Prevalence of Chronic Pain: Systematic review

Prevalence of Chronic Pain: Systematic review

Intr

od

ucti

on

to M

ed

icin

e


Intr

od

ucti

on

to M

ed

icin

e

This systematic review is part of a research project for the

Introduction to Medicine subject, of Biostatistical Service in the

Medicine Faculty of Oporto University

Intr

od

ucti

on

to M

ed

icin

e

In this work we will focus:1. Title and keywords2. Abstract3. Introduction4. Participants 5. Methods6. Results7. Discussion8. Website9. Acknowledgements10.References11.Authors


Intr

od

ucti

on

to M

ed

icin

e

TOP

1. Title and keywords

Prevalence of Chronic Pain in the General Population

Keywords: Prevalence, Chronic pain, Systematic review, General population


Intr

od

ucti

on

to M

ed

icin

e

2. Abstract

Objectives •quantify the Prevalence of Chronic Pain in the General Population; •relate chronic pain with other variables such as gender, age, geographical areas and anatomic regions;•describe the difficulties found during the work; •study the average duration of chronic pain.

Participants •All the articles that follow the inclusion criteria.


Intr

od

ucti

on

to M

ed

icin

e

TOP

Method •query “chronic pain” AND prevalence; •www.pubmed.com and www.scopus.com; •Endnote (to manage references); •1149 articles potentially could be included; •Screenphase and Inclusion phase; •29 articles; •Extracting data;•Statistical treatment.

Results and Discussion/Conclusion•The results will be presented in the Abstract as well as the Discussion and the Conclusion.


Intr

od

ucti

on

to M

ed

icin

e

3. Introduction

Chronic pain: definition

Pain definition: “(...)an unpleasant sensory and emotional experience associated with actual and potential tissue damage, or described in terms of such damage (...)” (IASP, 1986)

Chronic pain definition:“pain without apparent biological value that has persisted beyond the normal tissue healing time, usually taken to be 3 months” (IASP, 1986)


Intr

od

ucti

on

to M

ed

icin

e Definition of pain and chronic pain – Associated Problems:

•Incapacity in quantifying pain;•Subjective nature; •Contextualization;•No agreement about the necessary time to consider chronic pain (1 month, 3 months or 6 months beyond a normal recovery period);•Chronic pain duration.


Intr

od

ucti

on

to M

ed

icin

e

TOP

Systematic review: definition

•Planned review to answer a specific question and that uses systematic and explicit methods to identify, select and evaluate the studies;

•It consists in reviewing all the existence references in medicine´s data bases: Scopus; Pubmed (for example).


Intr

od

ucti

on

to M

ed

icin

e Relevance of the question and comments

Chronic pain:

•Has an impact in patients’ quality of life, in family, health workers and institutions related to them and in society in general.


Intr

od

ucti

on

to M

ed

icin

e Objectives

•Quantify the prevalence of chronic pain in general population and relate it with geographical regions and other variables •Identify the most affected anatomical regions; •Describe the dificulties found when defining chronic pain;•Study the average time of chronic pain duration.

TOP


Intr

od

ucti

on

to M

ed

icin

e

4. Participants•Study design – systematic review

•Selection criteria–Inclusion criteria:

•Being a scientific article;

•Focusing chronic pain (or its synonyms such as “continuous pain”, “delayed pain” and “intolerable pain”);

•Cross-sectional studies (study of prevalence);

•Studies with participants 18 years old or above;


Intr

od

ucti

on

to M

ed

icin

e

TOP

–Exclusion criteria:

•Studies focusing acute pain or other kind of pain;

•Studies related to children/teenagers (<18);

•Studies only comparing chronic pain with another type of pain;

•Studies with animals;

•Language not mastered.


Intr

od

ucti

on

to M

ed

icin

e

5. Methods•Search strategy in a systematic review:

–Query Formulation:•Pubmed

Pain – 308765

Pain AND prevalence – 27569

Pain AND prevalence AND chronic - 3966

“chronic pain” AND prevalence – 840•Scopus

“chronic pain” AND prevalence – 536

–Endnote (References management software)

–1149 (287 repeated articles)


Total: 1376

Intr

od

ucti

on

to M

ed

icin

e

•Articles selection•1st phase or screenphase – reading the title and abstract of the obtained articles in the databases and exclusion of the ones that do not fit.

–5 random groups of 2 people;

•2nd phase or inclusion phase – according with the pre-established criteria of inclusion and exclusion, the fitting articles were chosen

– the groups were maintained.


Intr

od

ucti

on

to M

ed

icin

e

•Statistical methods

After the extraction of the article data, the articles’ information will be processed and analyzed with graphics and tables, based on statistical methods such as variable statistic description and forest-plots.


Bibliographic SearchQuery – “chronic pain” AND prevalence

Pubmed840 Articles

Found

Scopus536 Articles

Found

ScreenphaseRevision through titles and abstracts

(5 groups of 2 revisers each)

135 articles selected

1014 articles not selected

· 65 articles not selected because the age of participants wasn t above 18

· 791 articles not selected because it didn t f ocus the chronic pain

· 151 articles not selected because it wasn’t a cross-sectional study

· 7 articles not selected because the participants weren’t humans

I nclusion PhaseRevision through the complete article

54 complete articles

EndnoteTotal of 1149 Articles Found

Exclusion Motives:· Unknown language· Didn’t f ocus the chronic pain· I t wasn’t a cross-sectional study· The participants weren’t above

18 years old· The participants weren’t only

humans

Data extraction and Quality Evaluation

29 articles included

25 articles excluded

Start

227 articles not selected (repeated)

End

81 articles not obtained

TOP

Intr

od

ucti

on

to M

ed

icin

e

TOP

6. ResultsThe articles’ information is being extracted with the help of the following table:

Authors

Research methods

DefinitionAspects taken in account

Prevalence

Demographic characteristics

•Author •Year of the study

•Research institute •Type of the questionaire•Age of the participants•Number•Response rate

•Time to be considered chronic pain•Intensity•Consequences•Pain localization

•Persistence of pain;•Settings•Gradation•Temporal characteristics•Social disability

•Prevalence

•Sexual distribution•Age•Association with social components, etc.


Intr

od

ucti

on

to M

ed

icin

e

TOP

7. Discussion

•Discussion of the study results;

•Discussion about the conceptual, methodological and operational limitations of the study, and their implication in the conclusions;

•Comments about the controversies and the implications of the results;


Intr

od

ucti

on

to M

ed

icin

e

8. Website

TOP


Intr

od

ucti

on

to M

ed

icin

e

TOP

9. Acknowledgements

•We also thank the teacher Luis Azevedo for the guidance throughout this work, and teacher Ana Ferreira for helping us with the flowchart.

•We thank the professor Altamiro da Costa Pereira, director of Introduction to Medicine subject, for the opportunity to complete this task, and for the constructive critic that helped us improve our work.


Intr

od

ucti

on

to M

ed

icin

e

10. References• Andersson, G.B., Epidemiological features of chronic low-back pain,

Lancet Journal, Volume 354, Issue 9178, Pages 581-5 (1999)• Blyth, F., Counsins, M., March, L., Chronic pain-related disability and use

of analgesia and heath services in a Sydney community, Medical Journal of Australia, Volume 179, Issue 2, Pages 84-87 (2003)

• Blyth, F., March, L., Brnabic, A., Jorm, L., Williamson, M., Cousins, M., Chronic Pain in Australia: a prevalence study, Pain Journal, Volume 89, Issue 2-3, Pages 127-34 (2001)

• Breivik, H., Collett, B., Ventafridda, V., Cohen, R., Gallacher, D., Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment, PMID: 16095934 (2005)

• Català, E., Reig, E., Artés, M., Aliaga, L., López, J., Segú, J.L., Prevalence of pain in the Spanish population: Telephone survey in 5000 homes, European Journal of Pain, Volume 6, Issue 2, Pages 133-140 (2002)

• Chrubasik, S., Junck, H., Zappe, H., Stuzke, O., A survey on pain complaints and heath care utilization in a German population sample, European Journal of Anaesthesiology, Volume 15, Issue 4, Pages 397-408 (1998)

• Chung, J., Kim, J., Kh, H., Kim, Y., Chung, S., Kim, H., Chronic orofacial pain among Korean elders: Prevalence, and impact using the graded chronic pain scale, Journal of pain, volume 112, Issue 1-2, Volume 164-170 (2004)


Intr

od

ucti

on

to M

ed

icin

e

•Elliot, A., Smith, B., Penny, K., Smith, W., Chambers, W., The Epidemiology of chronic pain in the community, Lancet Journal Volume 354, Issue 9186, Pages 1248-52 (1999)•Eriksen, J., Jensen, M., Sjogren, P., Ekholm, O., Rasmussen, N., Epidemiology of chronic non-malignant pain in Denmark, Journal of Pain, Volume 106, Issue 3, Pages 221-228 (2003)•Jahnsen, R., Stanghelle, J., Villien, L., Aamodt, G., Holm, I, Muscoskeletal pain in adults with cerebral palsy compared with the general population, Journal of Rehabilitation Medicine, Volume 36, Issue 2, Pages 78-84 (2004)•Kerssens, J., Verhaak, P., Bartelds, A., Sorbi, M., Bensing, J., Unexplained severe chronic pain in general practice, European Journal of Pain, Volume 6, Issue 3, Pages 203-12 (2002)•Lindell, L., Bergman, S., Petersson, I., Jacobssn, L., Herrstrom, P., Prevalence of fibromyalgia and chronic widespread pain, Scandinavian Journal of Primary Heath Care, Volume 18, Issue 3, Pages 149-153 (2000)•Mallen, C., Peat, G., Thomas, E., Croft, P., Severely disabling chronic pain in young adults: prevalence from a population-based survey in North Staffordshire, PMID: 16042761 (2005)•Meana, M., Cho, R., DesMeules, M., Chronic Pain: The Extra Burden on Canadian Women, BMC Womens Health Volume 4 Suppl 1 (2004)•Pai, M., McCulloch, M., Gorman, J.D., Pai, N., Enanoria, W., Kennedy, G., Tharyan, P. and Colford, G., Systematic reviews and meta-analyses: An illustrated, step-by-step guide, The national medical journal of India vol. 17 (2004)


Intr

od

ucti

on

to M

ed

icin

e

•Portenoy, R., Ugarte, C., Fuller, I., Haas, G., Population-based survey of pain in the United States: differences among white, African American and Hispanic subjects, Journal of Pain, Volume 5, Issue 6, Pages 317-28 (2004)•Rintala, D., Hart, K., Loubser, P., Castro, J., Fuhrer, M., Chronic pain in a community-based sample of men with spinal cord injury: Prevalence, severity, and relationship with impairment, disability, handicap, and subjective well-being, Archives of Physical Medicine and Rehabilitation, Volume 79, Issue 6, Pages 604-674 (1998)•Rustoen, T., Wahl, A., Hanestad, B., Lerdal, A., Paul, S., Miaskwski, C., Gender differences in chronic pain – findings from a population-based study of Norwegian adults (2004)•Rustoen, T., Whal, A., anestad, B., Lerdal, A., Paul, S., Miaskowski, C., Prevalence and characteristics of chronic pain in the general Norwegian population, European Journal of Pain, Volume 8, Issue 6, Pages 555-565 (2004)•Saastamoinen, P., Leino-Arjas, P., Laaksonen, M., Lahelma, E., Socio-economic differences in the prevalence of acute, chronic and disabling chronic pain among ageing employees, PMID: 15777862 (2005)•Smith, B., Elliot, A., Chambers, W., Smith, W., Hannaford, P., Penny, K., The impact of chronic pain in the community, Fam Pract, Volume 18, Issue 3, Pages 292-9 (2001)•Verhakk, P., Kerssens, J., Dekker, J., Sorbi, M. and Bensing, J., Prevalence of chronic benign pain disorder among adults: a review of literature, Pain, 77 (1998) 231-239•Von Korff, M., Mioglioretti, D., Simon, G., Saunders, K., Crane, P., Lane, M., Kessler, R., Stang, P., Branderburg, N., Chronic spinal pain and physical-mental comorbidity in the United States: Results from the national comorbidity survey replication, Journal of Pain, Volume 113, Issue 3, Pages 331-339 (2005)

TOP


Intr

od

ucti

on

to M

ed

icin

e

11. Authors• Ana Catarina Fareleira• Ana Sofia Sampaio• Ana Teresa Sousa• André da Silva Pinto• André de Castro Pinho• André Filipe Silva• Andreia Gomes da Costa• António Manuel Oliveira• Daniela Ladeiras Pina• Rita Bettencourt Silva• Rita Joana Matos

Class 4

First YearMedicine Faculty of Oporto University


Documents

Prevalence of Chronic Pain: Systematic review