The Clinical journal of pain
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Randomized Controlled Trial Meta Analysis
NGX-4010, a capsaicin 8% dermal patch, administered alone or in combination with systemic neuropathic pain medications, reduces pain in patients with postherpetic neuralgia.
Analyses of integrated data from 4 controlled postherpetic neuralgia studies evaluated the effect of NGX-4010, a capsaicin 8% patch, administered alone or together with systemic neuropathic pain medications. ⋯ A single 60-minute NGX-4010 treatment reduces PHN for up to 12 weeks regardless of concomitant systemic neuropathic pain medication use.
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Review Meta Analysis
Educational interventions by pharmacists to patients with chronic pain: systematic review and meta-analysis.
We hypothesized that educational interventions delivered by pharmacists to patients with chronic pain might improve pain-related outcomes and sought to establish "proof of concept" for this hypothesis. ⋯ Pharmacist-delivered educational interventions seem to reduce adverse events and improve satisfaction, but their clinical benefit on pain intensity is debatable. Our analysis suggests that the role of pharmacists may be important but a deeper understanding and evaluation of the active components of these interventions is needed within clinical trials before wider implementation into clinical practice can be recommended.
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It is likely that people with chronic pain who have low self-efficacy have a worse prognosis. A standard, high-quality measure of self-efficacy in such populations would improve evidence, by allowing meaningful comparisons amongst subgroups and between treatments, and by facilitating pooling across studies in systematic reviews. ⋯ Further research should focus on assessing responsiveness and interpretability of these questionnaires. Researchers should select questionnaires that are most appropriate for their study aims and population and contribute to further validation of these scales. Future research should measure outcome expectancy alongside self-efficacy to best predict future behavior.
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Review Meta Analysis
The association between chronic low back pain and sleep: a systematic review.
chronic low back pain (CLBP) adversely affects many quality of life components, and is reported to impair sleep. The aim of this review was to determine the association between CLBP and sleep. ⋯ many dimensions of sleep are adversely associated with CLBP. Management strategies for CLBP need to address these to maximize quality of life in this patient cohort.
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Meta Analysis
Predictors of placebo response in pooled lamotrigine neuropathic pain clinical trials.
One limitation of neuropathic pain clinical trials is the often large and variable extent of response in the placebo group, possibly obscuring true medication effects. We pooled data from 252 individuals in the placebo arms of 3 clinical trials of lamotrigine in patients with neuropathic pain to examine the relationship of baseline patient and study site characteristics with 12-week change in the Pain Intensity Numerical Rating Scale score (DeltaPI-NRS). The 574 patients in the pooled lamotrigine treatment arms were used as a replication dataset. ⋯ These results suggest that both patient and study site characteristics can influence the response in the placebo arms of neuropathic pain studies.