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Almeida DDS, Honorato LS, Moreira LKDS, Turones LC, Bellard E Silva R, Coimbra MC, Pereira LJ, Pereira MOA, Fajemiroye JO, Paula JRD, Melo JOF, Martins JLR, Gil EDS, Costa EA, Couto ROD. Antinociceptive, anti-inflammatory, and antioxidant effects of a flavonoid-rich phytocomplex from the leaves of Celtis iguanaea (jacq.) Sargent (Cannabaceae). Nat Prod Res 2024:1-11. [PMID: 39262209 DOI: 10.1080/14786419.2024.2401501] [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: 02/20/2024] [Revised: 08/01/2024] [Accepted: 09/02/2024] [Indexed: 09/13/2024]
Abstract
We demonstrated the antinociceptive and anti-inflammatory effects of the ethyl acetate leaf extract of Celtis iguanaea (Jacq.) Sargent (EAECi) in mice. The in vitro antioxidant activity of EAECi and its phytoconstituents was also investigated. The antinociceptive effect of EAECi is attributed to its anti-inflammatory activity, as evidenced by its anti-hyperalgesic and antiedematogenic effects. EAECi reduced polymorphonuclear cell migration, myeloperoxidase activity, pro-inflammatory cytokines (TNF-α and IL-1β), and PGE2 levels. The levels of anti-inflammatory cytokines (IL-4 and IL-10) were increased compared to the vehicle-treated groups. The overall antioxidant capacity of EAECi is noteworthy, with the Electrochemical Index determined by Differential Pulse Voltammetry being 42.7 μA/V. Concurrently, Square Wave Voltammetry revealed the reversibility of the redox process (Ep1a/Ep1c) at 0.254 V. The presence of twenty-six phytochemicals, primarily flavone aglycones, was suggested by paper-spray mass spectrometry. These findings represent a step towards validating C. iguanaea leaf extract for treating acute inflammatory conditions.
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Affiliation(s)
- Dionys de Souza Almeida
- Laboratório de Farmacologia de Produtos Naturais e Sintéticos, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Luiza Sousa Honorato
- Laboratório de Desenvolvimento Farmacotécnico (LADEF), Universidade Federal de São João del-Rei (UFSJ), Campus Centro-Oeste Dona Lindu (CCO), R. Sebastião Gonçalves Coelho, Divinópolis, Brazil
| | | | - Larissa Córdova Turones
- Laboratório de Farmacologia de Produtos Naturais e Sintéticos, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Rúbia Bellard E Silva
- Laboratório de Desenvolvimento Farmacotécnico (LADEF), Universidade Federal de São João del-Rei (UFSJ), Campus Centro-Oeste Dona Lindu (CCO), R. Sebastião Gonçalves Coelho, Divinópolis, Brazil
| | - Mairon Cesar Coimbra
- Laboratório de Desenvolvimento Farmacotécnico (LADEF), Universidade Federal de São João del-Rei (UFSJ), Campus Centro-Oeste Dona Lindu (CCO), R. Sebastião Gonçalves Coelho, Divinópolis, Brazil
| | - Laura Jéssica Pereira
- Laboratório de Desenvolvimento Farmacotécnico (LADEF), Universidade Federal de São João del-Rei (UFSJ), Campus Centro-Oeste Dona Lindu (CCO), R. Sebastião Gonçalves Coelho, Divinópolis, Brazil
| | - Marx Osório Araújo Pereira
- Laboratório de Análise Farmacêutica e Ambiental (LAFAM), Faculdade de Farmácia, Universidade Federal de Goiás, Goiânia, Brazil
| | | | - José Realino de Paula
- Laboratório de Pesquisa em Produtos Naturais (LPPN), Faculdade de Farmácia, Universidade Federal de Goiás, Goiânia, Brazil
| | - Júlio Onésio Ferreira Melo
- Departamento de Ciências Exatas e Biológicas, Campus Sete Lagoas, Universidade Federal de São João Del-Rei, Sete Lagoas, Brazil
| | | | - Eric de Souza Gil
- Laboratório de Análise Farmacêutica e Ambiental (LAFAM), Faculdade de Farmácia, Universidade Federal de Goiás, Goiânia, Brazil
| | - Elson Alves Costa
- Laboratório de Farmacologia de Produtos Naturais e Sintéticos, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Renê Oliveira do Couto
- Laboratório de Desenvolvimento Farmacotécnico (LADEF), Universidade Federal de São João del-Rei (UFSJ), Campus Centro-Oeste Dona Lindu (CCO), R. Sebastião Gonçalves Coelho, Divinópolis, Brazil
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2
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Goetschi AN, Verloo H, Wernli B, Wertli MM, Meyer-Massetti C. Prescribing pattern insights from a longitudinal study of older adult inpatients with polypharmacy and chronic non-cancer pain. Eur J Pain 2024. [PMID: 38838067 DOI: 10.1002/ejp.2298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/23/2024] [Accepted: 05/10/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND The present study sought to determine the prevalence of chronic non-cancer pain (CNCP) among older adult inpatients with polypharmacy. It also aimed to analyse prescription patterns and assess the therapy adequacy and patient complexity for those with and without CNCP. METHODS This 4-year longitudinal study examined data from an exhaustive acute care hospital register on home-dwelling older adult patients (≥65) with polypharmacy. Commonly known combinations of potentially inappropriate medications were used to estimate therapy adequacy. Patient complexity was evaluated by comparing number of comorbidities and investigating physical and cognitive deficits. RESULTS We determined a prevalence of CNCP of 9.7% among all older adult inpatients with polypharmacy, rising to 11.3% for those aged ≥85. Overall, CNCP patients were prescribed more drugs and had more comorbidities and physical and cognitive deficits than patients without CNCP. Older adult patients with CNCP received more analgesics, greater quantities of opioids, paracetamol and co-analgesics and elevated opioid dosages. Older adult patients with CNCP aged ≥85 received fewer analgesics, opioids, non-steroidal anti-inflammatory drugs and co-analgesics but more paracetamol. Older adult patients with CNCP were prescribed more potentially inappropriate medications involving opioids. In particular, 24.5% received an opioid and a hypnotic (benzodiazepine or Z-drug), and 8.6% received an opioid and a gabapentinoid. CONCLUSION Observed differences in medication use between older adult inpatients with or without CNCP may be relevant for clinical practice. Potentially inadequate co-prescribing (such as hypnotics and opioids) affects a higher proportion of patients with CNCP and may have serious unintended consequences. SIGNIFICANCE STATEMENT This study describes differences in prescription patterns between people with and without chronic non-cancer pain in a large dataset of 20,422 discharges. The differences found may be relevant to clinical practice. In particular, high co-prescribing of opioids and hypnotics may have serious unintended consequences. Greater physical and cognitive deficits may indicate greater patient complexity, and appropriate interventions need to be developed to improve the management of this vulnerable patient group.
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Affiliation(s)
- Aljoscha N Goetschi
- General Internal Medicine, University Hospital of Bern, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Henk Verloo
- School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland, Sion, Switzerland
- Service of Old Age Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Boris Wernli
- Swiss Centre of Expertise in the Social Sciences (FORS), Faculty of Social and Political Sciences, University of Lausanne, Lausanne, Switzerland
| | - Maria M Wertli
- General Internal Medicine, University Hospital of Bern, University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Cantonal Hospital of Baden, Baden, Switzerland
| | - Carla Meyer-Massetti
- General Internal Medicine, University Hospital of Bern, University of Bern, Bern, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
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Laksono RM, Siswagama TA, Asmoro AA, Sjahrir H, Musba AM, Halim W, der Weegen WV, Vissers K. Identifying pain problems, healthcare professional perceptions, expectations and challenges in multidisciplinary pain center establishment. Pain Manag 2023; 13:385-395. [PMID: 37458192 DOI: 10.2217/pmt-2023-0027] [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] [Indexed: 09/28/2023] Open
Abstract
Aim: Before establishing a multidisciplinary pain center (MPC), the pain problem, healthcare professionals (HCP) perceptions, expectations and the potential challenges of MPC establishment need to be identified. Methods: A quantitative survey study of 1058 Indonesian HCPs. The study uses a national inquiry sent by the International Association for the Study of Pain (IASP) chapter for pain. Results: 99.0% of respondents had met patients with pain as the primary complaint and acute pain as the most common complaint. Insufficient pain management in Indonesian healthcare, insufficient pain epidemiological data and unaware HCP about MPC become problems of pain management in Indonesia. However, most HCP agreed that health facilities should have MPC. Financial issues (insufficient patient insurance) were considered the most important barrier for referring patients to MPC. Conclusion: The identified core problem, HCP perceptions, expectations and challenges of MPC establishment should become a consideration in the strategic planning of MPC establishment.
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Affiliation(s)
- Ristiawan M Laksono
- Department of Anesthesiology & Intensive Therapy, Faculty of Medicine, Brawijaya University, Malang, Indonesia
| | - Taufiq A Siswagama
- Department of Anesthesiology & Intensive Therapy, Faculty of Medicine, Brawijaya University, Malang, Indonesia
| | - Aswoco A Asmoro
- Department of Anesthesiology & Intensive Therapy, Faculty of Medicine, Brawijaya University, Malang, Indonesia
| | - Hasan Sjahrir
- Department of Neurology, Faculty of Medicine, Sumatera Utara University, Medan, Indonesia
| | - Andi Mt Musba
- Department of Anesthesiology, Intensive Care & Pain Management, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Willy Halim
- Department of Medicine, Faculty of Medicine, Brawijaya University, Malang, Indonesia
| | | | - Kris Vissers
- Department of Anesthesiology, Pain & Palliative Medicine, Radboud University Medical Centre, The Netherlands
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Macchia L. Pain trends and pain growth disparities, 2009-2021. ECONOMICS AND HUMAN BIOLOGY 2022; 47:101200. [PMID: 36423490 DOI: 10.1016/j.ehb.2022.101200] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/27/2022] [Accepted: 11/10/2022] [Indexed: 06/16/2023]
Abstract
Physical pain is a major public health concern. Yet evidence on trends in physical pain around the world barely exists. Using nationally representative data from 146 countries (N = 1.6 million respondents), this paper finds that, all over the world, the percentage of people in pain increased from 26.3 in 2009 to 32.1 in 2021. This rising trend was present in both higher- and lower-income countries. This article also documents pain disparities: In the worldwide population, pain grew faster among women, the less educated, and the poor. Although the aggregate level of pain was greater among the elderly (> 60 years old), the growth in pain was faster among the younger (< 35 years old). These findings hold after controlling for sociodemographic factors. Disparities of pain growth in higher- and lower-income nations and potential explanatory factors are also discussed. Understanding how the level of pain varies over time and across demographic groups is crucial to evaluate and shape public health policies.
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Affiliation(s)
- Lucía Macchia
- City, University of London, School of Health & Psychological Sciences, Rhind Building, St John Street, London EC1R 0JD, UK.
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Zimmer Z, Fraser K, Grol-Prokopczyk H, Zajacova A. A global study of pain prevalence across 52 countries: examining the role of country-level contextual factors. Pain 2022; 163:1740-1750. [PMID: 35027516 PMCID: PMC9198107 DOI: 10.1097/j.pain.0000000000002557] [Citation(s) in RCA: 78] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/29/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT There is wide variation in population-level pain prevalence estimates in studies of survey data around the world. The role of country-level social, economic, and political contextual factors in explaining this variation has not been adequately examined. We estimated the prevalence of unspecified pain in adults aged 25+ years across 52 countries using data from the World Health Survey 2002 to 2004. Combining data sources and estimating multilevel regressions, we compared country-level pain prevalence and explored which country-level contextual factors explain cross-country variations in prevalence, accounting for individual-level demographic factors. The overall weighted age- and sex-standardized prevalence of pain across countries was estimated to be 27.5%, with significant variation across countries (ranging from 9.9% to 50.3%). Women, older persons, and rural residents were significantly more likely to report pain. Five country-level variables had robust and significant associations with pain prevalence: the Gini Index, population density, the Gender Inequality Index, life expectancy, and global region. The model including Gender Inequality Index explained the most cross-country variance. However, even when accounting for country-level variables, some variation in pain prevalence remains, suggesting a complex interaction between personal, local, economic, and political impacts, as well as inherent differences in language, interpretations of health, and other difficult to assess cultural idiosyncrasies. The results give new insight into the high prevalence of pain around the world and its demonstrated association with macrofactors, particularly income and gender inequalities, providing justification for regarding pain as a global health priority.
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Affiliation(s)
- Zachary Zimmer
- Global Aging and Community Initiative, Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, NS, Canada
| | - Kathryn Fraser
- Global Aging and Community Initiative, Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, NS, Canada
| | | | - Anna Zajacova
- Department of Sociology, University of Western Ontario, London, ON, CA
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Isa AS, Chetty S. Physiology and pathophysiology of chronic pain (Part I). SOUTHERN AFRICAN JOURNAL OF ANAESTHESIA AND ANALGESIA 2021. [DOI: 10.36303/sajaa.2021.27.6.2491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- AS Isa
- Department of Anaesthesiology and Critical Care, Faculty of Medicine and Health Sciences, Stellenbosch University,
South Africa
- Department of Human Physiology, Faculty of Basic Medical Sciences, College of Medical Sciences, Ahmadu Bello University,
Nigeria
| | - S Chetty
- Department of Anaesthesiology and Critical Care, Faculty of Medicine and Health Sciences, Stellenbosch University,
South Africa
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Tuck NL, Khuvtsagaan B, Rashid U, Aamir T, Goucke R, Regjii B, Dorjbal EA, Lundeg G, Bean DJ. The Adaptation of Pain Assessment Tools from High-Income to Low- and Middle-Income Countries: Psychometric Properties of a Set of Chronic Pain Questionnaires in Mongolian and New Zealand Patient Samples. PAIN MEDICINE 2021; 22:948-960. [PMID: 33001213 DOI: 10.1093/pm/pnaa267] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Chronic pain is a leading cause of disability in low- and middle-income countries; however, pain assessment tools have generally been developed and validated in high-income countries. This study examines the psychometric properties of a set of translated pain (and distress) questionnaires in Mongolia and documents the characteristics of people seeking treatment for chronic pain in Mongolia, compared with those in New Zealand, which is representative of high-income countries. DESIGN Cross-sectional, observational. SETTING Hospital-based pain treatment centers in New Zealand and Mongolia. SUBJECTS People seeking treatment for chronic pain in Mongolia (N = 142) and New Zealand (N = 159). METHODS The Brief Pain Inventory, the Depression Anxiety Stress Scale-21, the Pain Catastrophizing Scale, and the Pain Self-Efficacy Questionnaire were translated into Mongolian and administered to patients attending a hospital-based pain service. Questionnaires that were completed by patients in New Zealand were used for comparisons. Internal reliability, convergent validity, and factor structure were assessed in both groups. RESULTS Patients in Mongolia were older and reported lower pain intensity, interference, and distress and higher pain self-efficacy than those in New Zealand. The translated questionnaires had good internal consistencies, and the relationships between pain variables were similar across both groups. The factor structure for the Pain Catastrophizing Scale was consistent across both groups, but this was not the case for the Brief Pain Inventory or the Depression Anxiety Stress Scale-21. CONCLUSIONS Findings indicate that some pain outcome measures may be appropriate for use in Mongolia and should be investigated in other low- and middle-income countries.
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Affiliation(s)
- Natalie L Tuck
- The Auckland Regional Pain Service, Auckland District Health Board, Auckland, New Zealand.,The Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand.,The Waitematā District Health Board (WDHB) Chronic Pain Service, Department of Anesthesiology and Perioperative Medicine, Auckland, New Zealand
| | | | - Usman Rashid
- The Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Tipu Aamir
- The Auckland Regional Pain Service, Auckland District Health Board, Auckland, New Zealand
| | - Roger Goucke
- Medical School University of Western Australia, Nedlands, Western Australia, Australia
| | | | | | - Ganbold Lundeg
- The Mongolian National University of Medical Sciences, Ulaanbatar, Mongolia
| | - Debbie J Bean
- The Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand.,The Waitematā District Health Board (WDHB) Chronic Pain Service, Department of Anesthesiology and Perioperative Medicine, Auckland, New Zealand
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Iqbal A, David Knaggs R, Anderson C, Toh LS. Role of pharmacists in optimising opioid therapy for chronic non-malignant pain; A systematic review. Res Social Adm Pharm 2020; 18:2352-2366. [PMID: 33309322 DOI: 10.1016/j.sapharm.2020.11.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/16/2020] [Accepted: 11/19/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Opioid optimisation is a global issue in Chronic Non-malignant Pain (CNMP) management. OBJECTIVE This systematic review aims to assess the effectiveness of interventions delivered by pharmacists in outpatient clinical settings, community pharmacies and primary care services in optimising opioid therapy for people with CNMP and to explore stakeholders' opinions about role of pharmacists in optimising opioid therapy. METHODS We conducted searches in PubMed, CINAHL, Psych Info, EMBASE, ISI Web of Science and Conference Proceedings and International Pharmaceutical Abstracts. All studies where pharmacists in outpatient clinical settings, community pharmacies and patient care services helped in optimisation of opioids in the treatment of CNMP as individuals or part of a team were included. Authors followed the 27-item PRISMA guidelines and the review was registered in PROSPERO. All authors were involved in screening and selection of studies and included studies between January 1990-June 2020. Studies not published in English language and participants with cancer pain were excluded. All the included studies were descriptively synthesized. RESULTS Fourteen studies were included in the final data synthesis of this review and the total number of participants in all studies was 1175. Interventions by pharmacists were successful in decreasing opioid dose in 4 studies and improved patient opioid safety in 5 studies. Stakeholders considered that the role of pharmacists in optimisation of opioid therapy for people with CNMP can be promising and should be further developed. CONCLUSION This systematic review gives an overview of pharmacist intervention feasibility, stakeholders' opinions and possible benefits on opioid optimisation in people with CNMP in outpatient clinical settings, community pharmacies and primary care settings. However, further research is warranted, which can guide the development of new policies and guidelines for the utilisation of pharmacists to promote opioid safety in people using prescription opioids for CNMP management.
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Affiliation(s)
- Ayesha Iqbal
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, NG7 2RD, Nottingham, United Kingdom.
| | - Roger David Knaggs
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, NG7 2RD, Nottingham, United Kingdom; Primary Integrated Community Solutions, Unit H4 Ash Tree Court, Nottingham Business Park, Nottingham NG8 6PY, United Kingdom.
| | - Claire Anderson
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, NG7 2RD, Nottingham, United Kingdom.
| | - Li Shean Toh
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, NG7 2RD, Nottingham, United Kingdom.
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Almalki MT, BinBaz SS, Alamri SS, Alghamdi HH, El-Kabbani AO, Al Mulhem AA, Alzubaidi SA, Altowairqi AT, Alrbeeai HA, Alharthi WM, Alswat KA. Prevalence of chronic pain and high-impact chronic pain in Saudi Arabia. Saudi Med J 2020; 40:1256-1266. [PMID: 31828278 PMCID: PMC6969620 DOI: 10.15537/smj.2019.12.24690] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objectives: To estimate the prevalence of chronic pain (CP) and high-impact chronic pain (HICP) in a sample of the general adult population in Saudi Arabia. Methods: This is a cross-sectional online survey (N=24,265). Forty data collectors from 5 regions of Saudi Arabia approached people to complete the questionnaires through different social media applications, using a validated survey in Arabic language. Results: Chronic pain and HICP prevalences in the Saudi adult population were found to be 46.4% (CP) and 4% (HICP), with a higher prevalence among women and elderly. Chronic back pain was the most reported pain location. Half of the respondents reported dissatisfaction with pain services. Greater prevalence of HICP was found among women, elderly, unemployed, and those with low-income status. Patients with HICP were more likely to have more healthcare utilization and have more negative impacts on their physical and psychological wellbeing. Conclusion: Chronic pain and HICP are common in Saudi Arabia, especially among females and elderly, suggesting a public health problem. This calls for collaborative efforts at various levels of the social hierarchy to ensure the provision of effective management of CP in Saudi Arabia.
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Affiliation(s)
- Mohammed T Almalki
- Department of Anesthesia, King Salman Armed Forces Hospital, Tabuk, Kingdom of Saudi Arabia. E-mail.
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Mena-Iturriaga MJ, Mauri-Stecca MV, Sizer PS, Leppe J. Quality of life in chronic musculoskeletal symptomatic Chilean population: secondary analysis of National Health Survey 2009-2010. BMC Musculoskelet Disord 2020; 21:262. [PMID: 32316950 PMCID: PMC7175522 DOI: 10.1186/s12891-020-03261-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 04/02/2020] [Indexed: 12/14/2022] Open
Abstract
Background Health-related quality of life (HRQoL) is defined as the patient’s perception of their health status. HRQoL can be modified by illnesses, treatments or social and health policies. Chronic musculoskeletal pain is a modifying factor of HRQoL that leads to lower quality of life, elevated suffering and disability. Knowing HRQoL in subjects reporting chronic musculoskeletal symptoms (cMSS), like pain, discomfort or swollenness lasting more than 3 months, will provide information to health teams and organizations engaged in the Chilean health system. This study aim was to determine the relationship between HRQoL and musculoskeletal symptoms measured in three different Chilean groups: [1] without symptoms; [2] with acute symptoms; and [3] with cMSS. Methods A secondary analysis of the 2009–10 Chilean National Health Survey (NHS) was executed to determine the relationship between HRQoL (measured with SF-12) in three MSS groups. The Chilean NHS considered a national, probabilistic, stratified and multistage sample of 5293 participants aged 15 and older; it was representative at the national, urban-rural and regional levels. A multivariate logistic regression model studied the relationship between cMSS and HRQoL, adjusted for age, sex, educational level and residence area as control variables (p < 0.05). Results Out of 5293 participants in the NHS 2009–10, 5276 subjects were included for analysis. The median age was 46 years (IQR 31–60), 59.4% women, a median of 10 years formal education (IQR 7–12) and an urban residence in 85.2% of the population of the NHS 2009–10. The observed population prevalence of people with cMSS was 42.6% (95% CI 40.4–44.9). Presence of cMSS is a risk factor for low HRQoL, exhibited both in the physical (OR 3.1 95% CI 2.7–3.5) and mental (OR 1.9 95% CI 1.6–2,) HRQoL dimensions, independent of control variables. Conclusions Physical and mental HRQoL are affected in people with cMSS, low educational level and advanced age. This is especially seen in women. This information will facilitate assessment and treatment of cMSS as a prevalent and multidimensional health problem.
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Affiliation(s)
| | - Manuel Vicente Mauri-Stecca
- Physical Therapy School, Universidad del Desarrollo, Avenida Plaza 680, Las Condes, Santiago, Chile.,Advanced Physical Therapy, 1917 Abbott Rd Suite 200, Anchorage, AK, 99507, USA
| | - Phillip S Sizer
- Department of Rehabilitation Sciences, Texas Tech University Health Sciences Center, School of Health Professions, 3601 4th St.; Room 2B138, Lubbock, TX, Zip 79430, USA
| | - Jaime Leppe
- Physical Therapy School, Universidad del Desarrollo, Avenida Plaza 680, Las Condes, Santiago, Chile.
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11
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Joypaul S, Kelly F, McMillan SS, King MA. Multi-disciplinary interventions for chronic pain involving education: A systematic review. PLoS One 2019; 14:e0223306. [PMID: 31577827 PMCID: PMC6774525 DOI: 10.1371/journal.pone.0223306] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 09/18/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND There have been growing recommendations to include education in multi-disciplinary interventions targeting chronic pain management. However, effects of this strategy on short- and long-term self-management of chronic pain, remain largely unexplored. OBJECTIVES 1. To provide an updated overview of studies that report on the impact of patient education in multi-disciplinary interventions, on self-management of chronic pain; 2. To explore associations between education and chronic pain self-management techniques; and 3. To identify the format and duration of suitable chronic pain interventions targeted at patient self-management. METHODS Design: Narrative systematic literature review of randomised or controlled study designs. Data Sources: PubMed, CINAHL, EMBASE, PsycINFO. Participants: Adult patients with chronic pain of any aetiology participating in multi-disciplinary programs that included education. Main outcome measures: Assessments of level of pain, function, quality of life, self-efficacy, self-management, and any other relevant assessments. Study Appraisal and Synthesis Methods: PRISMA guidelines, Cochrane Risk of Bias tool, and TIDieR model. RESULTS Database searching identified 485 potential papers. After removal of duplicates, and irrelevant articles by title and abstract, 120 full-text articles were reviewed and 27 studies were included in this systematic review. Studies were predominantly from the United States (n = 8; 29.6%). Over one hundred outcome measures were identified across all studies, with significant variation also observed in terms of how chronic pain duration was defined, and how education was delivered to participants. Overall, positive benefits of education were reported. CONCLUSIONS Education, as part of multi-disciplinary programs, is likely to improve self-management and self-efficacy in people with chronic pain of any aetiology. Heterogeneity in terms of: chronic pain duration; educational resources; healthcare professionals; and outcome measures, were identified as limitations. Further research, in the form of Randomised Controlled Trials addressing these limitations, is recommended.
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Affiliation(s)
- Shirdhya Joypaul
- School of Pharmacy and Pharmacology, Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Fiona Kelly
- School of Pharmacy and Pharmacology, Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Sara S. McMillan
- School of Pharmacy and Pharmacology, Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Michelle A. King
- School of Pharmacy and Pharmacology, Menzies Health Institute Queensland, Griffith University, Queensland, Australia
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12
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Basati G, Abbaszadeh S, Zebardast A, Teimouri H. Analgesic Medicinal Plants in Shahrekord, Southwest of Iran: An Ethnobotanical Study. Galen Med J 2019; 8:e1593. [PMID: 34466534 PMCID: PMC8343823 DOI: 10.31661/gmj.v8i0.1593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/14/2019] [Accepted: 07/25/2019] [Indexed: 12/05/2022] Open
Abstract
Background: Identification of indigenous medicinal plants, including the gathering of information regarding the uses of these plants can help find out their traditional pharmacological activities and their benefits for the community’s healthcare system. In this study, an ethnobotanical investigation was conducted in Shahrekord city, southwest of Iran to indicate the ethnobotanical knowledge about analgesic medicinal plants in the region and the methods of using them. Materials and Methods: To this end, plant antioxidants and analgesic medicinal plants were identified. For this purpose, a questionnaire was used to obtain indigenous knowledge from traditional therapists in Shahrekord regarding pain relief using medicinal plants. This ethnobotanical study was conducted in 2018 with the participation of 29 traditional therapists of the region under purpose. Finally, the data drawn from the questionnaires were analyzed using the Excel software. The frequency of plants use was also calculated. Results:
Our study showed that in Shahrekord, 23 species of medicinal plants are used to relieve pain. The highest frequency of use was obtained for Eugenia caryophylata (44%), followed by Alhagi maurorum (31%), Tribulus terrestris (27%), and angustifolia (24%). The Laminaceae family (7 species) was the most frequently used plant family for pain relief. The most frequently used plant organ to relieve the pain was flower (25%), followed by the stem (22%) and leaves (19%).
Conclusion: Given the high importance of medicinal plants in Shahrekord, the results of this study and additional scientific investigations can help produce more effective and less harmful drugs from medicinal plants.
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Affiliation(s)
- Gholam Basati
- Biotechnology and Medicinal Plants Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Saber Abbaszadeh
- Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
- Hepatitis Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Arqavan Zebardast
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Hassan Teimouri
- Department of Anesthesiology, Lorestan University of Medical Sciences, Khorramabad, Iran
- Correspondence to: Dr. Hassan Teimouri, Department of Anesthesiology, Lorestan University of Medical Sciences, Khorramabad, Iran Telephone Number: 00989161613226 Email Address:
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Latin American and Caribbean consensus on noninvasive central nervous system neuromodulation for chronic pain management (LAC 2-NIN-CP). Pain Rep 2019; 4:e692. [PMID: 30801041 PMCID: PMC6370142 DOI: 10.1097/pr9.0000000000000692] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Accepted: 09/05/2018] [Indexed: 12/16/2022] Open
Abstract
Supplemental Digital Content is Available in the Text. Introduction: Chronic pain (CP) is highly prevalent and generally undertreated health condition. Noninvasive brain stimulation may contribute to decrease pain intensity and influence other aspects related to CP. Objective: To provide consensus-based recommendations for the use of noninvasive brain stimulation in clinical practice. Methods: Systematic review of the literature searching for randomized clinical trials followed by consensus panel. Recommendations also involved a cost-estimation study. Results: The systematic review wielded 24 transcranial direct current stimulation (tDCS) and 22 repetitive transcranial magnetic stimulation (rTMS) studies. The following recommendations were provided: (1) Level A for anodal tDCS over the primary motor cortex (M1) in fibromyalgia, and level B for peripheral neuropathic pain, abdominal pain, and migraine; bifrontal (F3/F4) tDCS and M1 high-definition (HD)-tDCS for fibromyalgia; Oz/Cz tDCS for migraine and for secondary benefits such as improvement in quality of life, decrease in anxiety, and increase in pressure pain threshold; (2) level A recommendation for high-frequency (HF) rTMS over M1 for fibromyalgia and neuropathic pain, and level B for myofascial or musculoskeletal pain, complex regional pain syndrome, and migraine; (3) level A recommendation against the use of anodal M1 tDCS for low back pain; and (4) level B recommendation against the use of HF rTMS over the left dorsolateral prefrontal cortex in the control of pain. Conclusion: Transcranial DCS and rTMS are recommended techniques to be used in the control of CP conditions, with low to moderate analgesic effects, and no severe adverse events. These recommendations are based on a systematic review of the literature and a consensus made by experts in the field. Readers should use it as part of the resources available to decision-making.
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15
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Lakha SF, Pennefather P, Agboatwala M, Siddique SZ, Badr HE, Mailis-Gagnon A. Chronic Non-Cancer Pain Management Capacity in Karachi. Pain Ther 2017; 6:179-191. [PMID: 28555331 PMCID: PMC5693803 DOI: 10.1007/s40122-017-0072-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Indexed: 11/30/2022] Open
Abstract
Chronic non-cancer pain (CNCP) affects people everywhere in the world, but people in developing countries have far less access to therapies that provide relief. There are often missed opportunities to implement these therapies. Karachi shares many characteristics with megacities of the global south and represents Pakistan in the global city league. This review informs readers about the availability of health management and pain services for CNCP in Karachi, and their comparability to those found in other global cities. The literature about CNCP and its management in Karachi and Pakistan is scarce. Nevertheless, some conclusions can be made. In order to inform readers based in other global cities, a brief review of the current health system and pain services in Karachi and Pakistan are discussed together with barriers that impede pain service outputs. The present review employs vignettes to illustrate typical experiences of CNCP patients seeking pain management services in three sectors: public, charitable, and private institutions.
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Affiliation(s)
- S Fatima Lakha
- University of Toronto, Toronto, Canada.
- Centre for Study of Pain, University of Toronto, Toronto, Canada.
- Pain and Wellness Center, Toronto, Canada.
| | - Peter Pennefather
- University of Toronto, Toronto, Canada
- Centre for Study of Pain, University of Toronto, Toronto, Canada
| | | | | | | | - Angela Mailis-Gagnon
- University of Toronto, Toronto, Canada
- Centre for Study of Pain, University of Toronto, Toronto, Canada
- Pain and Wellness Center, Toronto, Canada
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Elzahaf RA, Johnson MI, Tashani OA. The epidemiology of chronic pain in Libya: a cross-sectional telephone survey. BMC Public Health 2016; 16:776. [PMID: 27514513 PMCID: PMC4982430 DOI: 10.1186/s12889-016-3349-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 07/22/2016] [Indexed: 01/11/2023] Open
Abstract
Background Chronic pain is a public health problem although there is a paucity of prevalence data from countries in the Middle East and North Africa. The aim of this study was to estimate the prevalence of chronic pain and neuropathic pain in a sample of the general adult population in Libya. Methods A cross-sectional telephone survey was conducted before the onset of the Libyan Civil War (February 2011) on a sample of self-declared Libyans who had a landline telephone and were at least 18 years of age. Random sampling of household telephone number dialling was undertaken in three major cities and interviews conducted using an Arabic version of the Structured Telephone Interviews Questionnaire on Chronic Pain previously used to collect data in Europe. In addition, an Arabic version of S-LANSS was used. 1212 individuals were interviewed (response rate = 95.1 %, mean age = 37.8 ± 13.9 years, female = 54.6 %). Results The prevalence of chronic pain ≥ 3 months was 19.6 % (95 % CI 14.6 % to 24.6 %) with a mean ± SD duration of pain of 6 · 5 ± 5 · 7 years and a higher prevalence for women. The prevalence of neuropathic pain in the respondents reporting chronic pain was 19 · 7 % (95 % CI 14 · 6-24 · 7), equivalent to 3 · 9 % (95 % CI 2 · 8 to 5 · 0 %) of the general adult population. Only, 71 (29 · 8 %) of respondents reported that their pain was being adequately controlled. Conclusions The prevalence of chronic pain in the general adult population of Libya was approximately 20 % and comparable with Europe and North America. This suggests that chronic pain is a public health problem in Libya. Risk factors are being a woman, advanced age and unemployment. There is a need for improved health policies in Libya to ensure that patients with chronic pain receive effective management.
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Affiliation(s)
- Raga A Elzahaf
- Centre for Pain Research, Faculty of Health and Social Sciences, Leeds Beckett University, Leeds, UK.,Leeds Pallium Research Group, Leeds, UK.,Faculty of Medical Technology, Derna, Libya
| | - Mark I Johnson
- Centre for Pain Research, Faculty of Health and Social Sciences, Leeds Beckett University, Leeds, UK. .,Leeds Pallium Research Group, Leeds, UK.
| | - Osama A Tashani
- Centre for Pain Research, Faculty of Health and Social Sciences, Leeds Beckett University, Leeds, UK.,Leeds Pallium Research Group, Leeds, UK.,University of Benghazi, Benghazi, Libya
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Abstract
Epidemiological data suggests that the prevalence of musculoskeletal and neuropathic pain increases with age until at least late mid-life, though the pattern is somewhat unclear beyond this point. And though the prevalence of some types of pain may peak in late midlife, pain is still a substantial and common complaint even in the oldest age groups. This article provides an overview of later-life pain and includes a brief review of its epidemiology, describes commonly encountered barriers to its management, and discusses guidelines and recommended approaches to its assessment and management.
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Affiliation(s)
- Steven M Savvas
- Clinical Division, National Ageing Research Institute, 34-48 Poplar Road, Parkville, Victoria 3052, Australia.
| | - Stephen J Gibson
- Clinical Division, National Ageing Research Institute, 34-48 Poplar Road, Parkville, Victoria 3052, Australia
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Leung L, Han H, Martin M, Kotecha J. Mindfulness-based stress reduction (MBSR) as sole intervention for non-somatisation chronic non-cancer pain (CNCP): protocol for a systematic review and meta-analysis of randomised controlled trials. BMJ Open 2015; 5:e007650. [PMID: 25986638 PMCID: PMC4442214 DOI: 10.1136/bmjopen-2015-007650] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Chronic non-cancer pain (CNCP) affects up to 50% of the world's population. It impacts negatively on quality of life; entailing high costs on our medical systems, and translates to economic burden due to work loss. Aetiology of CNCP is complex and multifactorial, embracing the somatosensory, cognitive and affective domains. Opioid analgesia and other invasive interventions are often inadequate for clinical management of CNCP. Recently, mindfulness-based stress reduction (MBSR) has become a popular therapy for various medical conditions, including CNCP. However, studies reported varying efficacies, and relevant systematic reviews have included clinical trials with inherent heterogeneity either in study conditions or types of interventions used. Our study aims to provide an updated and more critical evaluation of the efficacy of MBSR as the intervention for non-somatisation CNCP. METHODS AND ANALYSIS A systematic review with meta-analysis of randomised controlled trials published in English will be performed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines and the Cochrane Collaboration format. MEDLINE, EMBASE, PsychINFO, and the Cochrane Central Register of Controlled Trials Intervention, will be searched independently by reviewers using defined MeSH terms. Studies with full texts using MBSR as the main intervention on patients with non-somatising CNCP will be included. Outcome measures include pain scores and disability assessment scales. Continuous data will be meta-analysed using the RevMan 5 Review Manager programme. Primary analysis will adopt the random effects model in view of heterogeneity between trials. The standardised mean difference will be expressed as the effect size with 95% CIs. Forest plots, funnel plots, the I(2) statistic and the Cochrane Risks of Bias Assessment table will be included. ETHICS AND DISSEMINATION No ethics approval is deemed necessary. Results of this study will be disseminated via peer-reviewed publications and scientific meetings. TRIALS REGISTRATION NUMBER PROSPERO CRD42014015568.
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Affiliation(s)
- Lawrence Leung
- Department of Family Medicine, Queen's University, Kingston, Ontario, Canada
- Centre of Studies in Primary Care, Queen's University, Kingston, Ontario, Canada
- School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Han Han
- Centre of Studies in Primary Care, Queen's University, Kingston, Ontario, Canada
| | - Mary Martin
- Centre of Studies in Primary Care, Queen's University, Kingston, Ontario, Canada
| | - Jyoti Kotecha
- Centre of Studies in Primary Care, Queen's University, Kingston, Ontario, Canada
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