scholarly journals Evaluation of Phenotypic and Genotypic Variations of Drug Metabolising Enzymes and Transporters in Chronic Pain Patients Facing Adverse Drug Reactions or Non-Response to Analgesics: A Retrospective Study

2020 ◽  
Vol 10 (4) ◽  
pp. 198
Author(s):  
Victoria Rollason ◽  
Célia Lloret-Linares ◽  
Kuntheavy Ing Lorenzini ◽  
Youssef Daali ◽  
Marianne Gex-Fabry ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Retrospective Study ◽  
Cytochromes P450 ◽  
Response To Treatment ◽  
Glycoprotein P ◽  
Chronic Pain Patients ◽  
Comt Activity ◽  
Pain Center ◽  
Pain Patients ◽  
Drug Metabolising Enzymes

This retrospective study evaluates the link between an adverse drug reaction (ADR) or a non-response to treatment and cytochromes P450 (CYP), P-glycoprotein (P-gp) or catechol-O-methyltransferase (COMT) activity in patients taking analgesic drugs for chronic pain. Patients referred to a pain center for an ADR or a non-response to an analgesic drug between January 2005 and November 2014 were included. The genotype and/or phenotype was obtained for assessment of the CYPs, P-gp or COMT activities. The relation between the event and the result of the genotype and/or phenotype was evaluated using a semi-quantitative scale. Our analysis included 243 individual genotypic and/or phenotypic explorations. Genotypes/phenotypes were mainly assessed because of an ADR (n = 145, 59.7%), and the majority of clinical situations were observed with prodrug opioids (n = 148, 60.9%). The probability of a link between an ADR or a non-response and the genotypic/phenotypic status of the patient was evaluated as intermediate to high in 40% and 28.2% of all cases, respectively. The drugs in which the probability of an association was the strongest were the prodrug opioids, with an intermediate to high link in 45.6% of the cases for occurrence of ADRs and 36.0% of the cases for non-response. This study shows that the genotypic and phenotypic approach is useful to understand ADRs or therapeutic resistance to a usual therapeutic dosage, and can be part of the evaluation of chronic pain patients.

scholarly journals Experience of Methadone Therapy in 100 Consecutive Chronic Pain Patients in a Multidisciplinary Pain Center

Pain Medicine ◽  
2008 ◽  
Vol 9 (7) ◽  
pp. 786-794 ◽  
Author(s):  
Philip Peng ◽  
Paul Tumber ◽  
Michael Stafford ◽  
Doug Gourlay ◽  
Patrick Wong ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Chronic Pain Patients ◽  
Pain Center ◽  
Pain Patients ◽  
Multidisciplinary Pain Center

Prediction of Pain Center Treatment Outcome for Geriatric Chronic Pain Patients

1994 ◽  
Vol 10 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Robert B. Cutler ◽  
David A. Fishbain ◽  
Ying Lu ◽  
Renée Steele Rosomoff ◽  
Hubert L. Rosomoff
Keyword(s):  
Chronic Pain ◽  
Treatment Outcome ◽  
Chronic Pain Patients ◽  
Pain Center ◽  
Pain Patients

scholarly journals Hypnotic approach for chronic pain patients in a multidisciplinary pain center

PAIN RESEARCH ◽  
2017 ◽  
Vol 32 (3) ◽  
pp. 191-202
Author(s):  
Miyuki Mizutani ◽  
Takahiro Ushida ◽  
Makoto Nishihara
Keyword(s):  
Chronic Pain ◽  
Chronic Pain Patients ◽  
Pain Center ◽  
Pain Patients ◽  
Multidisciplinary Pain Center

Clinical Update: The Impairment Impact Inventory: Comparison of Responses by Treatment-seekers and Claimants Undergoing Independent Medical Examinations

2005 ◽  
Vol 10 (1) ◽  
pp. 6-7
Author(s):  
Dennis C. Turk ◽  
James P. Robinson ◽  
Mary Aulet
Keyword(s):  
Chronic Pain ◽  
Burden Of Illness ◽  
Scientific Basis ◽  
Medical Evaluation ◽  
Independent Medical Evaluation ◽  
Chronic Pain Patients ◽  
Pain Center ◽  
Independent Medical Examinations ◽  
Medical Examinations ◽  
Pain Patients

Abstract In the adversarial setting of an independent medical evaluation (IME), claimants may be incentivized to exaggerate the severity of their problems. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) describes a protocol for assessing impairment associated with chronic pain, including the Impairment Impact Inventory (I3) that consists of 26 items that assess the burden of illness in three domains: pain intensity, interference with activities of daily living, and emotional distress. A study was performed to establish preliminary norms for the I3 and to compare responses of claimants undergoing IMEs with those of treatment-seeking chronic pain patients: 183 patients completed the I3, including fibromyalgia syndrome patients (FMS group), 35 multidisciplinary pain center patients (PC group), and 72 claimants undergoing IMEs. Patients in the latter two groups had a variety of chronic pain problems (and hypothetically may be more likely to exaggerate their problems). The three groups had similar mean scores on the total I3 and for each of the FMS, PC, and IME groups. Results support the hypothesis that participants, in aggregate, do not exaggerate their pain when they undergo IMEs, although some quite possibly do. These results are a step toward establishing a scientific basis for the impairment rating system described in the AMA Guides from consensus-based rules to an evidence-based system for making decisions about impairment.

scholarly journals Cognitive factors associated with locomotive syndrome in chronic pain patients: A retrospective study

2020 ◽  
Author(s):  
Hironori Tsuji ◽  
Tomoko Tetsunaga ◽  
Tomonori Tetsunaga ◽  
Haruo Misawa ◽  
Keiichiro Nishida ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Retrospective Study ◽  
Cognitive Factors ◽  
Locomotive Syndrome ◽  
Factors Associated ◽  
Chronic Pain Patients ◽  
Pain Patients
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