Showing papers by "Bruce D. Dick published in 2009"
TL;DR: A number of comorbid medical illnesses increased CNCP risk, including some (such as chronic obstructive pulmonary disease, epilepsy and thyroid disease) that have not hitherto been associated with pain.
Abstract: Chronic noncancer pain (CNCP) is a prevalent health problem with pervasive negative effects on the individual’s quality of life. Previous epidemiological studies of CNCP have suggested a number of individual biological, psychological and societal correlates of CNCP, but it has rarely been possible to simultaneously compare the relative strengths of many such correlates in a Canadian population sample. With data provided by the 1996/1997 Canadian National Population Health Survey, ordinal logistic regression was used to examine the extent to which a number of population variables are associated with CNCP in a large (n=69,365) dataset. The analysis revealed cross-sectional correlations of varying strengths between CNCP and 27 factors. Increasing age, low income, low educational achievement, daily cigarette smoking, physical inactivity and abstention from alcohol were among the factors found to increase CNCP risk. The considerable impact of distress and depression on CNCP are also highlighted. A number of comorbid medical illnesses increased CNCP risk, including some (such as chronic obstructive pulmonary disease, epilepsy and thyroid disease) that have not hitherto been associated with pain. White race and the affirmation of an important role for spirituality or faith reduced CNCP risk. In contrast to some previous studies, female sex did not emerge as an independent CNCP risk. The present exploratory analysis describes associations between CNCP and a number of characteristics from several domains, thus suggesting many areas for further research.
58 citations
TL;DR: The morbidity associated with chronic pain is worth approximately $1428 for every month in the chronic pain health state, and treatment and management strategies that focus on reducing pain intensity would have the greatest impact on improving health-related quality of life.
43 citations
TL;DR: A single IV infusion of propofol 2.4 mg/kg produces a statistically significant, but not clinically meaningful, reduction in disability from CDH 30 days after infusion and does not reduce pain intensity or analgesic use.
Abstract: BACKGROUND: On the basis of a small number of case studies, IV propofol has been advocated for the treatment of chronic daily headache (CDH) There has been no randomized controlled trial of this therapy Our objective in this randomized, double-blind, placebo-controlled trial was to determine whether a single IV dose of propofol 24 mg/kg results in clinically significant reduction in disability or pain in CDH for the next 30 days METHODS: Eligible adults with CDH received either active treatment with IV propofol infusion (n = 20) or active placebo of IV midazolam (n = 20) The main outcome measures were (a) Headache Disability Inventory (HDI) at 30 days posttreatment, (b) Headache Index, a summary measure of headache intensity over the 30-day period, and (c) analgesic consumption measured as the Medication Quantification Scale version III RESULTS: Propofol reduced the HDI by 947 points (sd 141) at 30 days after injection (P = 0009), but this is a smaller reduction in headache-related disability than that which the developers of the HDI regard as clinically significant There was no statistically significant change in HDI for the control group There were no significant within- or between-group reductions in mean pain intensity as measured by the Headache Index or medication use as measured by the Medication Quantification Scale version III in either group CONCLUSIONS: A single IV infusion of propofol 24 mg/kg produces a statistically significant, but not clinically meaningful, reduction in disability from CDH 30 days after infusion and does not reduce pain intensity or analgesic use This study does not support this regimen of IV propofol for clinical management of CDH
15 citations
TL;DR: The PRPQ is a psychometrically sound measure of preferences of pain-related social support and research with clinical samples is needed to further evaluate its psychometric properties and clinical utility.
Abstract: BACKGROUND: Behavioural conceptualizations of chronic pain posit that solicitous responses to pain behaviours are positively reinforcing and play a role in the development of chronic pain and disability. Recent research suggests that studies investigating this model were likely limited by the use of only a few narrowly defined categories of responses to pain behaviour. A measure of preferences regarding pain-related social support has the potential to improve behavioural models of chronic pain by identifying other potentially reinforcing responses to pain behaviour.
14 citations