Prevalence of Chronic Pain in the General Population: a Systematic Review

In this work we will focus:AuthorsTitle and keywordsAbstractIntroductionParticipants MethodsResultsDiscussionTask descriptionAcknowledgementsReferences

Authors

Ana Catarina FareleiraAna Sofia SampaioAna Teresa SousaAndré da Silva PintoAndré de Castro PinhoAndré Filipe SilvaAndreia Gomes da CostaAntónio Manuel OliveiraDaniela Ladeiras PinaRita Bettencourt SilvaRita Joana Matos

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Class 4

First YearMedicine Faculty of Porto University

Title and keywords

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Prevalence of Chronic Pain in the General Population: a Systematic ReviewKeywords: Prevalence, chronic pain, Epidemiology

Abstract

In this systematic review prevalence of chronic pain will be analyzed. In order to fulfill this task, several cross-sectional studies about chronic pain and its prevalence have been read and selected having into account a number of inclusion and exclusion criteria.Then the results will be presented and discussed.

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Introduction

1 – Chronic pain: definition

• Pain definition: “(...)an unpleasant sensory and emotional experience associated with actual and potential tissue damage, or described in terms of such damage (...)” (IASP, 1986)

• Chronic pain definition: Pain which lasts beyond a normal recovery period.

• Definition of pain and chronic pain – Associated Problems:

– Subjective nature;

– Incapacity in quantifying pain;

– Contextualization;

– No agreement about the necessary time to consider chronic pain (1 month, 3 months or 6 months);

– Chronic pain duration.

2 – Systematic review: definition

• Planned review to answer a specific question and that uses systematic and explicit methods to identify, select and evaluate the studies;

• It consists in reviewing all the existence references

3 – Relevance of the question and comments

Chronic pain:

• Strikes human population;• Has an impact in patients’ quality of life (at

different levels: physical, psychoemotional, social, sexual,...), in family, health workers and institutions related to them and in society in general.

The study of the question is important to:

• Minimize the dificulties found when defining chronic pain;

• Quantify the prevalence of chronic pain in general population and relate it with geographical regions and other variables (gender, age,...)

• Identify the most affected anatomical regions.

4 – Objectives

• To qualify and quantify the prevalence of chronic pain in general population;

• To explain differences in chronic pain between the analysed studies concerning its definition and geographical and anatomical regions;

• To study the average time of chronic pain duration.

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Participants

Study design – systematic reviewSelection criteria– Inclusion criteria:

• Focusing chronic pain;

• Cross-sectional studies (study of prevalence);

• Studies with participants between 18 and 75 years old (inclusive);

• Studies related only to humans.

– Exclusion criteria:

• Studies focusing acute pain or other kind of pain;

• Studies including only elders (>75) or children/teenagers (<18);

• Studies comparing chronic pain with another type of pain.

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Search strategy:

– Query Formulation:• Pubmed

Pain – 308765

Pain AND prevalence – 27569

Pain AND prevalence AND chronic - 3966

“chronic pain” AND prevalence – 820• Scopus

“chronic pain” AND prevalence – 540

– Endnote (References management software)

– Other sources - then other databases will be researched

Methods

Articles selection•1st phase or screenphase –

reading the title and abstract of the obtained articles in the databases and exclusion of the ones that do not fit.

– Random groups of 2 people:Ana Catarina e Ana Teresa Rita Silva e André PinhoRita Matos e Daniela PinaAndré Pinto e Andreia Ana Sofia e António

•2nd phase or inclusion phase – according with the pre-established criteria of inclusion and exclusion, the fitting articles were chosen.

Statistical methods• After the extraction of the article

data, the articles’ information will be processed and analyzed with graphics and tables, based on statistical methods such as variable statistic description and forest-plots.

x articles included

Bibliographic SearchQuery – “chronic pain” AND prevalence

Pubmed840 Articles

Found

Scopus520 Articles

Found

x articles not selected (repeated)

ScreenphaseRevision through titles and abstracts

(5 grups of 2 revisers each)

x articles selected

x articles not selected

· x articles not selected f or group I

· x articles not selected f or group I I

· x articles not selected f or group I I I

· x articles not selected f or group I V

· x articles not selected f or group V

I nclusion PhaseRevision through the complete article

X complete articles

EndnoteTotal of x Articles Found

Exclusion Motives:· We can’t have the

complete article· ...· ...· ...· ...

Quality Avaliation

x articles included

x articles excluded

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Results

• The articles’ information was extracted with the help of the following table:

AuthorsResearch methods

DefinitionAspects taken in account

Prevalence

Demographic characteristics

Author Year of

the study

Location Type of

the surveyAgeNumberResponse

rate

Time to be considered chronic pain

IntensityConsequenc

esPain

localization

Persistence of pain;

LocationGradationTemporal

characteristicsSocial

disability

Prevalence

Sexual distributionAgeAssociation with social

components, etc.

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Discussion

Presentation of the study conclusions; Discussion about the conceptual, methodological and operational limitations of the study, and their implication in the conclusions; Comments about the controversies and the implications resulting from the conclusions;Comments about future perspectives of chronic pain.

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Task description

Gantt map

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Acknowledgements

This systematic review is part of a research project for the Introduction to Medicine subject in the Medicine Faculty of Porto University

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ReferencesPai, M., McCulloch, M., Gorman, J.D., Pai, N., Enanoria, W., Kennedy, G., Tharyan, P. and Colford, G., Systematic reviews and meta-analyses: An illustrated, step-by-step guide, The national medical journal of India vol. 17 (2004)Verhakk, P., Kerssens, J., Dekker, J., Sorbi, M. and Bensing, J., Prevalence of chronic benign pain disorder among adults: a review of literature, Pain, 77 (1998) 231-239Rustoen, T., Wahl, A., Hanestad, B., Lerdal, A., Paul, S. and Miaskowski, C., Prevalence and characteristicas of chronic pain in the general Norwegian population, European Journal of Pain, 8 (2004) 555-565www.pubmed.comwww.scopus.comMagni,G., Carldieron, C., Rigatti-Lunchini, S. and Merskey, H., Chronic abdominal pain and depression. Epidemiology findings in the United States. Hispanic health and nutrition examination survey, Pain, 49 (1992) 77-85Brattberg, G., Thorslund, M. and Wikman, A., The prevalence of pain in the general population. The results of a postal survey in a county of Sweden, Pain, 37 (1989) 215-222

This was our first presentation of the annual Work of Introduction to Medicine.“Soldiers often have no choice when they are courageous. But Chronic Pain Patients choose daily the courage to 'endure the unendurable'.

They are the true heros. “ Sabaism

(Beverly P.) 2001