Effects of the COVID-19 pandemic on chronic pain in Spain: a scoping review.
Effects of the COVID-19 pandemic on chronic pain in Spain: a scoping review.
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DOI：
10.1097/pr9.0000000000000899
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发表时间：
2021-01
期刊：
影响因子：
4.8
通讯作者：
Triñanes Y
中科院分区：
文献类型：
--
作者：
Carrillo-de-la-Peña MT;González-Villar A;Triñanes Y
患者之间对止痛治疗的反应有很大的差异(即使是有效的治疗)，这可能是临床实践中巨大挫折的来源。这导致了对“精确医学”或个性化疼痛疗法(即，为个别患者确定最佳治疗或治疗组合的经验算法)的呼声，这些疗法可能会改善疼痛患者的临床护理，并在第二阶段和第三阶段临床试验中提高假定的止痛药的成功率。然而，在实施这种方法之前，需要确定个别患者或患者亚组的特征，这些特征会增加或减少对特定治疗的反应。挑战是确定最能预测止痛治疗结果个体差异的患者的可测量表型特征，以及最适合评估这些特征的测量工具。在这篇文章中，我们提出了这些表型特征中最有希望用于未来研究的证据，包括心理社会因素、症状特征、睡眠模式、对伤害性刺激的反应、内源性疼痛调节过程以及对药物挑战的反应。我们为核心表型域提供了基于证据的建议，并推荐了每个域的措施。
There is tremendous interpatient variability in the response to analgesic therapy (even for efficacious treatments), which can be the source of great frustration in clinical practice. This has led to calls for “precision medicine” or personalized pain therapeutics (ie, empirically based algorithms that determine the optimal treatments, or treatment combinations, for individual patients) that would presumably improve both the clinical care of patients with pain and the success rates for putative analgesic drugs in phase 2 and 3 clinical trials. However, before implementing this approach, the characteristics of individual patients or subgroups of patients that increase or decrease the response to a specific treatment need to be identified. The challenge is to identify the measurable phenotypic characteristics of patients that are most predictive of individual variation in analgesic treatment outcomes, and the measurement tools that are best suited to evaluate these characteristics. In this article, we present evidence on the most promising of these phenotypic characteristics for use in future research, including psychosocial factors, symptom characteristics, sleep patterns, responses to noxious stimulation, endogenous pain-modulatory processes, and response to pharmacologic challenge. We provide evidence-based recommendations for core phenotyping domains and recommend measures of each domain.