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Higgins C, Sharma S, Bimali I, Hales TG, Cameron PA, Smith BH, Colvin LA. Cross-sectional study examining the epidemiology of chronic pain in Nepal. Pain Rep 2023; 8:e1067. [PMID: 36818647 PMCID: PMC9928837 DOI: 10.1097/pr9.0000000000001067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/07/2022] [Accepted: 12/23/2022] [Indexed: 02/12/2023] Open
Abstract
Introduction The World Health Organization recognizes chronic pain as a global public health concern; however, there is a bias towards research conducted in relatively affluent nations. There is a dearth of large-scale epidemiological studies in Nepal using rigorously validated, cross-culturally adapted instruments. Objectives The aim of this study was to examine the prevalence of both chronic pain and chronic pain of predominantly neuropathic origin and their associations with a range of sociodemographic and psychosocial characteristics. Methods We conducted a cross-sectional study of adults (≥18 years) in all households in Ranipani, Baluwa Village Development Committee, Nepal. All adults (n = 887) were approached, and those consenting, who met the inclusion criteria (n = 520, 58.6%), participated. Questionnaires validated in Nepali were used to examine several constructs: demographics; chronic pain; neuropathic pain; pain catastrophizing; resilience, pain intensity; pain interference; sleep disturbance; and depression. Results The point prevalence of chronic pain was 53.3% (n = 277). The point prevalence of chronic pain of predominantly neuropathic origin was 12.7% (n = 66). Chronic pain was associated with female gender, older age, and manual labour occupations. Using standardized scoring techniques, compared with available population estimates from other countries, those with chronic pain were associated with lower pain intensity and resilience scores and higher pain catastrophizing, pain interference, and depression scores. Conclusion These findings are broadly comparable to epidemiological studies from other countries, and these indicate areas for targeting interventions (eg, occupational and mental health). For comparison, more data are needed, from larger population samples in this region.
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Affiliation(s)
- Cassie Higgins
- Division of Population Health and Genomics, School of Medicine, Ninewells Hospital, University of Dundee, Dundee, Scotland
| | - Saurab Sharma
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Inosha Bimali
- Department of Physiotherapy, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Tim G. Hales
- Division of Systems Medicine, School of Medicine, Ninewells Hospital, University of Dundee, Dundee, Scotland
| | - Paul A. Cameron
- Division of Population Health and Genomics, School of Medicine, Ninewells Hospital, University of Dundee, Dundee, Scotland
| | - Blair H. Smith
- Division of Population Health and Genomics, School of Medicine, Ninewells Hospital, University of Dundee, Dundee, Scotland
| | - Lesley A. Colvin
- Division of Population Health and Genomics, School of Medicine, Ninewells Hospital, University of Dundee, Dundee, Scotland
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Toccaceli V, Tenti M, Stazi MA, Fagnani C, Medda E, Gargiulo L, Burgio A, Sampaolo L, Ferri M, Raffaeli W. Development and Validation of the Italian "Brief Five-Item Chronic Pain Questionnaire" for Epidemiological Studies. J Pain Res 2022; 15:1897-1913. [PMID: 35837542 PMCID: PMC9275508 DOI: 10.2147/jpr.s362510] [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: 02/15/2022] [Accepted: 06/18/2022] [Indexed: 01/05/2023] Open
Abstract
Background Chronic pain (CP) prevalence estimates addressing a wide phenotype are still quite fragmented and may vary widely due to the lack of standardized tools of investigation. There is an urgent need to update general population CP estimates. Methods For this purpose, the Brief Five-item Chronic Pain Questionnaire was developed through experts’ consultations for design and content validity assessment; literature analysis of measures used to investigate CP for general population surveys; understandability evaluation through a survey on a convenience sample of affected and non-affected individuals; reliability assessment by means of two double-wave online surveys carried out by the Italian Twin Registry; criterion and construct validity assessment through the third wave of the 2019 European Health Interview Survey (Ehis). Results Key dimensions were defined to describe CP main aspects from a public health perspective. Literature analysis showed that validated questionnaires were rarely used to address important public health CP aspects. Understandability of the measure was good. Test-retest analyses showed adequate reliability of the measure: k values were at least “moderate” with highest values regarding CP “occurrence” and “intensity”. Correlations of CP with well-known comorbidities (cancer, depression), and specific traits (age, education) as well as of CP and its intensity with “physical pain occurrence and intensity” detected in the Ehis 2019, confirmed, respectively, a good construct and criterion validity. Construct validity was also evaluated through the correlation between “perceived treatment effectiveness” and “interference of pain in daily life activities” as recorded in the Ehis 2019. Conclusion The designed questionnaire is a brief self-administered measure, particularly suitable to detect persistent states of pain and related intensity in large-scale general population surveys by means of a first filtering item followed by four further items. It is, in fact, designed to detect CP possible underlying causes/triggers, drugs/treatments taking and frequency, and self-perceived effectiveness among CP sufferers. Further validation of the measure in different social and cultural contexts is desirable.
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Affiliation(s)
- Virgilia Toccaceli
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità (Italian National Institute of Health), Rome, Italy
| | - Michael Tenti
- Fondazione ISAL, Institute for Research on Pain, Torre Pedrera, Italy
| | - Maria Antonietta Stazi
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità (Italian National Institute of Health), Rome, Italy
| | - Corrado Fagnani
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità (Italian National Institute of Health), Rome, Italy
| | - Emanuela Medda
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità (Italian National Institute of Health), Rome, Italy
| | | | | | - Letizia Sampaolo
- Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità (Italian National Institute of Health), Rome, Italy
| | - Maurizio Ferri
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità (Italian National Institute of Health), Rome, Italy
| | - William Raffaeli
- Fondazione ISAL, Institute for Research on Pain, Torre Pedrera, Italy
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Thapa P, KC B, Lee SWH, Dujaili JA, Gyawali S, Mohamed Ibrahim MI, Alrasheedy AA. Managing Pain in Low Resource Settings: Healthcare Professionals’ Knowledge, Attitude and Practice Regarding Pain Management in Western Nepal. J Pain Res 2022; 15:1587-1599. [PMID: 35677698 PMCID: PMC9169832 DOI: 10.2147/jpr.s360243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/14/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Parbati Thapa
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Bhuvan KC
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
- College of Public Health, Medical, and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
- Correspondence: Bhuvan KC, School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Subang Jaya, Selangor, 47500, Malaysia, Email
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | | | - Sudesh Gyawali
- Department of Pharmacology, Manipal College of Medical Sciences, Pokhara, Nepal
| | | | - Alian A Alrasheedy
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah, Qassim, Saudi Arabia
- Alian A Alrasheedy, Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah, Qassim, Saudi Arabia, Email
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Liao ZW, Le C, Kynes JM, Niconchuk JA, Pinto E, Laferriere HE, Walters CB. Paediatric chronic pain prevalence in low- and middle-income countries: A systematic review and meta-analysis. EClinicalMedicine 2022; 45:101296. [PMID: 35198925 PMCID: PMC8850335 DOI: 10.1016/j.eclinm.2022.101296] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/17/2022] [Accepted: 01/21/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Chronic pain is a leading cause of morbidity in children and adolescents globally, with a significant impact on quality of life. This is the first systematic review and meta-analysis on paediatric chronic pain in low- and middle-income countries (LMICs). METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched MEDLINE (via PubMed), Embase, CINAHL, PsycINFO, Web of Science, Cochrane Database of Systematic Reviews, and the WHO Global Index Medicus for all studies published prior to January 7, 2022. Articles published in all languages that included populations age 19 years and under living in LMICs were considered. Chronic pain was defined as persistent or recurrent pain that is present for ≥3 months, per the International Classification of Diseases (ICD-11) definition. Summary data were extracted from published reports and evaluated with mixed-effects regression analysis. PROSPERO Record ID: CRD42021227967. FINDINGS Of the 2875 studies identified, 70 articles were reviewed, with 27 studies representing 20 LMICs eligible for analysis. The average prevalence for each pain type reported with 95% confidence interval is as follows: general/multi-site/any 20% (16-25), musculoskeletal (MSK) pain 9% (7-13), abdominal pain 7% (5-10), headache 4% (2-10), and fibromyalgia per American College of Rheumatology or Yunus and Masi criteria 3% (1-10). Overall, a pooled mean of 8% chronic pain was estimated across all studies. A significantly high level of heterogeneity was found across all studies (I2 >90%). Chronic headache (OR=1·65, 95% CI 1·39-1·96), abdominal pain (OR=1·36, 95% CI 1·22-1·51), and generalized/multi-site pain (OR=1·54, 95% CI 1·31-1·81) were significantly more prevalent in females than males. INTERPRETATION The characterization of paediatric chronic pain in low- and middle-income countries suffers from a paucity of data and significant heterogeneity in the assessment methods. Understanding the global burden of chronic pain in this group should be prioritized. FUNDING None.
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Affiliation(s)
- Zi Wei Liao
- 224 Eskind Biomedical Library and Learning Center, Vanderbilt University School of Medicine, Nashville, TN 37240-7939, USA
| | - Chi Le
- 224 Eskind Biomedical Library and Learning Center, Vanderbilt University School of Medicine, Nashville, TN 37240-7939, USA
| | - J. Matthew Kynes
- Vanderbilt University Medical Center, 2200 Children's Way, Nashville, TN 37232, USA
| | | | - Emilia Pinto
- Maputo Central Hospital, 1653 Avenida Eduardo Mondlane, Maputo, Mozambique
| | - Heather E. Laferriere
- 224 Eskind Biomedical Library and Learning Center, Vanderbilt University, Nashville, TN 37240-7939, USA
| | - Camila B. Walters
- Vanderbilt University Medical Center, 2200 Children's Way, Nashville, TN 37232, USA
- Corresponding author.
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Schroeck H, Wiredu K, Ko TW, Record D, Sirovich B. Survey research in anesthesiology: a field guide to interpretation. Reg Anesth Pain Med 2020; 45:544-551. [PMID: 32354845 DOI: 10.1136/rapm-2020-101299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/13/2020] [Accepted: 04/01/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND Survey research, indispensable for assessing subjective outcomes in anesthesiology, can nonetheless be challenging to undertake and interpret. OBJECTIVE To present a user-friendly guide for the appraisal of survey-derived evidence, and to apply it to published survey research in the anesthesia literature. METHODS Synthesizing published expert guidance regarding methodology and reporting, we discuss five essential criteria (with subcomponents) for evaluating survey research: (1) relevance of survey outcome to research objective, (2) trustworthiness of the instrument (testing/validation, availability), (3) collecting information well (sampling, administration), (4) representativeness (response rate), and (5) guidance towards interpretation of survey findings (generalizability, interpretation of numerical outcomes). These criteria were subsequently applied by two independent assessors to original research articles reporting survey findings, published in the five highest impact general anesthesia journals ('Anaesthesia', 'Anesthesia & Analgesia', 'Anesthesiology', 'British Journal of Anaesthesia' and 'European Journal of Anaesthesiology') between July 01, 2016, and December 31, 2017, which were identified using a prespecified PubMed search strategy. RESULTS Among 1107 original articles published, we identified 97 reporting survey research either employing novel survey instruments (58%), established surveys (30%), or sets of single-item scores (12%). The extent to which reader-oriented benchmarks were achieved varied by component and between survey types. Results were particularly mixed for validation (mentioned for 41% of novel and 86% of established surveys) and discussion of generalizability (59% of novel survey reports, 45% of established surveys, and 17% of sets of single-item scores). CONCLUSION Survey research is not uncommon in anesthesiology, frequently employs novel survey instruments, and demonstrates mixed results in terms of transparency and interpretability. We provide readers with a practical framework for critical interpretation of survey-derived outcomes.
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Affiliation(s)
- Hedwig Schroeck
- Anesthesiology, Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA .,Anesthesiology, Dartmouth-Hitchcock Health System, Lebanon, New Hampshire, USA
| | - Kwame Wiredu
- Anesthesiology, Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA
| | - Tae Wuk Ko
- Anesthesiology, Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA
| | - David Record
- Anesthesiology, Dartmouth-Hitchcock Health System, Lebanon, New Hampshire, USA
| | - Brenda Sirovich
- Medicine, White River Junction VA Medical Center, White River Junction, Vermont, USA.,The Dartmouth Institute, Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, United States
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Dudeney J, Law EF, Meyyappan A, Palermo TM, Rabbitts JA. Evaluating the psychometric properties of the Widespread Pain Index and the Symptom Severity scale in youth with painful conditions. CANADIAN JOURNAL OF PAIN-REVUE CANADIENNE DE LA DOULEUR 2019; 3:137-147. [PMID: 32051925 PMCID: PMC7015535 DOI: 10.1080/24740527.2019.1620097] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Assessing features of centralized pain may prove to be clinically meaningful in pediatric populations. However, we are currently limited by the lack of validated pediatric measures. Aim We examined the psychometric properties of the Widespread Pain Index (WPI) and Symptom Severity (SS) scale, to assess features of centralized pain, in youth with painful conditions from three clinical samples: (1) musculoskeletal surgery, (2) headache, and (3) chronic pain. Methods Participants were 240 youth aged 10-18 years (Mage=14.8, SD=1.9) who completed the WPI and SS scale. Subsets of participants also completed additional measures of pain region, pain intensity, quality of life, pain interference and physical function. Results Increased features of centralized pain by age were seen for the WPI (r=0.27, p<0.01) and SS scale (r=0.29, p<0.01). Expected differences in sex were seen for the WPI (sex:t132=-3.62, p<0.01), but not the SS scale (sex:t223=-1.73, p=0.09). Reliability for the SS scale was adequate (α=.70). Construct validity was demonstrated through relationships between the WPI and pain regions (r=.57, p<0.01), and between the SS scale and quality of life (r=-.59, p<0.01) and pain interference (r=.56, p<0.01). Criterion validity was demonstrated by differences on the WPI between the surgery sample and the headache and chronic pain samples (F2,237=17.55, p<0.001). Comprehension of the SS scale items was problematic for some youth. Conclusions The WPI showed adequate psychometric properties in youth; however the SS scale may need to be modified. Our findings support the need to develop psychometrically sound instruments for comprehensive assessment of pain in pediatric samples.
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Affiliation(s)
- Joanne Dudeney
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA.,School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, NSW, Australia
| | - Emily F Law
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA.,Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Alagumeena Meyyappan
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Tonya M Palermo
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA.,Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Jennifer A Rabbitts
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA.,Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, USA
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El-Metwally A, Shaikh Q, Aldiab A, Al-Zahrani J, Al-Ghamdi S, Alrasheed AA, Househ M, Da'ar OB, Nooruddin S, Razzak HA, Aldossari KK. The prevalence of chronic pain and its associated factors among Saudi Al-Kharj population; a cross sectional study. BMC Musculoskelet Disord 2019; 20:177. [PMID: 31027485 PMCID: PMC6485157 DOI: 10.1186/s12891-019-2555-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 04/03/2019] [Indexed: 11/10/2022] Open
Abstract
Background Chronic pain (CP) can be a symptom of many underlying health issues. The consequences of CP may vary from slight discomfort to disruption of quality of life and normal functioning. In this study, we aim to investigate the prevalence of CP and its associated factors in Al Kharj, Saudi Arabia. Methods This was a cross-sectional study conducted in Al Kharj, Saudi Arabia. We recruited 1031 participants for our study. Data was collected on socio-demographic, health predictors and anthropometric measurements (such as weight, height and waist circumference). The data analysis was performed on JMP®, Version 12. SAS Institute Inc., Cary, NC, 1989–2007. Results The prevalence of self-reported chronic pain in Al Kharj population was 19% with a mean age of 26.4 (SD = 8.6) years. The most common locations of pain included; back pain (30%), abdominal pain (26%), headache (13%), and any musculoskeletal pain (56%). Multiple logistic regression revealed that presence of a chronic disease (OR = 3.8; 95% CI = 2.3–6.2), psychological disease (OR = 2.3; 95% CI = 1.2–4.3), high General Health Questionnaire (GHQ)-12 score (OR = 1.06; 95% CI = 1.03–1.1), and pack-years of smoking (OR = 1.05; 95% CI = 1.01–1.08) were significantly related to chronic pain in Al Kharj population. Conclusions Our study results found a high burden of chronic pain in this selected Saudi population. The most prevalent pain was low back pain. The presence of chronic and psychological diseases were strongly related to chronic pain. Future prospective studies are needed to establish the temporal relationship of chronic pain with these factors.
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Affiliation(s)
- Ashraf El-Metwally
- College of Public Health & Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Mail Code 2350, P.O. Box 3660, Riyadh, 11481, Kingdom of Saudi Arabia. .,Docent of Epidemiology, School of Health Sciences, University of Tampere, Tampere, Finland.
| | - Quratulain Shaikh
- Indus Hospital Research Center, Indus Health Network, Karachi, Pakistan
| | - Abdulrahman Aldiab
- Department of Medicine, Oncology division, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Jamaan Al-Zahrani
- Family & Community Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Sameer Al-Ghamdi
- Department of Family Medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Abdullah A Alrasheed
- Family and Community Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mowafa Househ
- School of Health Information Science, University of Victoria, Victoria, Canada
| | - Omar B Da'ar
- College of Public Health & Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Mail Code 2350, P.O. Box 3660, Riyadh, 11481, Kingdom of Saudi Arabia.,St. Mary's University of Minnesota, Winona, MN, USA
| | | | | | - Khaled K Aldossari
- Family & Community Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
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Walters CB, Schwalbach T, Sevene E, Walters J, Jackson T, Hiremath G, Moon TD, McQueen KK. Chronic pain and associated factors in Maputo, Mozambique: a pilot study. Br J Pain 2019; 13:43-53. [PMID: 30671238 DOI: 10.1177/2049463718777009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Introduction Studies estimate that 20% of adults suffer from chronic pain. A meta-analysis in low- and middle-income countries (LMICs) found 34% had chronic pain. There are few studies on pain prevalence gathered in Africa. This study surveyed the capital city of Mozambique. Methods This was a cross-sectional study employed in a community setting. The Vanderbilt Global Pain Survey comprised questions on the behaviour and attitudes of respondents regarding pain, including previously validated metrics: the Pain Catastrophizing Scale, the World Health Organization Disability Assessment Schedule, the Brief Pain Inventory, Widespread Pain Index and Symptom Severity Score, and the Michigan Body Map. Results Ninety-seven surveys were completed out of 100. Pain every day lasting for more than 6 months in their lifetime was reported as 39.2% (CI: 29.4-49.6), and 52% of respondents had pain the day of the interview. However, the pain resulted in little difficulty with activities of daily living and maintaining relationships (61%-89%). Although none reported mental health disorders, 53.6% had experienced a traumatic event in their life, with 45.2% having related nightmares, anxiety, or fear. Most respondents (99%) would take oral medication if it helped their pain, with a large proportion willing to spend significant money for these (49% would pay >US$40) and willing to travel long distances to get help (55.2% would travel >40 kilometer). Conclusion The prevalence of chronic pain in Maputo, Mozambique is similar to the average for LMICs. Trends in high-income countries suggest that multimodal pain management and multidisciplinary treatments may improve optimal pain control in LMICs.
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