TY - JOUR
T1 - Multinational evidence-based recommendations for pain management by pharmacotherapy in inflammatory arthritis
T2 - Integrating systematic literature research and expert opinion of a broad panel of rheumatologists in the 3e initiative
AU - Whittle, Samuel L.
AU - Colebatch, Alexandra N.
AU - Buchbinder, Rachelle
AU - Edwards, Christopher J.
AU - Adams, Karen
AU - Englbrecht, Matthias
AU - Hazlewood, Glen
AU - Marks, Jonathan L.
AU - Radner, Helga
AU - Ramiro, Sofia
AU - Richards, Bethan L.
AU - Tarner, Ingo H.
AU - Aletaha, Daniel
AU - Bombardier, Claire
AU - Landewé, Robert B.
AU - Müller-ladner, Ulf
AU - Bijlsma, Johannes W.J.
AU - Branco, Jaime C.
AU - Bykerk, Vivian P.
AU - Da rocha castelar pinheiro, Geraldo
AU - Catrina, Anca I.
AU - Hannonen, Pekka
AU - Kiely, Patrick
AU - Leeb, Burkhard
AU - Lie, Elisabeth
AU - Martinez-osuna, Píndaro
AU - Montecucco, Carlomaurizio
AU - østergaard, Mikkel
AU - Westhovens, Rene
AU - Zochling, Jane
AU - Van der heijde, Désirée
N1 - Funding Information:
Funding: This work was supported by Abbott with an unrestricted educational grant.
PY - 2012/8
Y1 - 2012/8
N2 - Objective. To develop evidence-based recommendations for pain management by pharmacotherapy in patients with inflammatory arthritis (IA).Methods. A total of 453 rheumatologists from 17 countries participated in the 2010 3e (Evidence, Expertise, Exchange) Initiative. Using a formal voting process, 89 rheumatologists representing all 17 countries selected 10 clinical questions regarding the use of pain medications in IA. Bibliographic fellows undertook a systematic literature review for each question, using MEDLINE, EMBASE, Cochrane CENTRAL and 2008-09 European League Against Rheumatism (EULAR)/ACR abstracts. Relevant studies were retrieved for data extraction and quality assessment. Rheumatologists from each country used this evidence to develop a set of national recommendations. Multinational recommendations were then formulated and assessed for agreement and the potential impact on clinical practice.Results. A total of 49 242 references were identified, from which 167 studies were included in the systematic reviews. One clinical question regarding different comorbidities was divided into two separate reviews, resulting in 11 recommendations in total. Oxford levels of evidence were applied to each recommendation. The recommendations related to the efficacy and safety of various analgesic medications, pain measurement scales and pain management in the pre-conception period, pregnancy and lactation. Finally, an algorithm for the pharmacological management of pain in IA was developed. Twenty per cent of rheumatologists reported that the algorithm would change their practice, and 75% felt the algorithm was in accordance with their current practice.Conclusions. Eleven evidence-based recommendations on the management of pain by pharmacotherapy in IA were developed. They are supported by a large panel of rheumatologists from 17 countries, thus enhancing their utility in clinical practice.
AB - Objective. To develop evidence-based recommendations for pain management by pharmacotherapy in patients with inflammatory arthritis (IA).Methods. A total of 453 rheumatologists from 17 countries participated in the 2010 3e (Evidence, Expertise, Exchange) Initiative. Using a formal voting process, 89 rheumatologists representing all 17 countries selected 10 clinical questions regarding the use of pain medications in IA. Bibliographic fellows undertook a systematic literature review for each question, using MEDLINE, EMBASE, Cochrane CENTRAL and 2008-09 European League Against Rheumatism (EULAR)/ACR abstracts. Relevant studies were retrieved for data extraction and quality assessment. Rheumatologists from each country used this evidence to develop a set of national recommendations. Multinational recommendations were then formulated and assessed for agreement and the potential impact on clinical practice.Results. A total of 49 242 references were identified, from which 167 studies were included in the systematic reviews. One clinical question regarding different comorbidities was divided into two separate reviews, resulting in 11 recommendations in total. Oxford levels of evidence were applied to each recommendation. The recommendations related to the efficacy and safety of various analgesic medications, pain measurement scales and pain management in the pre-conception period, pregnancy and lactation. Finally, an algorithm for the pharmacological management of pain in IA was developed. Twenty per cent of rheumatologists reported that the algorithm would change their practice, and 75% felt the algorithm was in accordance with their current practice.Conclusions. Eleven evidence-based recommendations on the management of pain by pharmacotherapy in IA were developed. They are supported by a large panel of rheumatologists from 17 countries, thus enhancing their utility in clinical practice.
KW - Analgesics
KW - Arthritis
KW - Evidence-based medicine
UR - http://www.scopus.com/inward/record.url?scp=84865172404&partnerID=8YFLogxK
U2 - 10.1093/rheumatology/kes032
DO - 10.1093/rheumatology/kes032
M3 - Article
C2 - 22447886
AN - SCOPUS:84865172404
SN - 1462-0324
VL - 51
SP - 1416
EP - 1425
JO - Rheumatology (United Kingdom)
JF - Rheumatology (United Kingdom)
IS - 8
M1 - kes032
ER -