Pub Date : 2025-01-16DOI: 10.1016/j.jpain.2025.104790
Rony R. Sayegh MD , Susan Vitale PhD, MHS , Elvira Agrón MA , John T. Farrar MD, PhD , Penny A. Asbell MD, MBA , Emily Y. Chew MD , For the AREDS Research Group
Chronic ocular pain impacts quality of life and is often linked to ocular surgery. We assessed the prevalence of chronic postoperative pain (CPOP) after cataract surgery and associated risk factors using a secondary cohort post-hoc analysis of data from the Age-Related Eye Disease Study (AREDS), a multicenter, controlled, randomized clinical trial of antioxidant vitamins and minerals. Ocular pain was determined from item 4 of the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25), administered between 1997 and 2005. We included participants who underwent cataract surgery during the study and reported no or mild ocular pain before first-eye cataract surgery (n=325). Controls (n=283) reported no or mild ocular pain 3 or more months after first-eye cataract surgery; cases (n=42) reported moderate or severe pain 3 or more months after first-eye cataract surgery. Multivariable logistic regression models assessed associations between potential risk factors (age, sex, body mass index, smoking, diabetes, education level, use of anti-inflammatory agents, use of antacids, general health, AREDS treatment group) and CPOP. Of the 325 participants (mean age, 69.7±4.4 years, 59.4 % female); CPOP developed in 42 (13 %; 95 % CI, 9.3 – 16.6 %). The average time between cataract surgery and the post-surgery VFQ was 18.4±11.8 months (range 3.0 – 65.0 months). Multivariable analysis did not reveal any statistically significant associations with odds of developing CPOP after cataract surgery. As such, in this AREDS cohort who underwent cataract surgery, 13% developed CPOP, consistent with previous reports from cataract and refractive surgery. Our post-hoc analyses did not identify any significant risk factors for CPOP.
Perspective
We found a high prevalence of Chronic Postoperative Pain (CPOP) in the AREDS cohort, with 13 % of participants who underwent cataract surgery developing CPOP. Post-hoc analysis did not identify significant risk factors for CPOP. Our study contributes valuable insights into a growing area of interest in pain management within ophthalmology.
{"title":"Prevalence and risk factors for the development of chronic postoperative pain after cataract surgery in the Age-related Eye Disease Study (AREDS)","authors":"Rony R. Sayegh MD , Susan Vitale PhD, MHS , Elvira Agrón MA , John T. Farrar MD, PhD , Penny A. Asbell MD, MBA , Emily Y. Chew MD , For the AREDS Research Group","doi":"10.1016/j.jpain.2025.104790","DOIUrl":"10.1016/j.jpain.2025.104790","url":null,"abstract":"<div><div>Chronic ocular pain impacts quality of life and is often linked to ocular surgery. We assessed the prevalence of chronic postoperative pain (CPOP) after cataract surgery and associated risk factors using a secondary cohort post-hoc analysis of data from the Age-Related Eye Disease Study (AREDS), a multicenter, controlled, randomized clinical trial of antioxidant vitamins and minerals. Ocular pain was determined from item 4 of the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25), administered between 1997 and 2005. We included participants who underwent cataract surgery during the study and reported no or mild ocular pain before first-eye cataract surgery (n=325). Controls (n=283) reported no or mild ocular pain 3 or more months after first-eye cataract surgery; cases (n=42) reported moderate or severe pain 3 or more months after first-eye cataract surgery. Multivariable logistic regression models assessed associations between potential risk factors (age, sex, body mass index, smoking, diabetes, education level, use of anti-inflammatory agents, use of antacids, general health, AREDS treatment group) and CPOP. Of the 325 participants (mean age, 69.7±4.4 years, 59.4 % female); CPOP developed in 42 (13 %; 95 % CI, 9.3 – 16.6 %). The average time between cataract surgery and the post-surgery VFQ was 18.4±11.8 months (range 3.0 – 65.0 months). Multivariable analysis did not reveal any statistically significant associations with odds of developing CPOP after cataract surgery. As such, in this AREDS cohort who underwent cataract surgery, 13% developed CPOP, consistent with previous reports from cataract and refractive surgery. Our post-hoc analyses did not identify any significant risk factors for CPOP.</div></div><div><h3>Perspective</h3><div>We found a high prevalence of Chronic Postoperative Pain (CPOP) in the AREDS cohort, with 13 % of participants who underwent cataract surgery developing CPOP. Post-hoc analysis did not identify significant risk factors for CPOP. Our study contributes valuable insights into a growing area of interest in pain management within ophthalmology.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"28 ","pages":"Article 104790"},"PeriodicalIF":4.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impact of complementary health approaches on opioid prescriptions among veterans with musculoskeletal disorders","authors":"Chung-Chu Tung , Wei-Kai Lee MD , Wen-Bin Yeh , Renin Chang","doi":"10.1016/j.jpain.2025.104779","DOIUrl":"10.1016/j.jpain.2025.104779","url":null,"abstract":"","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"28 ","pages":"Article 104779"},"PeriodicalIF":4.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Methodological considerations in chronic pain treatment addressing the impact of mental health and the COVID-19 pandemic","authors":"Chung-Chu Tung , Wei-Kai Lee MD , Wen-Bin Yeh , Renin Chang","doi":"10.1016/j.jpain.2025.104780","DOIUrl":"10.1016/j.jpain.2025.104780","url":null,"abstract":"","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"28 ","pages":"Article 104780"},"PeriodicalIF":4.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In order to disentangle the effects of drugs from placebo responses, several approaches have been used, such as a placebo run-in phase in which only placebo nonresponders, or poor responders, are considered for further randomization to either placebo or active treatment. This study is aimed at investigating the variability of placebo nonresponders obtained through the classical placebo run-in paradigm (group RUN) and through mismatch conditioning (group MIS), as done in our previous study. To do this, we simulated a real clinical trial in the laboratory, in which the placebo responders of both groups were discarded and the remaining nonresponders of both groups RUN and MIS were randomized to either continuing on placebo (groups RUN-P and MIS-P, respectively) or receiving topical 0.5% lidocaine (groups RUN-L and MIS-L, respectively) applied to the skin. By measuring pain thresholds, we found that the placebo nonresponders selected on the first day of the experiment showed different responses on the following day in both group RUN and MIS. This led to no significant differences between placebo and lidocaine in both groups. Although this is an experimental laboratory situation far from the clinical trial setting, these findings show that placebo nonresponders are not necessarily constant over time, both when a placebo run-in protocol is used and when nonresponders are created in the laboratory. This questions the reliability of selecting placebo nonresponders as a methodological approach in clinical research. Therefore, we suggest reconsidering the validity and usefulness of placebo run-in protocols.
Perspective
Placebo nonresponders are sometime selected for further randomization to either placebo or active treatment. In this experimental study, which is a laboratory simulation of a clinical trial, we found that placebo nonresponders vary from day to day, thus questioning their validity as a methodological approach in clinical research.
{"title":"Placebo nonresponders: An experimental investigation on their unreliability over time","authors":"Fabrizio Benedetti , Wilma Thoen , Aziz Shaibani , Claudia Arduino","doi":"10.1016/j.jpain.2025.104777","DOIUrl":"10.1016/j.jpain.2025.104777","url":null,"abstract":"<div><div>In order to disentangle the effects of drugs from placebo responses, several approaches have been used, such as a placebo run-in phase in which only placebo nonresponders, or poor responders, are considered for further randomization to either placebo or active treatment. This study is aimed at investigating the variability of placebo nonresponders obtained through the classical placebo run-in paradigm (group RUN) and through mismatch conditioning (group MIS), as done in our previous study. To do this, we simulated a real clinical trial in the laboratory, in which the placebo responders of both groups were discarded and the remaining nonresponders of both groups RUN and MIS were randomized to either continuing on placebo (groups RUN-P and MIS-P, respectively) or receiving topical 0.5% lidocaine (groups RUN-L and MIS-L, respectively) applied to the skin. By measuring pain thresholds, we found that the placebo nonresponders selected on the first day of the experiment showed different responses on the following day in both group RUN and MIS. This led to no significant differences between placebo and lidocaine in both groups. Although this is an experimental laboratory situation far from the clinical trial setting, these findings show that placebo nonresponders are not necessarily constant over time, both when a placebo run-in protocol is used and when nonresponders are created in the laboratory. This questions the reliability of selecting placebo nonresponders as a methodological approach in clinical research. Therefore, we suggest reconsidering the validity and usefulness of placebo run-in protocols.</div></div><div><h3>Perspective</h3><div>Placebo nonresponders are sometime selected for further randomization to either placebo or active treatment. In this experimental study, which is a laboratory simulation of a clinical trial, we found that placebo nonresponders vary from day to day, thus questioning their validity as a methodological approach in clinical research.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"28 ","pages":"Article 104777"},"PeriodicalIF":4.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-10DOI: 10.1016/j.jpain.2025.104778
Nandini Raghuraman, Titilola Akintola, Fenan S Rassu, Timothy D O'Connor, Shuo Chen, Ann Gruber-Baldini, Luana Colloca
Socioeconomic Position (SEP) is a multidimensional construct encompassing education, income, occupation, and neighborhood distress, influencing chronic pain severity, interference, and duration. However, its impact on placebo analgesia, where reduced pain perception occurs due to treatment belief, remains understudied. Using a quasi-experimental approach, we investigated SEP's influence on placebo analgesia in 401 participants with temporomandibular disorder (TMD) and 400 pain-free individuals. Using latent class analysis, we grouped participants into two SEP groups based on self-reported education, income, occupation, and neighborhood distress indices, including the area deprivation and distressed community indexes. Ancestry Informative Markers (AIMs) and self-reported race were included to account for genetic and demographic influences. Placebo analgesia was elicited using verbal suggestion and classical conditioning. Linear mixed models were employed to analyze SEP's impact, while multiple regression and ANCOVA assessed AIMs' and race's effects. Comparable placebo effects were observed between participants with TMD and pain-free individuals (F(1,4765.73) = 0.49, p = 0.48). A trend was noted in the main effect of SEP (F(1,4764.5) = 3.64, p = 0.056). Among TMD participants, those with distressed SEP exhibited lower placebo analgesia (F(1,4765.73) = 7.9, p = 0.005), while placebo response did not differ by SEP in pain-free participants (F(1,4765.73) = 0.27, p = 0.59). East Asian ancestry (β = 5.71, 95% CI [1.50, 9.92]) and self-reported Asian (mean = 24.20, sem = 1.52, p = 0.020) were associated with greater placebo analgesia. This study highlights the interplay of SEP, AIMs, and race in placebo analgesia and calls for tailored pain management interventions. PERSPECTIVE: SEP significantly contributes to pain disparities. This quasi-experimental study demonstrates analogous placebo analgesia between chronic pain and pain-free individuals but finds lower placebo analgesia only among individuals with chronic pain and distressed SEP. This highlights a link between chronic pain, SEP, and impaired placebo effects, suggesting new avenues for research.
社会经济地位（SEP）是一个多维结构，包括教育、收入、职业和邻里窘迫，影响慢性疼痛的严重程度、干扰和持续时间。然而，其对安慰剂镇痛的影响仍未得到充分研究，安慰剂镇痛是由于治疗信念导致疼痛感知减少。采用准实验方法，我们研究了SEP对401名颞下颌紊乱（TMD）患者和400名无痛患者安慰剂镇痛的影响。利用潜类分析，我们根据自我报告的教育程度、收入、职业和社区贫困指数（包括区域剥夺指数和贫困社区指数）将参与者分为两个SEP组。包括祖先信息标记（AIMs）和自我报告的种族，以解释遗传和人口统计学的影响。采用言语暗示和经典条件反射诱导安慰剂镇痛。采用线性混合模型分析SEP的影响，多元回归和ANCOVA评估AIMs和种族的影响。在TMD患者和无痛患者之间观察到相当的安慰剂效应（F(1,4765.73) = 0.49, p = 0.48）。SEP的主效应有一定的趋势（F(1,4764.5) = 3.64, p = 0.056）。在TMD参与者中，SEP患者表现出较低的安慰剂镇痛（F(1,4765.73) = 7.9, p = 0.005），而无SEP患者的安慰剂反应无差异（F(1,4765.73) = 0.27, p = 0.59）。东亚血统（β = 5.71, 95% CI[1.50, 9.92]）和自我报告的亚洲人（平均= 24.20,sem = 1.52, p = 0.020）与安慰剂镇痛效果显著相关。本研究强调了SEP、AIMs和种族在安慰剂镇痛中的相互作用，并呼吁采取量身定制的疼痛管理干预措施。观点：SEP对疼痛差异有显著影响。这项准实验研究表明，在慢性疼痛和无痛个体之间存在类似的安慰剂镇痛作用，但仅在慢性疼痛和SEP疼痛个体中发现安慰剂镇痛作用较低。这突出了慢性疼痛、SEP和安慰剂效应受损之间的联系，为研究提供了新的途径。
{"title":"The effects of socioeconomic position on endogenous pain modulation: A quasi-experimental approach.","authors":"Nandini Raghuraman, Titilola Akintola, Fenan S Rassu, Timothy D O'Connor, Shuo Chen, Ann Gruber-Baldini, Luana Colloca","doi":"10.1016/j.jpain.2025.104778","DOIUrl":"10.1016/j.jpain.2025.104778","url":null,"abstract":"<p><p>Socioeconomic Position (SEP) is a multidimensional construct encompassing education, income, occupation, and neighborhood distress, influencing chronic pain severity, interference, and duration. However, its impact on placebo analgesia, where reduced pain perception occurs due to treatment belief, remains understudied. Using a quasi-experimental approach, we investigated SEP's influence on placebo analgesia in 401 participants with temporomandibular disorder (TMD) and 400 pain-free individuals. Using latent class analysis, we grouped participants into two SEP groups based on self-reported education, income, occupation, and neighborhood distress indices, including the area deprivation and distressed community indexes. Ancestry Informative Markers (AIMs) and self-reported race were included to account for genetic and demographic influences. Placebo analgesia was elicited using verbal suggestion and classical conditioning. Linear mixed models were employed to analyze SEP's impact, while multiple regression and ANCOVA assessed AIMs' and race's effects. Comparable placebo effects were observed between participants with TMD and pain-free individuals (F(1,4765.73) = 0.49, p = 0.48). A trend was noted in the main effect of SEP (F(1,4764.5) = 3.64, p = 0.056). Among TMD participants, those with distressed SEP exhibited lower placebo analgesia (F(1,4765.73) = 7.9, p = 0.005), while placebo response did not differ by SEP in pain-free participants (F(1,4765.73) = 0.27, p = 0.59). East Asian ancestry (β = 5.71, 95% CI [1.50, 9.92]) and self-reported Asian (mean = 24.20, sem = 1.52, p = 0.020) were associated with greater placebo analgesia. This study highlights the interplay of SEP, AIMs, and race in placebo analgesia and calls for tailored pain management interventions. PERSPECTIVE: SEP significantly contributes to pain disparities. This quasi-experimental study demonstrates analogous placebo analgesia between chronic pain and pain-free individuals but finds lower placebo analgesia only among individuals with chronic pain and distressed SEP. This highlights a link between chronic pain, SEP, and impaired placebo effects, suggesting new avenues for research.</p>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":" ","pages":"104778"},"PeriodicalIF":4.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-05DOI: 10.1016/j.jpain.2025.104776
Dana Rubenstein , Michael J. Green , Francis J. Keefe , F. Joseph McClernon , Maggie M. Sweitzer
Chronic pain affects ∼20% of the adult population and is associated with smoking. Smoking and pain worsen each other in the long term, but short-term temporal associations between smoking and pain throughout the day are unclear. Understanding these relationships may inform strategies for managing comorbid smoking and pain. Participants with chronic back pain who smoke responded to 81.5% of ecological momentary assessment (EMA) prompts delivered 5 times daily. Independent variables were: 1) urge to smoke (from 1–9), 2) intention to smoke (about to smoke, not about to smoke), and 3) smoking recency (smoked <30 min ago, smoked >30 min ago); smoking now was included as a separate category in models 2 and 3. Associations with pain intensity (from 1–9) were estimated using multi-level models, including an interaction term between the independent variable and Pain and Smoking Inventory score (PSI). Urge to smoke was associated with increased pain intensity (β=0.10 [SE=0.02], p<0.001), and this difference was greater for individuals with higher PSI scores (β=0.03 [0.01], p=0.003). Not being about to smoke was associated with lower pain intensity than smoking now (β=−0.29 [0.09], p=0.001). Compared to smoking now, both smoking <30 min ago (β=−0.30 [0.09], p=0.001) and smoking >30 min ago (β=−0.23 [0.11], p=0.029) were associated with lower pain intensity. Smoking urges may increase pain intensity (or vice versa), especially when people perceive strong relationships between smoking and pain. Smoking may also attenuate perceived pain. Further research is needed on interventions that combine tailored smoking cessation treatments and behavioral pain management strategies.
Perspective
This analysis of momentary data reported throughout the day by people with back pain who smoke revealed novel insights into short-term relationships between pain and smoking. Study results can inform future treatment development for individuals with chronic pain who smoke.
{"title":"Ecological momentary assessment of cigarette smoking behavior and pain intensity among individuals with chronic back pain who smoke","authors":"Dana Rubenstein , Michael J. Green , Francis J. Keefe , F. Joseph McClernon , Maggie M. Sweitzer","doi":"10.1016/j.jpain.2025.104776","DOIUrl":"10.1016/j.jpain.2025.104776","url":null,"abstract":"<div><div>Chronic pain affects ∼20% of the adult population and is associated with smoking. Smoking and pain worsen each other in the long term, but short-term temporal associations between smoking and pain throughout the day are unclear. Understanding these relationships may inform strategies for managing comorbid smoking and pain. Participants with chronic back pain who smoke responded to 81.5% of ecological momentary assessment (EMA) prompts delivered 5 times daily. Independent variables were: 1) urge to smoke (from 1–9), 2) intention to smoke (about to smoke, not about to smoke), and 3) smoking recency (smoked <30 min ago, smoked >30 min ago); smoking now was included as a separate category in models 2 and 3. Associations with pain intensity (from 1–9) were estimated using multi-level models, including an interaction term between the independent variable and Pain and Smoking Inventory score (PSI). Urge to smoke was associated with increased pain intensity (β=0.10 [SE=0.02], p<0.001), and this difference was greater for individuals with higher PSI scores (β=0.03 [0.01], p=0.003). Not being about to smoke was associated with lower pain intensity than smoking now (β=−0.29 [0.09], p=0.001). Compared to smoking now, both smoking <30 min ago (β=−0.30 [0.09], p=0.001) and smoking >30 min ago (β=−0.23 [0.11], p=0.029) were associated with lower pain intensity. Smoking urges may increase pain intensity (or vice versa), especially when people perceive strong relationships between smoking and pain. Smoking may also attenuate perceived pain. Further research is needed on interventions that combine tailored smoking cessation treatments and behavioral pain management strategies.</div></div><div><h3>Perspective</h3><div>This analysis of momentary data reported throughout the day by people with back pain who smoke revealed novel insights into short-term relationships between pain and smoking. Study results can inform future treatment development for individuals with chronic pain who smoke.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"28 ","pages":"Article 104776"},"PeriodicalIF":4.0,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-03DOI: 10.1016/j.jpain.2024.104774
Marelle K Wilson, Dianne J Wilson, Amelia K Searle, Shylie F Mackintosh
Group-delivered programs for chronic pain are evidence-based and frequently used. The contribution of group factors to outcomes is unclear and there are no integrated findings on consumer perceptions of the group itself in programs for people with chronic pain. The aim of this systematic review was to search and synthesise qualitative data specifically related to the group itself in studies investigating group-delivered programs for people with chronic pain (PROSPERO, CRD42023382447). MEDLINE, EMBASE, EmCare, PsycINFO, Scopus, and CINAHL databases were searched, and qualitative studies that explored the experiences of consumers who had attended any style of group-delivered program for people with chronic pain were included. Methodological quality was assessed using the Critical Appraisal Skills Programme checklist and meta-synthesis was guided by a thematic synthesis approach. Ninety-three studies were included, with 1806 participants. Programs were predominantly multi-component, with diverse interventions and facilitators. Three analytical themes were generated: (1) Peer interaction: a program component in and of itself; (2) Comparison: frequently used and mostly helpful; and (3) Beyond the program: when the group itself contributes to change. Findings highlighted that most consumers valued the group itself, finding interaction, and comparing themselves with peers useful. Future research related to group factors in programs for people with chronic pain should include consumer participation and co-design. PERSPECTIVE: This review demonstrates that many consumers valued peer interaction and used comparison-based cognitive processing within group-delivered programs for chronic pain. Dialogue-based interactions with similar others promoted cognitive, affect, and behaviour changes. Group factors may have been underestimated and outcomes could be influenced if peer interactions within programs were optimised.
{"title":"Consumer perspectives of the group itself in group-delivered programs for people with chronic pain: A systematic review and meta-synthesis.","authors":"Marelle K Wilson, Dianne J Wilson, Amelia K Searle, Shylie F Mackintosh","doi":"10.1016/j.jpain.2024.104774","DOIUrl":"10.1016/j.jpain.2024.104774","url":null,"abstract":"<p><p>Group-delivered programs for chronic pain are evidence-based and frequently used. The contribution of group factors to outcomes is unclear and there are no integrated findings on consumer perceptions of the group itself in programs for people with chronic pain. The aim of this systematic review was to search and synthesise qualitative data specifically related to the group itself in studies investigating group-delivered programs for people with chronic pain (PROSPERO, CRD42023382447). MEDLINE, EMBASE, EmCare, PsycINFO, Scopus, and CINAHL databases were searched, and qualitative studies that explored the experiences of consumers who had attended any style of group-delivered program for people with chronic pain were included. Methodological quality was assessed using the Critical Appraisal Skills Programme checklist and meta-synthesis was guided by a thematic synthesis approach. Ninety-three studies were included, with 1806 participants. Programs were predominantly multi-component, with diverse interventions and facilitators. Three analytical themes were generated: (1) Peer interaction: a program component in and of itself; (2) Comparison: frequently used and mostly helpful; and (3) Beyond the program: when the group itself contributes to change. Findings highlighted that most consumers valued the group itself, finding interaction, and comparing themselves with peers useful. Future research related to group factors in programs for people with chronic pain should include consumer participation and co-design. PERSPECTIVE: This review demonstrates that many consumers valued peer interaction and used comparison-based cognitive processing within group-delivered programs for chronic pain. Dialogue-based interactions with similar others promoted cognitive, affect, and behaviour changes. Group factors may have been underestimated and outcomes could be influenced if peer interactions within programs were optimised.</p>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":" ","pages":"104774"},"PeriodicalIF":4.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-03DOI: 10.1016/j.jpain.2025.104775
Tahmina Begum , Bhagyavalli Veeranki , Ogenna Joy Chike , Suzanne Tamang , Julia F. Simard , Jonathan Chen , Yashaar Chaichian , Sean Mackey , Beth D. Darnall , Titilola Falasinnu
The use of electronic health records (EHR) for chronic pain phenotyping has gained significant attention in recent years, with various algorithms being developed to enhance accuracy. Structured data fields (e.g., pain intensity, treatment modalities, diagnosis codes, and interventions) offer standardized templates for capturing specific chronic pain phenotypes. This study aims to determine which chronic pain case definitions derived from structured data elements achieve the best accuracy, and how these validation metrics vary by sociodemographic and disease-related factors. We used EHR data from 802 randomly selected adults with autoimmune rheumatic diseases seen at a large academic center in 2019. We extracted structured data elements to derive multiple phenotyping algorithms. We confirmed chronic pain case definitions via manual chart review of clinical notes, and assessed the performance of derived algorithms, e.g., sensitivity/recall, specificity, positive predictive value (PPV). The highest sensitivity (67%) was observed when using ICD codes alone, while specificity peaked at 96% with a quadrimodal algorithm combining pain scores, ICD codes, prescriptions, and interventions. Specificity was generally higher in males and younger patients, particularly those aged 18–40 years, and highest among Asian/Pacific Islander and privately insured patients. PPV was highest among patients who were female, younger, or privately insured. PPV and sensitivity were lowest among males, Asian/Pacific Islander, and older patients. Variability of phenotyping results underscores the importance of refining chronic pain phenotyping algorithms within EHRs to enhance their accuracy and applicability. While our current algorithms provide valuable insights, enhancement is needed to ensure more reliable chronic pain identification across diverse patient populations.
Perspectives
This study evaluates chronic pain phenotyping algorithms using electronic health records, highlighting variability in performance across sociodemographic and disease-related factors. By combining structured data elements, the findings advance chronic pain identification, promoting equitable healthcare practices and highlighting the need for tailored algorithms to address subgroup-specific biases and improve outcomes.
{"title":"Refining chronic pain phenotypes: A comparative analysis of sociodemographic and disease-related determinants using electronic health records","authors":"Tahmina Begum , Bhagyavalli Veeranki , Ogenna Joy Chike , Suzanne Tamang , Julia F. Simard , Jonathan Chen , Yashaar Chaichian , Sean Mackey , Beth D. Darnall , Titilola Falasinnu","doi":"10.1016/j.jpain.2025.104775","DOIUrl":"10.1016/j.jpain.2025.104775","url":null,"abstract":"<div><div>The use of electronic health records (EHR) for chronic pain phenotyping has gained significant attention in recent years, with various algorithms being developed to enhance accuracy. Structured data fields (e.g., pain intensity, treatment modalities, diagnosis codes, and interventions) offer standardized templates for capturing specific chronic pain phenotypes. This study aims to determine which chronic pain case definitions derived from structured data elements achieve the best accuracy, and how these validation metrics vary by sociodemographic and disease-related factors. We used EHR data from 802 randomly selected adults with autoimmune rheumatic diseases seen at a large academic center in 2019. We extracted structured data elements to derive multiple phenotyping algorithms. We confirmed chronic pain case definitions via manual chart review of clinical notes, and assessed the performance of derived algorithms, e.g., sensitivity/recall, specificity, positive predictive value (PPV). The highest sensitivity (67%) was observed when using ICD codes alone, while specificity peaked at 96% with a quadrimodal algorithm combining pain scores, ICD codes, prescriptions, and interventions. Specificity was generally higher in males and younger patients, particularly those aged 18–40 years, and highest among Asian/Pacific Islander and privately insured patients. PPV was highest among patients who were female, younger, or privately insured. PPV and sensitivity were lowest among males, Asian/Pacific Islander, and older patients. Variability of phenotyping results underscores the importance of refining chronic pain phenotyping algorithms within EHRs to enhance their accuracy and applicability. While our current algorithms provide valuable insights, enhancement is needed to ensure more reliable chronic pain identification across diverse patient populations.</div></div><div><h3>Perspectives</h3><div>This study evaluates chronic pain phenotyping algorithms using electronic health records, highlighting variability in performance across sociodemographic and disease-related factors. By combining structured data elements, the findings advance chronic pain identification, promoting equitable healthcare practices and highlighting the need for tailored algorithms to address subgroup-specific biases and improve outcomes.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"28 ","pages":"Article 104775"},"PeriodicalIF":4.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.jpain.2024.104755
Caterina Grano
{"title":"Reply to Letter to Editor by Bordoni Bruno, regarding Pain severity and depressive symptoms in endometriosis patients: Mediation of negative body awareness and interoceptive self-regulation","authors":"Caterina Grano","doi":"10.1016/j.jpain.2024.104755","DOIUrl":"10.1016/j.jpain.2024.104755","url":null,"abstract":"","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"26 ","pages":"Article 104755"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.jpain.2024.104708
Jiaxin An , Wei Fan , Anant Mittal , Yan Zhang , Annie T. Chen
{"title":"Corrigendum to “Mobile app use among persons with fibromyalgia: a cross-sectional survey” [J Pain, Volume 25, Issue 8, August 2024, 104515]","authors":"Jiaxin An , Wei Fan , Anant Mittal , Yan Zhang , Annie T. Chen","doi":"10.1016/j.jpain.2024.104708","DOIUrl":"10.1016/j.jpain.2024.104708","url":null,"abstract":"","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"26 ","pages":"Article 104708"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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