Systematic Review of Outcome Measures in Pharmacologically Managed Chronic Pain: Informing a New Outcome Framework for Healthcare Provider-Led Pharmacotherapy Services

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES Journal of evaluation in clinical practice Pub Date : 2025-02-26 DOI:10.1111/jep.70029

Abdulrahman Sharaf, Emma Dunlop, Natalie Weir, Rosemary Newham, Sumaya Alsalah, Marion Bennie

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Abstract

Background and Objective

Chronic pain represents a global burden, highlighting the necessity for accurate outcome measures in treatment evaluation. This systematic review aims to identify what outcome measures and tools are applied in chronic pain primary care-based pharmacotherapy services.

Databases and Data Treatment

The MEDLINE, Embase, and CINAHL databases, along with the reference lists of published articles, were systematically searched from 2013 to July 2023. This search included observational studies that employed pharmacological interventions recommended by the World Health Organisation pain ladder and the Scottish Intercollegiate Guidelines Network guidelines. The studies targeted chronic pain patients treated in outpatient settings and examined five predefined outcomes: health-related quality of life (HRQoL), cost-effectiveness, medication optimisation, adverse events, and patient experience. The quality of included studies was assessed using the Newcastle-Ottawa Scale (NOS).

Results

Among the 23 studies included a total of 51 outcome measurement tools were employed to assess the five predefined outcomes, involving 44,472 patients with chronic pain. Fifteen were cohort studies, while 8 were cross-sectional surveys or questionnaire-based. Most studies focused on one to two outcomes only (n = 19; 82.6%). HRQoL emerged as the primary outcome studied across all 23 studies (100%), predominantly assessed through the Brief Pain Inventory (BPI) tool (n = 9; 39.1%). Conversely, the least studied outcomes were medication optimisation and cost-effectiveness. The timing of measurement post-intervention and follow-up durations displayed significant variability across the studies.

Conclusions

This review identifies gaps in enabling a more holistic assessment of pharmacotherapy services and underscores the need for enhanced consistency via standardised tools in clinical practice.

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.