Articles: pain.
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Review Meta Analysis
How effective are patient-based educational interventions in the management of cancer pain? Systematic review and meta-analysis.
This review aimed to quantify the benefit of patient-based educational interventions in the management of cancer pain. We undertook a systematic review and meta-analysis of experimentally randomised and non-randomised controlled clinical trials identified from six databases from inception to November 2007. Two reviewers independently selected trials comparing intervention (formal instruction on cancer pain and analgesia on an individual basis using any medium) to usual care or other control in adults with cancer pain. ⋯ Compared to usual care or control, educational interventions improved knowledge and attitudes by half a point on 0-5 rating scale (weighted mean difference 0.52, 95% confidence interval 0.04-1.0), reduced average pain intensity by over one point on 0-10 rating scale (WMD -1.1, -1.8 to -0.41) and reduced worst pain intensity by just under one point (WMD -0.78, -1.21 to -0.35). We found equivocal evidence for the effect of education on self-efficacy, but no significant benefit on medication adherence or on reducing interference with daily activities. Patient-based educational interventions can result in modest but significant benefits in the management of cancer pain, and are probably underused alongside more traditional analgesic approaches.
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ANZ journal of surgery · Jun 2009
Review Meta AnalysisNeedlescopic versus laparoscopic cholecystectomy: a meta-analysis.
To systematically analyse clinical trials on needlescopic (NC) versus laparoscopic cholecystectomy (LC) that evaluated the effectiveness of both procedures for the management of cholelithiasis. ⋯ NC is a safe and effective procedure for the management of gallstone disease. NC is as effective as LC for perioperative complications and total stay in hospital. NC is superior to LC for less post-operative pain and better cosmetic results. NC is associated with longer operative time and higher conversion rate.
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Review Meta Analysis
The diagnostic accuracy of brief screening questions for psychosocial risk factors of poor outcome from an episode of pain: A systematic review.
To determine the diagnostic accuracy of brief screening questions for psychosocial risk factors predictive of poor outcome from an episode of pain. ⋯ Data were only available on the accuracy of brief screening instruments for depression and anxiety, and there was variability in the results. Head-to-head studies are required to determine if this variability reflects differential question accuracy or population characteristics, and studies that determine the diagnostic accuracy of brief screening questions for other common psychosocial risk factors would be useful.
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Gen Hosp Psychiatry · May 2009
Review Meta AnalysisPharmacotherapy of chronic pain: a synthesis of recommendations from systematic reviews.
Chronic pain is one of the most prevalent, costly and disabling conditions in both clinical practice and the workplace, yet often remains inadequately treated. Moreover, chronic pain commonly co-occurs with depression, anxiety and somatoform disorders, and adversely affects response of these conditions to psychiatric treatments. This article provides an evidence-based approach to the pharmacotherapy of chronic pain. ⋯ A number of medications have proven effective in chronic pain disorders and their use individually or in combination should improve the management of chronic pain.
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Cochrane Db Syst Rev · Apr 2009
Review Meta AnalysisSingle dose oral etoricoxib for acute postoperative pain in adults.
Etoricoxib is a selective cyclo-oxygenase-2 (COX-2) inhibitor prescribed for the relief of chronic pain in osteoarthritis and rheumatoid arthritis, and acute pain. The drug is believed to be associated with fewer upper gastrointestinal adverse effects than conventional non-steroidal anti-inflammatory drugs (NSAIDs). A number of studies in acute postoperative pain have now been published. ⋯ Single dose oral etoricoxib produces high levels of good quality pain relief after surgery. The 120 mg dose is as effective as, or better than, other commonly used analgesics.