict all functional outcomes above and beyond all other satisfaction variables modeled simultaneously. Conclusions Patients reported not feeling satisfied with the attention to the social and existential life domains. Furthermore, practitioners' attention to the existential domain seems highly important for patient functioning. Openness to existential concerns of pain patients might thus be an important aspect of chronic pain care.
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Affiliation(s)
- Jessie Dezutter
- 1 Faculty of Psychology and Educational Sciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Martin Offenbaecher
- 2 Institute of General Medicine, Ludwig-Maximilians University of Munich, Munich, Germany
| | | | - Siebrecht Vanhooren
- 1 Faculty of Psychology and Educational Sciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Evalyne Thauvoye
- 1 Faculty of Psychology and Educational Sciences, KU Leuven - University of Leuven, Leuven, Belgium
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15
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Haase R, Kullmann JS, Ziemssen T. Therapy satisfaction and adherence in patients with relapsing-remitting multiple sclerosis: the THEPA-MS survey. Ther Adv Neurol Disord 2016; 9:250-63. [PMID: 27366231 PMCID: PMC4916516 DOI: 10.1177/1756285616634247] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Improved clinical effectiveness and therefore positive modification of multiple sclerosis (MS) with basic therapy can be achieved by long-term regular intake of drugs as prescribed but investigations have shown that a high percentage of patients do not take their medications as prescribed. OBJECTIVES We assessed the satisfaction and adherence of patients with MS with their current disease-modifying treatment under clinical practice conditions. We compared different facets of satisfaction as well as their internal relationship and identified predictors in an exploratory manner. METHODS Therapy satisfaction in patients with relapsing-remitting multiple sclerosis (THEPA-MS) was a noninterventional, prospective cross-sectional study performed throughout Germany in 2013 and 2014, and included patients with clinically isolated syndrome or relapsing-remitting MS. We applied a standardized approach to document satisfaction and adherence by patient-reported outcomes (Treatment Satisfaction Questionnaire for Medication) as well as by physician ratings. RESULTS Of 3312 patients with a mean age of 43.7 years, 73.3% were women and the mean level of disability according to the Expanded Disability Status Scale was 2.29; 13.3% did not receive any medication at the time of documentation, 21.3% received interferon β1a intramuscularly, 20.7% had interferon β1a subcutaneously, 17.0% had interferon β1b subcutaneously and 23.7% had glatiramer acetate. Adherence rates varied between 60% (lifetime) and 96.5% (current medication). Differences between current medications were found for side effects and convenience scores but not for effectiveness, satisfaction and adherence. Higher global satisfaction and effectiveness were associated with fewer relapses, longer duration of medication, lower disability score and the absence of several side effects. CONCLUSION In a connected model of patient satisfaction, effectiveness, side effects, convenience and adherence, patients' individual needs and concerns have to be addressed. Most differences were found with respect to side effects and convenience of treatment. Therefore, an improvement in these two domains seems to be the most promising proximate approach to elevate adherence levels.
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Affiliation(s)
- Rocco Haase
- Center of Clinical Neuroscience, Neurological Clinic, University Clinic Carl Gustav Carus Dresden, TU Dresden, Germany
| | | | - Tjalf Ziemssen
- Multiple Sklerose Zentrum, Zentrum für klinische Neurowissenschaften, Universitätsklinik Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany
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16
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Wong WS, Chen PP, Chow YF, Wong S, Fielding R. A Study of the Reliability and Concurrent Validity of the Chinese Version of the Pain Medication Attitude Questionnaire (ChPMAQ) in a Sample of Chinese Patients with Chronic Pain. PAIN MEDICINE 2016; 17:1137-1144. [PMID: 26843593 DOI: 10.1093/pm/pnv086] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES The Pain Medication Attitude Questionnaire (PMAQ) was designed to assess concerns about pain medication among patients with chronic nonmalignant pain. The instrument has been demonstrated to be a reliable measure with good psychometric properties, yet its validity among Chinese has not been evaluated. This study aimed to translate the English-language version of the PMAQ into Chinese (ChPMAQ) and to evaluate its reliability and concurrent validity. METHODS A total of 201 Chinese patients with chronic pain attending two multidisciplinary pain clinics in Hong Kong completed the ChPMAQ, the Chronic Pain Grade (CPG) questionnaire, the mental health subscale of the SF-12 (QoL-Mental), and questions assessing sociodemographic and pain characteristics. RESULTS Our results showed that the seven ChPMAQ scales possessed good internal consistency. Except for the correlation between Withdrawal and Mistrust (r = 0.13), all ChPMAQ scales were significantly correlated with each other (all p < 0.01). The scales also correlated with two concurrent criterion measures, QoL-Mental and Pain Disability, in a predictable direction. Results of hierarchical multiple regression analyses showed that the ChPMAQ scales predicted concurrent QoL-Mental (F(7,190) = 2.75, p < 0.05) and pain disability (F(7,188) = 3.00, p < 0.01). Need (std β = -0.23, p<0.05) and Side effects (std β = 0.27, p < 0.01) emerged as independent predictors of concurrent QoL-Mental and pain disability, respectively. CONCLUSION Despite the current preliminary findings for the reliability and concurrent validity of the ChPMAQ, more research is needed to substantiate the reliability, validity and other psychometric properties of the instrument.
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Affiliation(s)
- Wing S Wong
- *Department of Psychological Studies and Center for Psychosocial Health, the Hong Kong Institute of Education, Tai Po, Hong Kong SAR, China
| | - P P Chen
- Department of Anesthesiology and Operating Services, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong
| | - Y F Chow
- Department of Anesthesiology and Operating Services, Queen Elizabeth Hospital, Kowloon, Hong Kong
| | - S Wong
- Department of Anesthesiology and Operating Services, Queen Elizabeth Hospital, Kowloon, Hong Kong
| | - R Fielding
- School of Public Health, University of Hong Kong, Pokfulam, Hong Kong SAR, China
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17
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Wong WS, Chen PP, Chow YF, Wong S, Fielding R. The Reliability and Validity of the Cantonese Version of the Pain Treatment Satisfaction Scale (ChPTSS) in a Sample of Chinese Patients with Chronic Pain. PAIN MEDICINE 2015; 16:2316-23. [PMID: 26179924 DOI: 10.1111/pme.12790] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES The Pain Treatment Satisfaction Scale (PTSS) was developed in a Western context for evaluating patients' satisfaction with pain treatment. Although the instrument was shown to possess good psychometric properties, its reliability and validity among ethnic Chinese has not been examined. This article reports the translation of the English-language version of the PTSS into Traditional Chinese Cantonese (ChPTSS) and the preliminary examination of the reliability and concurrent predictive validity of the ChPTSS. METHODS A total of 201 Chinese patients with chronic pain completed the ChPTSS, the Chronic Pain Grade questionnaire, the mental health questions of the 12-item Short Form Health Survey (SF-12), and questions assessing sociodemographic and pain characteristics. RESULTS All ChPTSS scales demonstrated good internal consistency, with Cronbach's αs ranging from 0.77 to 0.90, and they all correlated with two criterion measures, mental health quality life (QoL) and pain disability, in expected directions. Results of hierarchical multiple regression models showed that the ChPTSS scales predicted concurrent mental health QoL (F(6,191) = 5.20, P < 0.001) and pain disability (F(6,189) = 4.20, P < 0.01). "Side Effects" emerged as the only significant independent predictor in both models (mental health QoL: std β = -0.31, P < 0.001; pain disability: std β = 0.25, P < 0.01). CONCLUSION Our results offer preliminary evidence for the reliability and concurrent predictive validity of the ChPTSS, which can be applied in Cantonese speaking context.
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Affiliation(s)
- Wing S Wong
- Department of Psychological Studies and Center for Psychosocial Health, The Hong Kong Institute of Education, 10 Lo Ping Road, Tai Po, Hong Kong SAR, China
| | - Phoon P Chen
- Department of Anesthesiology and Operating Services, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong
| | - Yu F Chow
- Department of Anesthesiology and Operating Services, Queen Elizabeth Hospital, Kowloon, Hong Kong
| | - Steven Wong
- Department of Anesthesiology and Operating Services, Queen Elizabeth Hospital, Kowloon, Hong Kong
| | - Richard Fielding
- Department of Anesthesiology and Operating Services, School of Public Health, University of Hong Kong, Pokfulam, Hong Kong SAR, China
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