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      Implementation of Patient‐Reported Outcomes (PROMs) from specialist pain clinics in England and Wales: Experience from a nationwide study

      1 , 2 , 3 , 4
      European Journal of Pain
      Wiley

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          Abstract

          Evaluating outcomes in routine clinical practice is a significant challenge for specialist pain clinics due to the complexity of interventions provided and the subjective nature of pain. This study reports findings from implementation of Patient Reported Outcomes (PROMs) in pain clinics in England and Wales between 2011 and 2013.

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          Most cited references21

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          Neuropathic pain in the general population: a systematic review of epidemiological studies.

          Most patients with neuropathic pain symptoms present and are managed in primary care, with only a minority being referred for specialist clinical assessment and diagnoses. Previous reviews have focused mainly on specific neuropathic pain conditions based in specialist settings. This is the first systematic review of epidemiological studies of neuropathic pain in the general population. Electronic databases were searched from January 1966 to December 2012, and studies were included where the main focus was on neuropathic pain prevalence and/or incidence, either as part of a specific neuropathic pain-related condition or as a global entity in the general population. We excluded studies in which data were extracted from pain or other specialist clinics or focusing on specific population subgroups. Twenty-one articles were identified and underwent quality assessment and data extraction. Included studies differed in 3 main ways: method of data retrieval, case ascertainment tool used, and presentation of prevalence/incidence rates. This heterogeneity precluded any meta-analysis. We categorised comparable incidence and prevalence rates into 2 main subgroups: (1) chronic pain with neuropathic characteristics (range 3-17%), and (2) neuropathic pain associated with a specific condition, including postherpetic neuralgia (3.9-42.0/100,000 person-years [PY]), trigeminal neuralgia (12.6-28.9/100,000 PY), painful diabetic peripheral neuropathy (15.3-72.3/100,000 PY), glossopharyngeal neuralgia (0.2-0.4/100,000 PY). These differences highlight the importance of a standardised approach for identifying neuropathic pain in future epidemiological studies. A best estimate of population prevalence of pain with neuropathic characteristics is likely to lie between 6.9% and 10%. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
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            Validity of the Brief Pain Inventory for Use in Documenting the Outcomes of Patients With Noncancer Pain

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              Catalogue of EQ-5D scores for the United Kingdom.

              The National Institute for Health and Clinical Excellence (NICE) has issued guidance on cost-effectiveness analyses, suggesting that preference-based health-related quality of life (HRQL) weights or utilities be based on UK community preferences, preferably using the EQ-5D; ideally all analyses would use the same system for deriving HRQL weights, to encourage consistency and comparability across analyses. Development of a catalogue of EQ-5D scores for a range of health conditions based on UK preferences would help achieve many of these goals. . To provide a UK-based catalogue of EQ-5D index scores. . s were consistent with the previously published catalogue of EQ-5D scores for the US. Community-based UK preferences were applied to EQ-5D descriptive questionnaire responses in the US-based Medical Expenditure Panel Survey (MEPS). Ordinary least squares (OLS), Tobit, and censored least absolute deviations (CLAD) regression methods were used to estimate the 'marginal disutility' of each condition controlling for covariates. . Pooled MEPS files (2000-2003) resulted in 79,522 individuals with complete EQ-5D scores. Marginal disutilities for 135 chronic ICD-9 and 100 CCC codes are provided. Unadjusted descriptive statistics including mean, median, 25th and 75th percentiles are also reported. . This research provides community-based EQ-5D index scores for a wide variety of chronic conditions that can be used to estimate QALYs in cost-effectiveness analyses in the UK. Although using EQ-5D questionnaire responses from the US-based MEPS is less than ideal, the estimates approximate HRQL guidelines by NICE and provide an easily accessible"off-the-shelf" resource for cost-effectiveness and public-health applications.
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                Author and article information

                Journal
                European Journal of Pain
                Eur J Pain
                Wiley
                1090-3801
                1532-2149
                May 31 2019
                May 31 2019
                Affiliations
                [1 ]Solent NHS Trust Southampton UK
                [2 ]Research Department of Clinical Educational & Health Psychology, UCL London UK
                [3 ]Department of Population Health Sciences University of Dundee, Ninewells Hospital and Medical School Dundee UK
                [4 ]Dr Foster Unit Imperial College London London UK
                Article
                10.1002/ejp.1406
                31025797
                029ad333-6966-47ad-a770-21d9a3a746a4
                © 2019

                http://doi.wiley.com/10.1002/tdm_license_1.1

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