Pharmacological interventions for patients with chronic primary musculoskeletal pain: disparity between synthesized evidence and real-world clinical practice
Introduction:. Chronic primary musculoskeletal pain (CPMP) poses a major problem of public health, with high prevalence rates and economic burden. There is a wealth of clinical trials examining pharmacological interventions for patients with CPMP. Nevertheless, evidence from such trials does not nec...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2025-02-01
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| Series: | PAIN Reports |
| Online Access: | http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001216 |
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| author | Helen Koechlin Cedric Werdelis Antonia Barke Beatrice Korwisi Roland von Känel Julia Wagner Cosima Locher |
| author_facet | Helen Koechlin Cedric Werdelis Antonia Barke Beatrice Korwisi Roland von Känel Julia Wagner Cosima Locher |
| author_sort | Helen Koechlin |
| collection | DOAJ |
| description | Introduction:. Chronic primary musculoskeletal pain (CPMP) poses a major problem of public health, with high prevalence rates and economic burden. There is a wealth of clinical trials examining pharmacological interventions for patients with CPMP. Nevertheless, evidence from such trials does not necessarily mirror clinical realities.
Objectives:. We aimed to compare data sets from a clinical sample with an randomized controlled trial (RCT)-based sample.
Methods:. Both data sets included participants living with CPMP who received pharmacological interventions. The clinical sample was retrieved from electronic health records. The RCT-based sample stemmed from a network meta-analysis project. The following outcomes were used: demographic information, diagnosis-specific data, and pharmacological interventions (categorized according to the World Health Organization [WHO] analgesic ladder).
Results:. The clinical sample consisted of 103 patients (mean age: 50.25 years; SD: 14.0) and the RCT-based samples contributed 8665 participants (mean age: 51.97 years; SD: 6.74). In both samples, the proportion of women was higher than that of men (ie, 74.8% vs 58.9%). Psychiatric disorders were the most common comorbidities in the clinic sample but also the most frequent reason for patient exclusion in RCTs. The 2 samples differed significantly in medication classified as WHO III (clinical sample: 12.9%; RCT sample: 23.5%; P = 0.023) and WHO IV (clinical sample: 23.4%; RCT sample: 8.6%; P < 0.001), yet not WHO I and II.
Conclusion:. Our findings suggest a disparity between research-based study populations and clinical populations with CPMP. We advocate for future investigations on how to implement robust scientific evidence into real-world clinical practice, with a particular focus on addressing psychiatric comorbidities. |
| format | Article |
| id | doaj-art-cc7d33ffcb9141a8958138e464a65d5a |
| institution | Kabale University |
| issn | 2471-2531 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | PAIN Reports |
| spelling | doaj-art-cc7d33ffcb9141a8958138e464a65d5a2024-12-24T09:47:10ZengWolters KluwerPAIN Reports2471-25312025-02-01101e121610.1097/PR9.0000000000001216PR90000000000001216Pharmacological interventions for patients with chronic primary musculoskeletal pain: disparity between synthesized evidence and real-world clinical practiceHelen Koechlin0Cedric Werdelis1Antonia Barke2Beatrice Korwisi3Roland von Känel4Julia Wagner5Cosima Locher6a Department of Psychosomatics and Psychiatry, University Children's Hospital, University of Zurich, Zurich, Switzerlandd Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerlande Division of Clinical Psychology and Psychological Intervention, Department of Psychology, University of Duisburg-Essen, Essen, Germanye Division of Clinical Psychology and Psychological Intervention, Department of Psychology, University of Duisburg-Essen, Essen, Germanyd Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerlandd Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerlandd Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandIntroduction:. Chronic primary musculoskeletal pain (CPMP) poses a major problem of public health, with high prevalence rates and economic burden. There is a wealth of clinical trials examining pharmacological interventions for patients with CPMP. Nevertheless, evidence from such trials does not necessarily mirror clinical realities. Objectives:. We aimed to compare data sets from a clinical sample with an randomized controlled trial (RCT)-based sample. Methods:. Both data sets included participants living with CPMP who received pharmacological interventions. The clinical sample was retrieved from electronic health records. The RCT-based sample stemmed from a network meta-analysis project. The following outcomes were used: demographic information, diagnosis-specific data, and pharmacological interventions (categorized according to the World Health Organization [WHO] analgesic ladder). Results:. The clinical sample consisted of 103 patients (mean age: 50.25 years; SD: 14.0) and the RCT-based samples contributed 8665 participants (mean age: 51.97 years; SD: 6.74). In both samples, the proportion of women was higher than that of men (ie, 74.8% vs 58.9%). Psychiatric disorders were the most common comorbidities in the clinic sample but also the most frequent reason for patient exclusion in RCTs. The 2 samples differed significantly in medication classified as WHO III (clinical sample: 12.9%; RCT sample: 23.5%; P = 0.023) and WHO IV (clinical sample: 23.4%; RCT sample: 8.6%; P < 0.001), yet not WHO I and II. Conclusion:. Our findings suggest a disparity between research-based study populations and clinical populations with CPMP. We advocate for future investigations on how to implement robust scientific evidence into real-world clinical practice, with a particular focus on addressing psychiatric comorbidities.http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001216 |
| spellingShingle | Helen Koechlin Cedric Werdelis Antonia Barke Beatrice Korwisi Roland von Känel Julia Wagner Cosima Locher Pharmacological interventions for patients with chronic primary musculoskeletal pain: disparity between synthesized evidence and real-world clinical practice PAIN Reports |
| title | Pharmacological interventions for patients with chronic primary musculoskeletal pain: disparity between synthesized evidence and real-world clinical practice |
| title_full | Pharmacological interventions for patients with chronic primary musculoskeletal pain: disparity between synthesized evidence and real-world clinical practice |
| title_fullStr | Pharmacological interventions for patients with chronic primary musculoskeletal pain: disparity between synthesized evidence and real-world clinical practice |
| title_full_unstemmed | Pharmacological interventions for patients with chronic primary musculoskeletal pain: disparity between synthesized evidence and real-world clinical practice |
| title_short | Pharmacological interventions for patients with chronic primary musculoskeletal pain: disparity between synthesized evidence and real-world clinical practice |
| title_sort | pharmacological interventions for patients with chronic primary musculoskeletal pain disparity between synthesized evidence and real world clinical practice |
| url | http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001216 |
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