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Goetschi AN, Meyer-Massetti C. Characterising pharmacists' interventions in chronic non-cancer pain care: a scoping review. Int J Clin Pharm 2024; 46:1010-1023. [PMID: 38861043 PMCID: PMC11399199 DOI: 10.1007/s11096-024-01741-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 04/08/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND Chronic non-cancer pain may affect up to 51% of the general population. Pharmacist interventions have shown promise in enhancing patient safety and outcomes. However, our understanding of the scope of pharmacists' interventions remains incomplete. AIM Our goal was to characterise pharmacists' interventions for the management of chronic non-cancer pain. METHOD Medline, Embase, PsycINFO via Ovid, CINAHL via EBSCO databases and the Cochrane Library were systematically searched. Abstracts and full texts were independently screened by two reviewers. Data were extracted by one reviewer, and validated by the second. Outcomes of studies were charted using the dimensions of the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT). RESULTS Forty-eight reports were included. Interventions ensuring appropriate drug prescription occurred in 37 (79%) studies. Patient education and healthcare professional education were reported in 28 (60%) and 5 (11%) studies, respectively. Therapy monitoring occurred in 17 (36%) studies. Interventions regularly involved interprofessional collaboration. A median of 75% of reported outcome domains improved due to pharmacist interventions, especially patient disposition (adherence), medication safety and satisfaction with therapy. CONCLUSION Pharmacists' interventions enhanced the management of chronic non-cancer pain. Underreported outcome domains and interventions, such as medication management, merit further investigation.
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Affiliation(s)
- Aljoscha Noël Goetschi
- Clinical Pharmacology and Toxicology, General Internal Medicine, University Hospital of Bern, Anna-Von-Krauchthal-Weg 7, 3010, Bern, Switzerland.
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
| | - Carla Meyer-Massetti
- Clinical Pharmacology and Toxicology, General Internal Medicine, University Hospital of Bern, Anna-Von-Krauchthal-Weg 7, 3010, Bern, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
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Main A, McCartney H, Ibrar M, Rai HK, Muirhead F, Mavroeidi A, Maguire R. Patients' Experiences of Digital Health Interventions for the Self-Management of Chronic Pain: Protocol for a Systematic Review and Thematic Synthesis. JMIR Res Protoc 2024; 13:e52469. [PMID: 38451694 PMCID: PMC10958340 DOI: 10.2196/52469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Chronic pain is a highly prevalent condition that requires multidisciplinary treatment. However, in the United Kingdom, access to specialist pain clinics where patients can receive medical multidisciplinary treatment is limited, and provision varies between health boards. As such, self-management of chronic pain using digital tools has been gaining traction recently, but evidence of its effectiveness from clinical-based trials focuses mainly on quantitative outcomes. OBJECTIVE This systematic review aims to identify, appraise, and synthesize qualitative evidence on patients' experiences with digital health interventions (DHIs) for the management of chronic pain. METHODS This systematic review will consider qualitative and mixed methods studies that explore the experience of patients (aged 18 years and older) with chronic pain engaging in DHIs to manage their pain. MEDLINE Ovid, PubMed, Embase, CINAHL, PsycINFO, and Scopus databases will be searched for published studies. The systematic review will be conducted in accordance with the ENTREQ (Enhancing Transparency in Reporting the Synthesis of Qualitative Research) guidelines. Following the 3-step thematic synthesis methodology of Thomas and Harden, titles and abstracts will be screened by 2 independent reviewers (AM and HM), and a third reviewer (MI or FM) will resolve any conflict that arises before the full-text screening. The Critical Appraisal Skills Programme checklist tool will be used to critically appraise the included studies. The extracted data will be imported to NVivo (QSR International), where thematic synthesis will be used to derive analytical themes from the included studies. RESULTS Themes that encapsulate the patient experience will be identified from qualitative evidence, and these themes will shed light on the perceived benefits and disadvantages, usability, acceptability, and the overall impact digital tools can have on the lives of those with chronic pain. CONCLUSIONS This systematic review will identify, appraise, and synthesize the overall experience of patients engaging in DHI to manage a diverse range of chronic pain conditions. By elaborating the patient experience through qualitative analysis, the findings from this review will enhance our current understanding of the experiences of patients with chronic pain using digital tools for the self-management of their pain and highlight what person-centered elements are essential for future DHI development. TRIAL REGISTRATION PROSPERO CRD42023445100; http://tinyurl.com/4z77khfs. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/52469.
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Affiliation(s)
- Ashleigh Main
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Haruno McCartney
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Maryam Ibrar
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Harleen Kaur Rai
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Fiona Muirhead
- Physical Activity for Health, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom
| | - Alexandra Mavroeidi
- Department of Occupational Therapy and Human Nutrition and Dietetics, School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Roma Maguire
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
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Tomé-Pires C, Aragonès E, Rambla C, López-Cortacans G, Sánchez-Rodríguez E, Caballero A, Miró J. Perceived barriers, facilitators and usefulness of a psychoeducational intervention for individuals with chronic musculoskeletal pain and depression in primary care. Front Psychol 2023; 14:1099419. [PMID: 37179874 PMCID: PMC10167008 DOI: 10.3389/fpsyg.2023.1099419] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 04/03/2023] [Indexed: 05/15/2023] Open
Abstract
Background and aims Self-management interventions have the potential to improve patient' pain condition as they involve tasks aimed at managing symptoms and reducing interference with activities, mood and relationships due to pain. However, research on factors that facilitate or hinder pain self-management has overlooked patients with both chronic musculoskeletal pain and depression in primary care settings, also leaving unattended patient views on the usefulness of such programs. Thus, the main aim of this study was to gather meaningful information to help promoting adequate self-management. Specifically, it attempts to identify patients' perceptions of barriers and facilitators of group-based psychoeducational intervention and to explore its perceived usefulness in promoting self-management. Method This qualitative study explored perceived barriers and facilitators of a psychoeducational intervention for the management of chronic musculoskeletal pain and depression previously tested in a Randomized Control Trial. We conducted focus groups and individual interviews with fifteen adult patients with both chronic musculoskeletal pain and depression recruited from primary care centres in Tarragona province (Catalonia, Spain). A content thematic analysis was carried out to examine the data. This study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Results Findings revealed that perceived barriers included lack of motivation, time constraints, pain, depression, ineffectiveness of pain-relief strategies and activity avoidance. Facilitators were having a supportive family/friends, the positive effects of self-management, high motivation, being a proactive patient. Peer support and identification, the positive effect of sessions, and free expression were highlighted as key elements of the psychoeducational intervention. Conclusion The psychoeducational intervention was perceived as useful in promoting self-management practices. Barriers and facilitators in using self-management strategies were related, mainly, to internal personal characteristics of the patients being similar among different cultural backgrounds and distinct chronic conditions. Implications These findings can help to guide clinicians in the development and implementation of more effective pain self-management interventions for patients with chronic pain and depression by attending to their needs and preferences.
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Affiliation(s)
- Catarina Tomé-Pires
- Department of Psychology, Psychology Research Centre, Autonomous University of Lisbon, Lisbon, Portugal
- Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - Enric Aragonès
- Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Atenció Primària Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain
| | - Concepción Rambla
- Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Atenció Primària Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain
| | - Germán López-Cortacans
- Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Atenció Primària Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain
| | - Elisabet Sánchez-Rodríguez
- Unit for the Study and Treatment of Pain—ALGOS, Department of Psychology, Research Center for Behavior Assessment, Universitat Rovira i Virgili (URV), Tarragona, Spain
- Institut d’Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili (URV), Tarragona, Spain
- Chair in Pediatric Pain Universitat Rovira i Virgili (URV)—Fundación Grünenthal, Catalonia, Spain
| | - Antonia Caballero
- Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Atenció Primària Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain
| | - Jordi Miró
- Unit for the Study and Treatment of Pain—ALGOS, Department of Psychology, Research Center for Behavior Assessment, Universitat Rovira i Virgili (URV), Tarragona, Spain
- Institut d’Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili (URV), Tarragona, Spain
- Chair in Pediatric Pain Universitat Rovira i Virgili (URV)—Fundación Grünenthal, Catalonia, Spain
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Takahashi N, Takatsuki K, Kasahara S, Yabuki S. Characteristics of patients who dropped out after multidisciplinary pain management in Japan: A prospective cohort study. J Back Musculoskelet Rehabil 2022; 35:793-802. [PMID: 34957984 PMCID: PMC9398070 DOI: 10.3233/bmr-200292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 10/29/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Because regular visits to distant hospitals may be a burden to patients, both in terms of time and cost, some patients with chronic musculoskeletal pain may discontinue multidisciplinary pain treatment, unable to maintain motivation to attend. OBJECTIVE To evaluate and compare the pre-program characteristics of patients who dropped out and patients who continued treatment, thereby clarifying the characteristics of patients at risk of dropping out. METHODS A multidisciplinary pain management treatment program was implemented for patients at the Pain Management Center, Hoshi General Hospital. From April 2015 to March 2018, 23 patients participated in the program. Twelve of the 23 patients lived outside the prefecture where the hospital is located. Of these 12 patients, five completed the program, while seven did not. We compared the dropout and continuation groups in terms of patient characteristics, pain severity, pain-related psychosocial factors, and quality of life. RESULTS We found significant differences (p< 0.05) in median age, Japanese Orthopaedic Association Back Pain Evaluation Questionnaire walking ability dysfunction score, and Roland-Morris Disability Questionnaire score. CONCLUSIONS The characteristics of patients who dropped out were older age, walking ability dysfunction, and low quality of life associated with low back pain.
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Affiliation(s)
- Naoto Takahashi
- Department of Pain Medicine, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
- Pain Management Center, Hoshi General Hospital, Koriyama City, Fukushima, Japan
| | - Kozue Takatsuki
- Department of Pain Medicine, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
| | - Satoshi Kasahara
- Department of Pain Medicine, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
- Pain Management Center, Hoshi General Hospital, Koriyama City, Fukushima, Japan
| | - Shoji Yabuki
- Department of Pain Medicine, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
- Pain Management Center, Hoshi General Hospital, Koriyama City, Fukushima, Japan
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Takahashi N, Takatsuki K, Kasahara S, Yabuki S. Multidisciplinary pain management program for patients with chronic musculoskeletal pain in Japan: a cohort study. J Pain Res 2019; 12:2563-2576. [PMID: 31686898 PMCID: PMC6708881 DOI: 10.2147/jpr.s212205] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 08/02/2019] [Indexed: 11/23/2022] Open
Abstract
Introduction Multidisciplinary pain management is a useful method for treating chronic musculoskeletal pain. Currently, few facilities in Japan offer multidisciplinary pain treatment, especially in the inpatient setting. We implemented a multidisciplinary pain management program based on International Association for the Study of Pain recommendations. This study described our initial efforts in implementing the program, and reported 3- and 6-month follow-up results. Materials and methods Our pain management team included orthopedic surgeons, psychiatrists, nurses, physical therapists, clinical psychologists, pharmacists, and nutritionists. The 3-week inpatient pain management program comprised exercise therapy, psychotherapy, and patient education. We evaluated patients using the Brief Pain Inventory (BPI), Pain Catastrophizing Scale (PCS), Pain Disability-Assessment Scale (PDAS), Hospital Anxiety and Depression Scale (HADS), Pain Self-Efficacy Questionnaire (PSEQ), EuroQol Five Dimensions (EQ-5D), and physical examinations (flexibility, muscle endurance, walking ability, and physical fitness). Statistical analyses were performed using paired t-tests and Wilcoxon matched-pairs signed-rank sum tests with Bonferroni correction after the Friedman test. Results Data for 23 patients were analyzed before and immediately after the program. Statistically significant improvements were seen in BPI, PCS, PDAS, HADS, PSEQ, EQ-5D, flexibility, muscle endurance, walking ability, and physical fitness. Eight patients were also assessed 3 and 6 months after the program. PCS (rumination and helplessness) scores and flexibility showed significant improvement at 3 and 6 months. Significant improvement was seen in PDAS and HADS (anxiety) scores and muscle endurance at 6 months, and in PSEQ scores immediately and at 3 and 6 months. Conclusion Our inpatient pain management program can improve patients' physical function and ability to cope with chronic musculoskeletal pain, which supports improved quality of life. Our program is currently being expanded to better assist patients with chronic musculoskeletal pain.
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Affiliation(s)
- Naoto Takahashi
- Department of Pain Medicine, Fukushima Medical University School of Medicine, Fukushima 9601295, Japan.,Pain Management Center, Hoshi General Hospital, Koriyama 963-8501, Japan
| | - Kozue Takatsuki
- Department of Pain Medicine, Fukushima Medical University School of Medicine, Fukushima 9601295, Japan
| | - Satoshi Kasahara
- Department of Pain Medicine, Fukushima Medical University School of Medicine, Fukushima 9601295, Japan.,Pain Management Center, Hoshi General Hospital, Koriyama 963-8501, Japan
| | - Shoji Yabuki
- Department of Pain Medicine, Fukushima Medical University School of Medicine, Fukushima 9601295, Japan.,Pain Management Center, Hoshi General Hospital, Koriyama 963-8501, Japan
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Lewis GN, Bean D, Mowat R. How Have Chronic Pain Management Programs Progressed? A Mapping Review. Pain Pract 2019; 19:767-784. [DOI: 10.1111/papr.12805] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 05/09/2019] [Accepted: 06/04/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Gwyn N. Lewis
- Health and Rehabilitation Research Institute Auckland University of Technology AucklandNew Zealand
| | - Debbie Bean
- Department of Psychological Medicine University of Auckland AucklandNew Zealand
- The Auckland Regional Pain Service Auckland District Health Board AucklandNew Zealand
| | - Rebecca Mowat
- Toi Ohomai Institute of Technology Tauranga New Zealand
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