Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Pain Treatments for Nursing Home Residents with Advanced Dementia and Substantial Impaired Communication: A Cross-Sectional Analysis at Baseline of a Cluster Randomized Controlled Trial.
This is a cross-sectional analysis at baseline of a cluster randomized controlled trial to identify factors associated with the use of pharmacological and nonpharmacological pain treatments by nursing home residents with dementia and impaired communication. ⋯ Suboptimal pain management was common among this population. Severe impairment in the ability to communicate is a major reason for the underuse of pain medications. Staff may become desensitized and fail to perceive subtle changes in the residents' behavior as indicative of pain, leading to the underadministering of nonpharmacological treatments. To improve this situation, it is suggested that observational pain assessments be systematically carried out in nursing homes.
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Randomized Controlled Trial
Pain Among Community-Dwelling Older Adults with Dementia: Factors Associated with Undertreatment.
To identify factors associated with no analgesic treatment in community-dwelling older adults with mild-to-moderate dementia and moderate-to-severe pain. ⋯ The initiation of analgesic trials is complicated for individuals with dementia and comorbid pain and depressive symptomology. Future research should focus on identifying the most effective assessment and treatment procedures to best direct clinical care for this population.
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Randomized Controlled Trial
Evoked Pressure Pain Sensitivity Is Associated with Differential Analgesic Response to Verum and Sham Acupuncture in Fibromyalgia.
Fibromyalgia is a chronic pain condition with few effective treatments. Many fibromyalgia patients seek acupuncture for analgesia; however, its efficacy is limited and not fully understood. This may be due to heterogeneous pathologies among participants in acupuncture clinical trials. We hypothesized that pressure pain tenderness would differentially classify treatment response to verum and sham acupuncture in fibromyalgia patients. ⋯ These findings suggest that acupuncture efficacy in fibromyalgia may be underestimated and a more personalized treatment for fibromyalgia may also be possible.
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Randomized Controlled Trial
Effect of Repetitive Intracutaneous Injections with Local Anesthetics and Steroids for Acute Thoracic Herpes Zoster and Incidence of Postherpetic Neuralgia.
Treatment of established postherpetic neuralgia (PHN) is difficult and often disappointing. In this study, we assessed the efficacy of repetitive intracutaneous injections with local anesthetics and steroids in acute thoracic herpes zoster (HZ) pain, herpetic eruption, and incidence of PHN. ⋯ Repetitive intracutaneous injections with local anesthetics and steroids along with standard treatment significantly reduce the duration of pain and herpetic eruption and incidence of PHN.
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Randomized Controlled Trial Multicenter Study
Reliability and Construct Validity of the Patient-Reported Outcomes Measurement Information System (PROMIS) Instruments in Women with Fibromyalgia.
The Patient-Reported Outcomes Measurement Information System (PROMIS) was developed to standardize measurement of clinically relevant patient-reported outcomes. This study evaluated the reliability and construct validity of select PROMIS static short-form (SF) instruments in women with fibromyalgia. ⋯ Select PROMIS static SF instruments demonstrate convergent validity with the FIQR, a legacy measure of fibromyalgia disease severity. These results highlight the potential utility of select PROMIS static SFs for assessment and tracking of patient-reported outcomes in fibromyalgia.