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      Características de los pacientes con dolor musculoesquelético moderado a intenso, tratados con comprimidos bucodispersables de paracetamol 325 mg/tramadol HCI 37,5 mg (Paxiflas(r)) respecto a otras formas orales de la misma combinación. Estudio PROPAX Translated title: Characteristics of patients suffering mild to severe pain treated with orodispersible tablets of paracetamol 325 mg/tramadol HCL 37,5mg (Paxiflas(r)) in comparison with other oral formulations containing the same combination. PROPAX study

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          Abstract

          RESUMEN Objetivo: Comparar el perfil del paciente con dolor musculoesquelético moderado a intenso en tratamiento con los comprimidos bucodispersables, Paxiflas(r) [tramadol HCl (37,5 mg) y paracetamol (325 mg)] respecto a otras combinaciones de tramadol HCl (37,5 mg) y paracetamol (325 mg). Secundariamente, se comparó la adherencia, satisfacción y preferencia entre grupos. Materiales y métodos: El estudio Propax es un estudio postautorización, observacional, transversal, retrospectivo y multicéntrico. La variable principal fue el perfil sociodemográfico y clínico del paciente. La satisfacción de los pacientes en tratamiento se midió mediante el cuestionario genérico SATMED-Q; la adherencia, con el cuestionario Morisky-Green; y la preferencia, mediante una batería de preguntas con respuesta tipo Likert. Resultados: Se evaluaron 835 pacientes. No se observaron diferencias estadísticamente significativas en el perfil clínico y sociodemográfico de los pacientes entre ambos grupos de tratamiento, pero sí entre los pacientes en tratamiento con Paxiflas(r), en relación con la evaluación de la satisfacción, tanto en la puntuación total (p = 0,002) como en las dimensiones: la interferencia de los efectos secundarios de la medicación en las actividades cotidianas (p = 0,006), la comodidad de uso (p < 0,001) y la opinión general respecto a la medicación y su estado de salud (p = 0,010). Además, la preferencia de los pacientes por el tratamiento con Paxiflas(r) fue estadísticamente significativas (p < 0,001) en comparación con otras combinaciones orales de tramadol HCI (37,5 mg) y paracetamol (325 mg), incluyendo la percepción de rapidez en el alivio del dolor, comodidad de la medicación, sabor y sensación agradable, conveniencia del tamaño del comprimido, y elección final del tratamiento. Conclusiones: Entre los distintos grupos de tratamiento no se encontraron diferencias estadísticamente significativas en el perfil de los pacientes, ni en el grado de adherencia a la medicación. Los comprimidos bucodispersables Paxiflas(r) han demostrado un mayor grado de satisfacción y preferencia por parte de los pacientes con dolor musculoesquelético agudo y crónico moderado e intenso frente a otras formas orales.

          Translated abstract

          ABSTRACT Objective: To compare profiles of patients suffering mild to severe pain treated with orodispersible formulation of paracetamol 325 mg/tramadol HCL 37,5mg (Paxiflas(r)) in comparison with other oral formulations of paracetamol 325 mg/tramadol HCL 37,5mg. In addition, to compare adherence, satisfaction and preference between groups. Materials and methods: Propax is a postautorization, observational, cross-sectional retrospective and multicentre study. The primary variable was the clinic and sociodemographic profile of the patient. Patient satisfaction was measured by STAMED generic questionnaire; adherence was measured by Morisky-Green questionnaire and preference was measured using a battery of questions with Likert-like answer. Results: A number 835 patients were evaluated. Clinical and sociodemographic statistically significant differences were not observed between both groups of patients. However, there were statistically significant differences among Paxiflas(r) group of patients in satisfaction assessment, in both total score (p = 0,002) and dimensions: side effects interferences in everyday life (p = 0,006), convenience and ease of use (p < 0,001) and overall opinion of medication and health condition (p = 0,010). In addition, patient preference of Paxiflas(r) over other oral combinations of tramadol HCI (37.5 mg) and paracetamol (325 mg) was statistically significant (p < 0,001), including perception of pain relief speed, medication convenience, taste and likeable sensation, tablet size convenience and final election of treatment. Conclusions: Statistically significant differences were not observed in neither patient profile nor adherence. Paxiflas(r) orodispersible tablets demonstrated to provide greater satisfaction and preference among patients suffering acute and mild chronic musculoskeletal pain than other oral formulations.

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          Most cited references24

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          To develop and validate a multidimensional generic questionnaire measuring satisfaction with treatment with medicines. The questionnaire was designed to be used in chronic patients undergoing pharmacological treatment for any disease. After a literature review and cognitive debriefing process with an expert panel of six members and 21 chronic patients in four focus groups, a preliminary instrument with 36 items grouped into six dimensions was developed. Three samples of patients were enrolled during the whole process: 1) 12 patients to assess feasibility and pertinence of items; 2) 150 patients for item reduction; and 3) 455 patients for psychometric properties assessment of the instrument. The latter two were stratified by gender, age, and main disease (type 2 diabetes, hypertension, osteoarthritis, benign prostate hyperplasia, chronic obstructive pulmonary disease/asthma, depression, and migraine). Additional measures were gathered for concept validity: clinical and treatment information, patient and clinician assessment of treatment tolerability and effectiveness, treatment satisfaction (Treatment Satisfaction Questionnaire for Medication [TSQM]), and therapeutic compliance (Morisky-Green). Feasibility, reliability, and validity (content, discriminant, construct, and concurrent) were assessed. Factor analysis item reduction resulted in a 17-item questionnaire with six dimensions: treatment effectiveness, convenience of use, impact on daily activities, medical care, global satisfaction, and undesirable side effects. Unidimensional scales (Cronbach's alpha ranging 0.813-0.912) were correlated, and allowed computation of a summary composite score (alpha = 0.890). SATMED-Q dimensions showed moderate but significant correlations with TSQM dimensions (0.577-0.680). Differences between tolerability and effectiveness groups were found, depending on dimension and whether the clinician or the patient were informing. Therapeutic compliance groups showed differences in some treatment satisfaction dimensions. The SATMED-Q is a reliable and valid measure of treatment satisfaction, structured in six dimensions, and a summary composite score. Additional work is needed to assess sensitivity to change.
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            To investigate the impact of musculoskeletal pain on health-related quality of life and work productivity losses among US workers. Data from the 2008 US National Health and Wellness Survey were used. Among those currently employed aged 20 to 64 years (N = 30,868), workers with arthritis (n = 2,670), back (n = 4,920), and fibromyalgia (n = 439) pain were compared with workers without those respective musculoskeletal pain conditions. Arthritis, back, and fibromyalgia pain were all associated with significantly lower levels of health-related quality of life, often at clinically meaningful levels. All pain conditions were associated with higher levels of work productivity loss, even after adjusting for demographic and health characteristics. Musculoskeletal pain conditions were highly prevalent and associated with a significant burden. Improved management of these conditions may lead to improved productivity, benefiting both employers and workers alike.
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              Pharmacology of oral combination analgesics: rational therapy for pain.

              No single analgesic agent is perfect and no single analgesic can treat all types of pain. Yet each agent has distinct advantages and disadvantages compared to the others. Hence, clinical outcomes might be improved under certain conditions with the use of a combination of analgesics, rather than reliance on a single agent. A combination is most effective when the individual agents act through different analgesic mechanisms and act synergistically. By activating multiple pain-inhibitory pathways, combination analgesics can provide more effective pain relief for a broader spectrum of pain, and might also reduce adverse drug reactions. This overview highlights the therapeutic potential of combining analgesic medications with different mechanisms of action, particularly a nonsteroidal anti-inflammatory drug (NSAID) or acetaminophen with an opioid or tramadol.
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                Author and article information

                Journal
                dolor
                Revista de la Sociedad Española del Dolor
                Rev. Soc. Esp. Dolor
                Inspira Network Group, S.L (Madrid, Madrid, Spain )
                1134-8046
                June 2020
                : 27
                : 3
                : 168-177
                Affiliations
                [2] Barcelona orgnameLaboratorios Gebro Pharma España
                [1] Barcelona orgnameHospital Teknon-Quirón orgdiv1Servicio de Traumatología España
                Article
                S1134-80462020000300168 S1134-8046(20)02700300168
                10.20986/resed.2020.3771/2019
                82ed70bd-88c4-403d-9352-38fff91e3979

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 23 March 2020
                : 16 October 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 34, Pages: 10
                Product

                SciELO Spain

                Categories
                Originales

                preference,adherence,satisfaction,orodispersible tablets,tramadol/paracetamol,Musculoskeletal pain,preferencia,adherencia,satisfacción,comprimidos bucodispersables,Dolor musculoesquelético

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