Evaluation of spin in the abstracts of systematic reviews focused on analgesic opioids for non-cancer chronic pain management: A cross sectional analysis (Preprint)

2021 ◽  
Author(s):  
Analise Claassen ◽  
Jonathan Staheli ◽  
Ryan Ottwell ◽  
Wade Arthur ◽  
Will Roberts ◽  
...  

BACKGROUND Patients with chronic, non-cancer pain are frequently prescribed opioids, often due to favourable results from systematic reviews. However, even studies with high-quality evidence can suffer from spin, which includes misleading reporting, interpretation, and extrapolation of study results. OBJECTIVE This study evaluated spin in systematic review abstracts concerning analgesic opioids for non-cancer, chronic pain management and the relationship between its presence and study characteristics. METHODS We searched MEDLINE and Embase for systematic reviews pertaining to analgesic opioids for non-cancer, chronic pain management. Screening and data extraction were done in a masked, duplicate fashion. Abstracts were evaluated for the presence of the nine most-severe types of spin. RESULTS Our search returned 1,109 articles; of which, 53 systematic reviews met our eligibility criteria. We found at least one type of spin in 30.2% of the included systematic review abstracts. Spin type 5 was the most common type of spin in our sample and occurred in 17% of abstracts. Spin types 1, 2, 4, 6, and 8 were not detected. Abstracts of systematic reviews published in journals that recommend PRISMA adherence were 9.33 times more likely to contain spin compared to those published in journals without specific PRISMA guidelines. The remaining study characteristics were not significantly associated with spin. CONCLUSIONS Our results showed that nearly one-third of the 53 included systematic reviews contained at least one type of spin in their abstract. Based on our results, systematic reviews about managing chronic, non-cancer pain with opioids require improvements in their abstract reporting.

2018 ◽  
Vol 19 (8) ◽  
pp. 960-972 ◽  
Author(s):  
Daniele Nascimento Gouveia ◽  
Lícia Tairiny Santos Pina ◽  
Thallita Kelly Rabelo ◽  
Wagner Barbosa da Rocha Santos ◽  
Jullyana Souza Siqueira Quintans ◽  
...  

2021 ◽  
Vol 8 ◽  
pp. 205435812199399
Author(s):  
Sara N. Davison ◽  
Sarah Rathwell ◽  
Sunita Ghosh ◽  
Chelsy George ◽  
Ted Pfister ◽  
...  

Background: Chronic pain is a common and distressing symptom reported by patients with chronic kidney disease (CKD). Clinical practice and research in this area do not appear to be advancing sufficiently to address the issue of chronic pain management in patients with CKD. Objectives: To determine the prevalence and severity of chronic pain in patients with CKD. Design: Systematic review and meta-analysis. Setting: Interventional and observational studies presenting data from 2000 or later. Exclusion criteria included acute kidney injury or studies that limited the study population to a specific cause, symptom, and/or comorbidity. Patients: Adults with glomerular filtration rate (GFR) category 3 to 5 CKD including dialysis patients and those managed conservatively without dialysis. Measurements: Data extracted included title, first author, design, country, year of data collection, publication year, mean age, stage of CKD, prevalence of pain, and severity of pain. Methods: Databases searched included MEDLINE, CINAHL, EMBASE, and Cochrane Library, last searched on February 3, 2020. Two reviewers independently screened all titles and abstracts, assessed potentially relevant articles, and extracted data. We estimated pooled prevalence of overall chronic pain, musculoskeletal pain, bone/joint pain, muscle pain/soreness, and neuropathic pain and the I2 statistic was computed to measure heterogeneity. Random effects models were used to account for variations in study design and sample populations and a double arcsine transformation was used in the model calculations to account for potential overweighting of studies reporting either very high or very low prevalence measurements. Pain severity scores were calibrated to a score out of 10, to compare across studies. Weighted mean severity scores and 95% confidence intervals were reported. Results: Sixty-eight studies representing 16 558 patients from 26 countries were included. The mean prevalence of chronic pain in hemodialysis patients was 60.5%, and the mean prevalence of moderate or severe pain was 43.6%. Although limited, pain prevalence data for peritoneal dialysis patients (35.9%), those managed conservatively without dialysis (59.8%), those following withdrawal of dialysis (39.2%), and patients with earlier GFR category of CKD (61.2%) suggest similarly high prevalence rates. Limitations: Studies lacked a consistent approach to defining the chronicity and nature of pain. There was also variability in the measures used to determine pain severity, limiting the ability to compare findings across populations. Furthermore, most studies reported mean severity scores for the entire cohort, rather than reporting the prevalence (numerator and denominator) for each of the pain severity categories (mild, moderate, and severe). Mean severity scores for a population do not allow for “responder analyses” nor allow for an understanding of clinically relevant pain. Conclusions: Chronic pain is common and often severe across diverse CKD populations providing a strong imperative to establish chronic pain management as a clinical and research priority. Future research needs to move toward a better understanding of the determinants of chronic pain and to evaluating the effectiveness of pain management strategies with particular attention to the patient outcomes such as overall symptom burden, physical function, and quality of life. The current variability in the outcome measures used to assess pain limits the ability to pool data or make comparisons among studies, which will hinder future evaluations of the efficacy and effectiveness of treatments. Recommendations for measuring and reporting pain in future CKD studies are provided. Trial registration: PROSPERO Registration number CRD42020166965


Author(s):  
Parbati Thapa ◽  
Shaun Wen Huey Lee ◽  
Bhuvan KC ◽  
Juman Abdulelah Dujaili ◽  
Mohamed Izham Mohamed Ibrahim ◽  
...  

2021 ◽  
Vol 2021 (1) ◽  
pp. 11391
Author(s):  
Karleen F. Giannitrapani ◽  
Natalie Connell ◽  
Pallavi Prathivadi ◽  
Sophia Zupanc ◽  
Hong-Nei Wong ◽  
...  

2020 ◽  
pp. 204946372094034
Author(s):  
Anna Hurley-Wallace ◽  
Daniel E Schoth ◽  
Suzanne Lilley ◽  
Glyn Williams ◽  
Christina Liossi

Background: Adolescent chronic pain is prevalent, and interdisciplinary treatment is recommended. Although it is well known that technology is a key part of adolescents’ daily lives, there have not been any online, interdisciplinary interventions developed for adolescents with chronic pain in a UK healthcare context. Little is known about how adolescents currently use online resources to manage chronic pain, or what guidance they seek. Methods: Ninety-five participants from the community answered this mixed-methods, online survey (adolescent n = 54, parent n = 41), which assessed the needs of UK-based adolescents for a new online chronic pain management resource. Results: Findings indicated that, at the time of the survey, adolescents frequently used social media platforms, such as Instagram, for chronic pain management. Desired techniques for a new interdisciplinary resource for adolescents included ‘advice on explaining chronic pain to others’ (86.7% of adolescents) and sleep hygiene (82.2% of adolescents), though access to a range of pain management techniques was desired. Qualitative results indicated endorsement of a new programme by adolescents and parents. Conclusions: Adolescents and parents had a positive outlook towards the development of a UK-specific online resource to help manage chronic pain. Such an intervention should aim to be made accessible via the National Health Service. Adolescent use of social media platforms to seek support for chronic pain requires further exploration in future research.


2019 ◽  
Vol 51 (1) ◽  
pp. 2-10 ◽  
Author(s):  
J Oosterhaven ◽  
H Wittink ◽  
J Mollema ◽  
C Kruitwagen ◽  
W Devillé

2019 ◽  
Vol 15 (2) ◽  
pp. 147-158 ◽  
Author(s):  
Tony O’Brien, MB, FRCPI ◽  
Jin Seok Ahn, MD ◽  
Richard Chye, MBBS, FRACP, FFPMANZCA, FAChPM ◽  
Brian Le, MBBS (Hons), MPH, FRACP, FAChPM ◽  
Henry Lu, MD, DABPN, DPBPM ◽  
...  

Transdermal buprenorphine (TDB) has demonstrated effectiveness in treating a range of chronic pain conditions, including cancer pain, nociceptive pain, and neuropathic pain and has a favorable safety profile. Worldwide, clinical experience of its use is relatively limited. There is considerable misunderstanding about the pharmacology, mechanism of action, and safety of buprenorphine. There is also limited guidance on the appropriate use of TDB for chronic pain management. This article presents an overview of TDB and also provides practical recommendations for its use as part of a multifaceted strategy in chronic cancer and non-cancer pain.


Author(s):  
MLA Moabelo ◽  
R Parker

Background: Neuropathic pain (NP), defined as pain caused by a lesion or disease of the somatosensory system, affects 6.9–10% of people worldwide. Pregabalin is currently recommended as a first line drug for NP in South Africa. Methods: A cross-sectional, retrospective, descriptive medicines usage evaluation (MUE) of pregabalin at Groote Schuur Hospital (GSH) Chronic Pain Management Clinic for the year 2017 was conducted. A MUE using a standardised data collection form was performed on 100 randomly selected patient folders. Data was summarised using descriptive statistics. Results: The majority of cases were women (76) with a mean age of 55.9 years (SD12.49). A diagnosis of NP was recorded in 58 folders and a “possible” diagnosis recorded in 7 folders. In 79 cases there was no mention of a tool/method used to diagnose NP. The most common condition diagnosed was chronic postsurgical pain with a neuropathic component (n = 16), followed by NP (n = 15). The most common initiating and current dose of pregabalin was 75 mg twice daily. In 56 patients, pregabalin was prescribed in conjunction with a tricyclic antidepressant (TCA) or selective noradrenaline reuptake inhibitor (SNRI). Patient education was documented as having taken place in 76 of cases. Conclusions: Based on this MUE we recommend the use of screening tools for the diagnosis of neuropathic pain, and a focus on the initiating dose of pregabalin. The use of a standardised assessment document and the interdisciplinary team input at this clinic appears to optimise prescribing of pregabalin in line with practice guidelines.


2019 ◽  
Vol 123 (2) ◽  
pp. e359-e371 ◽  
Author(s):  
Christina Liossi ◽  
Lauren Johnstone ◽  
Suzanne Lilley ◽  
Line Caes ◽  
Glyn Williams ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document