We wanted to identify a five-item short form of the Problem Areas in Diabetes Scale and a single-item measure for rapid screening of diabetes-related emotional distress.
14 October 2009 in Journal of Intellectual Disability Research
Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: eHealth is the use of information and communication technology in the context of healthcare and health research. Recently, there has been a rise in the number of eHealth modalities and the frequency in which they are used to deliver technology-assisted self-management interventions for people living with chronic pain. However, there has been little or no research directly comparing these eHealth modalities. Objective: The aim of the current systematic review with a network meta-analysis is to directly compare the effectiveness of eHealth modalities in the context of chronic pain. Methods: Randomised controlled trials (N>20 per arm) that investigated technologically delivered interventions for adults with chronic pain were included. Data were extracted on pain severity, psychological distress and HRQoL, and the risk of bias was assessed. Studies were classified by their primary mode of delivery. Pair-wise meta-analyses were undertaken and a network meta-analysis was conducted to generate indirect comparisons of modalities for reducing pain severity. Results: The search returned 18,470 studies with 18,349 excluded (duplicates [2,310]; title and abstract [16,039]). Of the remaining papers, 30 studies with 4,595 randomised participants were included in the review. Rankings tentatively indicate that telephone supported interventions are the most effective, with a 46% chance that telephone intervention was the best modality, followed by studies delivered via interactive voice response, internet and virtual reality. Conclusions: This current systematic review with a network meta-analysis generated comparisons between previously un-compared technological modalities to determine which delivered the most effective interventions for the reduction of pain severity in chronic pain patients. There are limitations with this review; in particular, the underrepresented nature of some eHealth modalities included in the analysis. However, in the event that the review is regularly updated a clear ranking of eHealth modalities for the reduction of pain severity will emerge. Clinical Trial: PROSPERO: Registration database number: CRD42016035595
14 October 2009 in Journal of Intellectual Disability Research
A growing body of empirical research has confirmed an association between chronic pain and cognitive dysfunction. The aim of the present study was to determine whether cognitive function is affected in patients with a diagnosis of chronic neuropathic or radicular pain relative to healthy control participants matched by age, gender, and years of education. We also examined the interaction of pain with age in terms of cognitive performance. Some limitations of previous clinical research investigating the effects of chronic pain on cognitive function include differences in the pain and cognitive scale materials used, and the heterogeneity of patient participants, both in terms of their demographics and pathological conditions. To address these potential confounds, we have used a relatively homogenous patient group and included both experimental and statistical controls. We have also specifically investigated the interaction effect of pain and age on cognitive performance. Patients (n = 38) and controls (n = 38) were administered a battery of cognitive tests measuring IQ, spatial and verbal memory, attention, and executive function. Educational level, depressive symptoms, and state anxiety were assessed as were medication usage, caffeine, and nicotine consumption to control for possible confounding effects. Both the level of depressive symptoms and the state anxiety score were higher in chronic pain patients than in matched control participants. Chronic pain patients had a lower estimated IQ than controls, and showed impairments on measures of spatial and verbal memory. Attentional responding was altered in the patient group, possibly indicative of impaired inhibitory control. There were significant interactions between chronic pain condition and age on a number of cognitive outcome variables, such that older patients with chronic pain were more impaired than both age-matched controls and younger patients with chronic pain. Chronic pain did not appear to predict performance on the Wisconsin Card Sorting Task, which was used a measure of executive function. This study supports and extends previous research indicating that chronic pain is associated with impaired memory and attention. Perspective: Compared to healthy control participants, patients with chronic neuropathic or radicular pain showed cognitive deficits which were most pronounced in older pain patients.