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  • 1
    Online Resource
    Online Resource
    Operationalization of the new Pain and Disability Drivers Management model: A modified Delphi survey of multidisciplinary pain management experts
    Wiley ; 2020
    In:  Journal of Evaluation in Clinical Practice Vol. 26, No. 1 ( 2020-02), p. 316-325
    Details
    In: Journal of Evaluation in Clinical Practice, Wiley, Vol. 26, No. 1 ( 2020-02), p. 316-325
    Abstract: We recently proposed the Pain and Disability Drivers Management (PDDM) model, which was designed to outline comprehensive factors driving pain and disability in low back pain (LBP). Although we have hypothesized and proposed 41 elements, which make up the model's five domains, we have yet to assess the external validity of the PDDM's elements by expert consensus. Research objectives This study aimed to reach consensus among experts regarding the different elements that should be included in each domain of the PDDM model. Relevance The PDDM may assist clinicians and researchers in the delivery of targeted care and ultimately enhance treatment outcomes in LBP. Methods Using a modified Delphi survey, a two‐round online questionnaire was administered to a group of experts in musculoskeletal pain management. Participants were asked to rate the relevance of each element proposed within the model. Participants were also invited to add and rate new elements. Consensus was defined by a greater than or equal to 75% level of agreement. Results A total of 47 (round 1) and 33 (round 2) participants completed the survey. Following the first round, 38 of 41 of the former model elements reached consensus, and 10 new elements were proposed and later rated in the second round. Following this second round, consensus was reached for all elements (10 new + 3 from first round), generating a final model composed of 51 elements. Conclusion This expert consensus–derived list of clinical elements related to the management of LBP represents a first step in the validation of the PDDM model.
    Type of Medium: Online Resource
    ISSN: 1356-1294 , 1365-2753
    URL: Issue
    URL: Article
    DOI: 10.1111/jep.v26.1
    DOI: 10.1111/jep.13190
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2006772-0
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  • 2
    Online Resource
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    Interdisciplinary strategies to prevent long-term and detrimental opioid use following trauma: a stakeholder consensus study
    Oxford University Press (OUP) ; 2023
    In:  Pain Medicine Vol. 24, No. 8 ( 2023-08-01), p. 933-940
    Details
    In: Pain Medicine, Oxford University Press (OUP), Vol. 24, No. 8 ( 2023-08-01), p. 933-940
    Abstract: Prolonged opioid use is common following traumatic injuries. Although preventive strategies have been recommended, the evidence supporting their use is low. The objectives of this study were to select interdisciplinary strategies to prevent long-term, detrimental opioid use in trauma patients for further evaluation and to identify implementation considerations. Design A consensus study using the nominal group technique. Setting Four trauma systems in Canada. Subjects Participants included expert clinicians and decision makers, and people with lived experience. Methods Participants had to discuss the relevance and implementation of 15 strategies and then rank them using a 7-point Likert scale. Implementation considerations were identified through a synthesis of discussions. Results A total of 41 expert stakeholders formed the nominal groups. Overall, eight strategies were favored: 1) using multimodal approach for pain management, 2) professional follow-up in physical health, 3) assessment of risk factors for opioid misuse, 4) physical stimulation, 5) downward adjustment of opioids based on patient recovery, 6) educational intervention for patients, 7) training offered to professionals on how to prescribe opioids, and 8) optimizing communication between professionals working in different settings. Discussions with expert stakeholders revealed the rationale for the selected strategies and identified issues to consider when implementing them. Conclusion This stakeholder consensus study identified, for further scientific study, a set of interdisciplinary strategies to promote appropriate opioid use following traumatic injuries. These strategies could ultimately decrease the burden associated with long-term opioid use.
    Type of Medium: Online Resource
    ISSN: 1526-2375 , 1526-4637
    URL: Article
    DOI: 10.1093/pm/pnad037
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2023869-1
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  • 3
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    Opioid versus opioid-free analgesia after surgical discharge: protocol for a systematic review and meta-analysis
    BMJ ; 2020
    In:  BMJ Open Vol. 10, No. 1 ( 2020-01), p. e035443-
    Details
    In: BMJ Open, BMJ, Vol. 10, No. 1 ( 2020-01), p. e035443-
    Abstract: Excessive prescribing after surgery has contributed to a public health crisis of opioid addiction and overdose in North America. However, the value of prescribing opioids to manage postoperative pain after surgical discharge remains unclear. We propose a systematic review and meta-analysis to assess the extent to which opioid analgesia impact postoperative pain intensity and adverse events in comparison to opioid-free analgesia in patients discharged after surgery. Methods and analysis Major electronic databases (MEDLINE, Embase, Cochrane Library, Scopus, AMED, BIOSIS, CINAHL and PsycINFO) will be searched for multi-dose randomised-trials examining the comparative effectiveness of opioid versus opioid-free analgesia after surgical discharge. Studies published from January 1990 to July 2019 will be targeted, with no language restrictions. The search will be re-run before manuscript submission to include most recent literature. We will consider studies involving patients undergoing minor and major surgery. Teams of reviewers will, independently and in duplicate, assess eligibility, extract data and evaluate risk of bias. Our main outcomes of interest are pain intensity and postoperative vomiting. Study results will be pooled using random effects models. When trials report outcomes for a common domain (eg, pain intensity) using different scales, we will convert effect sizes to a common standard metric (eg, Visual Analogue Scale). Minimally important clinical differences reported in previous literature will be considered when interpreting results. Subgroup analyses defined a priori will be conducted to explore heterogeneity. Risk of bias will be assessed according to the Cochrane Collaboration's Risk of Bias Tool 2.0. The quality of evidence for all outcomes will be evaluated using the GRADE rating system. Ethics and dissemination Ethical approval is not required since this is a systematic review of published studies. Our results will be published in a peer-reviewed journal and presented at relevant conferences. Further knowledge dissemination will be sought via public and patient organisations focussed on pain and opioid-related harms.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2019-035443
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2599832-8
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  • 4
    Online Resource
    Online Resource
    The stress model of chronic pain: evidence from basal cortisol and hippocampal structure and function in humans
    Oxford University Press (OUP) ; 2013
    In:  Brain Vol. 136, No. 3 ( 2013-03), p. 815-827
    Details
    In: Brain, Oxford University Press (OUP), Vol. 136, No. 3 ( 2013-03), p. 815-827
    Type of Medium: Online Resource
    ISSN: 0006-8950 , 1460-2156
    URL: Article
    DOI: 10.1093/brain/aws371
    RVK:
    XA 10000
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2013
    detail.hit.zdb_id: 1474117-9
    SSG: 12
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  • 5
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    Online Resource
    The Expression of Pain Behaviors in High Catastrophizers: The Influence of Automatic and Controlled Processes
    Elsevier BV ; 2012
    In:  The Journal of Pain Vol. 13, No. 8 ( 2012-08), p. 808-815
    Details
    In: The Journal of Pain, Elsevier BV, Vol. 13, No. 8 ( 2012-08), p. 808-815
    Type of Medium: Online Resource
    ISSN: 1526-5900
    URL: Article
    DOI: 10.1016/j.jpain.2012.05.015
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2012
    detail.hit.zdb_id: 2040378-1
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  • 6
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    Online Resource
    Stratégies pour éviter l’utilisation à long terme des opioïdes après un traumatisme : enquête sur les pratiques canadiennes
    Springer Science and Business Media LLC ; 2023
    In:  Canadian Journal of Anesthesia/Journal canadien d'anesthésie Vol. 70, No. 1 ( 2023-01), p. 87-99
    Details
    In: Canadian Journal of Anesthesia/Journal canadien d'anesthésie, Springer Science and Business Media LLC, Vol. 70, No. 1 ( 2023-01), p. 87-99
    Type of Medium: Online Resource
    ISSN: 0832-610X , 1496-8975
    URL: Article
    DOI: 10.1007/s12630-022-02328-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2050416-0
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  • 7
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    Development and validation of the Treatment Expectations in Chronic Pain Scale
    Wiley ; 2019
    In:  British Journal of Health Psychology Vol. 24, No. 3 ( 2019-09), p. 610-628
    Details
    In: British Journal of Health Psychology, Wiley, Vol. 24, No. 3 ( 2019-09), p. 610-628
    Abstract: To develop and examine the psychometric properties of the Treatment Expectations in Chronic Pain (TEC) scale, a brief measure of treatment expectations of chronic non‐cancer pain treatment. Design A cross‐sectional study design was used. Methods After conducting a literature review and expert discussions, a preliminary version of the TEC scale was developed. Cognitive interviews with 10 clinicians and 14 patients were conducted to examine the scale's face validity and item wording. Last, two hundred and five patients on the waitlist for a multidisciplinary pain treatment centre completed a battery of self‐report questionnaires to examine the TEC scale's reliability and construct validity. Mokken scale analysis was conducted to select the final items. Reliability (Cronbach's alpha and Guttman's lambda 2 ) and construct validity (Pearson correlations) were assessed. Results The final scale was composed of nine items that each measured ideal and predicted expectations about process and outcome of treatment. Mokken scale analysis showed the presence of two subscales: ideal and predicted expectations. The TEC scale had good internal consistency ( α  = 0.876–0.869) and adequate discriminant validity as assessed by its low correlation with measures of depression, anxiety, and quality of life ( r  =   −.038 to .114). The scale had however low correlation with a theoretically related measure of optimism ( r  = .240). Conclusion The TEC scale is a reliable scale measuring pain treatment expectation. Further evaluation of its psychometric properties is needed. The scale has the potential to deepen our understanding of the role treatment expectations play in chronic non‐cancer pain treatment response. Statement of contribution What is already known on this subject? Expectations play a role in pain perception and the response to pain treatment Patients' expectations about pain and its management are associated with treatment satisfaction The absence of a validated tool to measure treatment expectations in chronic non‐cancer pain prevents further exploration and understanding of the role of expectations in the context of multidisciplinary pain treatment . What does this study add? A new, reliable 9‐item scale measuring treatment expectations among chronic non‐cancer pain patients attending specialized multidisciplinary pain clinics .
    Type of Medium: Online Resource
    ISSN: 1359-107X , 2044-8287
    URL: Issue
    URL: Article
    DOI: 10.1111/bjhp.v24.3
    DOI: 10.1111/bjhp.12371
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2026500-1
    SSG: 5,2
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  • 8
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    What do you expect? Catastrophizing mediates associations between expectancies and pain‐facilitatory processes
    Wiley ; 2019
    In:  European Journal of Pain Vol. 23, No. 4 ( 2019-04), p. 800-811
    Details
    In: European Journal of Pain, Wiley, Vol. 23, No. 4 ( 2019-04), p. 800-811
    Abstract: Pain expectancies are associated with altered pain sensitivity in individuals with chronic pain. However, little is known about the processes by which pain expectancies impact pain processing. This study assessed the association between pain expectancies and temporal summation (TS) of pain, and examined whether pain catastrophizing mediated this association. Methods In this cross‐sectional study, participants (437 chronic low back pain [CLBP] patients, 115 controls) completed self‐report measures of pain intensity, pain expectancies and pain catastrophizing before undergoing psychophysical pain‐testing procedures designed to assess mechanical TS of mechanical pain. Pearson's correlations examined the associations between study variables in CLBP patients and controls. Bootstrapping mediation analyses assessed the mediating role of pain catastrophizing on the association between pain expectancies and TS of pain. Results Temporal summation of pain was significantly associated with pain expectancies ( r  = 0.113) and pain catastrophizing ( r  = 0.171) in CLBP patients. Results of mediation analyses revealed that pain catastrophizing mediated the relationship between pain expectancies and TS of pain in CLBP patients (ab = 0.309, 95% CI = 0.1222–0.5604), but not in healthy controls (ab = −0.125, 95% CI = −0.5864 to 0.0244). Conclusions The findings from this study suggest that compared to controls, CLBP patients show increased sensitivity to mechanical pain procedures and enhanced pain‐facilitatory processing, proving further evidence for changes in central nervous system pain processing in CLBP patients. Our results also suggest that pain catastrophizing may be the mechanism by which pain expectancies are associated with TS of pain in CLBP patients. Significance Individuals with chronic low back pain who expect higher levels of pain and catastrophize about their pain are more likely to experience altered pain sensitivity. Our results point to catastrophizing as a mechanism of action through which psychological factors may operate and lead to the development and maintenance of chronic low back pain.
    Type of Medium: Online Resource
    ISSN: 1090-3801 , 1532-2149
    URL: Issue
    URL: Article
    DOI: 10.1002/ejp.2019.23.issue-4
    DOI: 10.1002/ejp.1348
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2002493-9
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  • 9
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    The Influence of Expectancies on Pain and Function Over Time After Total Knee Arthroplasty
    Oxford University Press (OUP) ; 2022
    In:  Pain Medicine Vol. 23, No. 10 ( 2022-09-30), p. 1767-1776
    Details
    In: Pain Medicine, Oxford University Press (OUP), Vol. 23, No. 10 ( 2022-09-30), p. 1767-1776
    Abstract: Expectancies have a well-documented influence on the experience of pain, responses to treatment, and postsurgical outcomes. In individuals with osteoarthritis, several studies have shown that expectations predict increased pain and disability after total knee replacement surgery. Despite the growing recognition of the importance of expectancies in clinical settings, few studies have examined the influence of expectancies throughout postsurgical recovery trajectories. The objective of the present study was to examine the role of presurgical expectancies on pain and function at 6-week, 6-month, and 1-year follow-ups after total knee arthroplasty. Design and Participants Data were collected from patients scheduled for total knee arthroplasty 1 week before surgery and then at 6 weeks, 6 months, and 1 year after surgery. Correlational and multivariable regression analyses examined the influence of expectancies on patients’ perceptions of pain reduction and functional improvement at each time point. Analyses controlled for age, sex, body mass index, presurgical pain intensity and function, pain catastrophizing, anxiety, and depression. Results Results revealed that expectancies significantly predicted pain reduction and functional improvement at 1-year follow-up. However, expectancies did not predict outcomes at the 6-week and 6-month follow-ups. Catastrophizing and depressive symptoms emerged as short-term predictors of postsurgical functional limitations at 6-week and 6-month follow-ups, respectively. Conclusions The results suggest that targeting high levels of catastrophizing and depressive symptoms could optimize short-term recovery after total knee arthroplasty. However, the results demonstrate that targeting presurgical negative expectancies could prevent prolonged recovery trajectories, characterized by pain and loss of function up to 1 year after total knee arthroplasty.
    Type of Medium: Online Resource
    ISSN: 1526-4637
    URL: Article
    DOI: 10.1093/pm/pnac067
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2023869-1
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  • 10
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    Strategies aimed at preventing chronic opioid use in trauma and acute care surgery: a scoping review protocol
    BMJ ; 2020
    In:  BMJ Open Vol. 10, No. 4 ( 2020-04), p. e035268-
    Details
    In: BMJ Open, BMJ, Vol. 10, No. 4 ( 2020-04), p. e035268-
    Abstract: Globally every year, millions of patients sustain traumatic injuries and require acute care surgeries. A high incidence of chronic opioid use (up to 58%) has been documented in these populations with significant negative individual and societal impacts. Despite the importance of this public health issue, optimal strategies to limit the chronic use of opioids after trauma and acute care surgery are not clear. We aim to identify existing strategies to prevent chronic opioid use in these populations. Methods and analysis We will perform a scoping review of peer-reviewed and non-peer-reviewed literature to identify studies, reviews, recommendations and guidelines on strategies aimed at preventing chronic opioid use in patients after trauma and acute care surgery. We will search MEDLINE, EMBASE, PsycINFO, CINHAL, Cochrane Central Register of Controlled Trials, Web of Science, ProQuest and websites of trauma and acute care surgery, pain, government and professional organisations. Databases will be searched for papers published from 1 January 2005 to a maximum of 6 months before submission of the final manuscript. Two reviewers will independently evaluate studies for eligibility and extract data from included studies using a standardised data abstraction form. Preventive strategies will be classified according to their types and targeted trauma populations and acute care surgery procedures. Ethics and dissemination Research ethics approval is not required as this study is based on the secondary use of published data. This work will inform research and clinical stakeholders on the required next steps towards the uptake of effective strategies aimed at preventing chronic opioid use in trauma and acute care surgery patients.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2019-035268
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2599832-8
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