scholarly journals Health outcomes among adults initiating medical marijuana for chronic pain: A 3-month prospective study incorporating ecological momentary assessment (EMA)

Cannabis ◽  
2021 ◽  
Vol 4 (2) ◽  
pp. 69-83
Author(s):  
Yan Wang ◽  
Jennifer Jacques ◽  
Zhigang Li ◽  
Kimberly Sibille ◽  
Robert Cook
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Sleep Quality ◽  
Prospective Study ◽  
Ecological Momentary Assessment ◽  
Medical Cannabis ◽  
Ecological Momentary ◽  
Anxiety Depression ◽  
Momentary Assessment

In response to the need of more rigorous data on medical cannabis and chronic pain, we conducted a 3-month prospective study incorporating ecological momentary assessment (EMA) to examine the effects of medical cannabis on pain, anxiety/depression, sleep, and quality of life. Data were collected from 46 adults (Mean age=55.7±11.9, 52.2% male) newly initiating medical cannabis treatment for chronic pain. Participants completed a baseline survey, EMA for approximately 1 week pre- and up to 3 weeks post- medical cannabis treatment, and a 3-month follow-up survey. The self-reported EMA data (2535 random and 705 daily assessments) indicated significant reductions in momentary pain intensity (b = -16.5, p < .001, 16.5 points reduction on 0-100 visual analog) and anxiety (b = -0.89, p < .05), and significant increase in daily sleep duration (b = 0.34, p < .01) and sleep quality (b = 0.32, p <.001) after participants initiated medical cannabis for a few weeks. At 3 months, self-reported survey data showed significantly lower levels of worst pain (t = -2.38, p < .05), pain interference (t = -3.82, p < .05), and depression (t = -3.43, p < .01), as well as increased sleep duration (t = 3.95, p < .001), sleep quality (t = -3.04, p < .01), and quality of life (t = 4.48, p < .001) compared to baseline. In our sample of primarily middle-aged and older adults with chronic pain, medical cannabis was associated with reduced pain intensity/inference, lower anxiety/depression, and improved sleep and quality of life.

scholarly journals Ecological momentary assessment versus retrospective assessment for measuring change in health-related quality of life following cardiac intervention

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Tom H. Oreel ◽  
Philippe Delespaul ◽  
Iris D. Hartog ◽  
José P. S. Henriques ◽  
Justine E. Netjes ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ecological Momentary Assessment ◽  
Health Related Quality ◽  
Cardiac Intervention ◽  
Measuring Change ◽  
Related Quality ◽  
Health Related ◽  
Ecological Momentary ◽  
Momentary Assessment

Abstract Background Measuring change in health-related quality-of-life (HRQoL) is important to assess the impact of disease and/or treatment. Ecological momentary assessment (EMA) comprises the repeated assessment of momentary HRQoL in the natural environment and is particularly suited to capture daily experiences. Our objective was to study whether change in momentary measures or retrospective measures of HRQoL are more strongly associated with criterion measures of change in HRQoL. Twenty-six coronary artery disease patients completed momentary and retrospective HRQoL questionnaires before and after coronary revascularization. Momentary HRQoL was assessed with 14 items which were repeatedly presented 9 times a day for 7 consecutive days. Each momentary assessment period was followed by a retrospective HRQoL questionnaire that used the same items, albeit phrased in the past tense and employing a one-week time frame. Criterion measures of change comprised the New York Heart Association functioning classification system and the Subjective Significance Change Questionnaire. Regression analysis was used to determine the association of momentary and retrospective HRQoL change with the criterion measures of change. Results Change according to momentary HRQoL items was more strongly associated with criterion measures of change than change according to retrospective HRQoL items. Five of 14 momentary items were significantly associated with the criterion measures. One association was found for the retrospective items, however, in the unexpected direction. Conclusion Momentary HRQoL measures better captured change in HRQoL after cardiac intervention than retrospective HRQoL measures. EMA is a valuable expansion of the armamentarium of psychometrically sound HRQoL measures.

Sleep disturbance in patients attending specialized chronic pain clinics in Denmark: a longitudinal study examining the relationship between sleep and pain outcomes

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Henrik Bjarke Vaegter ◽  
Mette Terp Høybye ◽  
Frederik Hjorth Bergen ◽  
Christine E. Parsons
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Sleep Quality ◽  
Pain Intensity ◽  
Sleep Disturbances ◽  
Pain Disability ◽  
Pain Clinics ◽  
Pain Outcomes

Abstract Objectives Sleep disturbances are highly prevalent in patients with chronic pain. However, the majority of studies to date examining sleep disturbances in patients with chronic pain have been population-based cross-sectional studies. The aims of this study were to 1) examine the frequency of sleep disturbances in patients referred to two interdisciplinary chronic pain clinics in Denmark, 2) explore associations between sleep disturbances and pain intensity, disability and quality of life at baseline and follow-up, and 3) explore whether changes in sleep quality mediated the relationships between pain outcomes at baseline and pain outcomes at follow-up. Methods We carried out a longitudinal observational study, examining patients enrolled in two chronic pain clinics assessed at baseline (n=2,531) and post-treatment follow-up (n=657). Patients reported on their sleep disturbances using the sleep quality subscale of the Karolinska Sleep Questionnaire (KSQ), their pain intensity using 0–10 numerical rating scales, their pain-related disability using the Pain Disability Index (PDI), and quality of life using the EuroQol-VAS scale. The average time between baseline and follow-up was 207 days (SD=154). Results At baseline, the majority of patients reported frequent sleep disturbances. We found a significant association at baseline between self-reported sleep disturbances and pain intensity, pain-related disability, and quality of life, where greater sleep disturbance was associated with poorer outcomes. At follow-up, patients reported significant improvements across all pain and sleep outcomes. In two mediation models, we showed that changes in sleep disturbances from baseline to follow-up were significantly associated with (i) pain intensity at follow-up, and (ii) pain disability at follow-up. However, baseline pain intensity and disability scores were not associated with changes in sleep disturbances and, we did not find evidence for significant mediation of either pain outcome by changes in sleep disturbances. Conclusions Self-reported sleep disturbances were associated with pain outcomes at baseline and follow-up, with greater sleep disturbances associated with poorer pain outcomes. Changes in sleep quality did not mediate the relationships between baseline and follow-up scores for pain intensity and disability. These findings contribute to a growing body of evidence confirming an association between sleep and chronic pain experience, particularly suggestive of a sleep to pain link. Our data following patients after interdisciplinary treatment suggests that improved sleep is a marker for a better outcome after treatment.

scholarly journals Daily factors driving daily substance use and chronic pain among older adults with HIV: An exploratory study using ecological momentary assessment

Alcohol ◽  
2019 ◽  
Vol 77 ◽  
pp. 31-39 ◽  
Author(s):  
Alexis Kuerbis ◽  
M. Carrington Reid ◽  
Jordan E. Lake ◽  
Suzette Glasner-Edwards ◽  
Jessica Jenkins ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Substance Use ◽  
Ecological Momentary Assessment ◽  
Exploratory Study ◽  
Ecological Momentary ◽  
Momentary Assessment

Associations of health-related quality of life with sociodemographic characteristics, health, pain, and lifestyle factors, and motivation for changing lifestyle in adults living with chronic pain: a cross-sectional exploratory study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Svetlana Solgaard Nielsen ◽  
Søren T. Skou ◽  
Anette Enemark Larsen ◽  
Jens Søndergaard ◽  
Jeanette Reffstrup Christensen
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Sleep Quality ◽  
Lifestyle Factors ◽  
Lifestyle Changes ◽  
Poor Sleep ◽  
Related Quality ◽  
Health Related ◽  
Study Population

Abstract Objectives We investigated the associations between health-related quality of life (HRQoL) and health, pain and lifestyle factors, as well as motivation for lifestyle changes, in adults living with chronic pain referred to a Danish pain centre. Methods A total of 144 outpatients completed a questionnaire on HRQoL (EQ-5D-5L), health, pain, lifestyle factors (Body Mass Index [BMI], physical activity, smoking, alcohol, physical fitness, eating, sleep and stress) and motivation for lifestyle changes. We used multiple linear regression analyses to assess associations between HRQoL and the independent variables. Results The participants (age mean 50 years, 81% females) had ≥2 body pain sites (93%), BMI≥25 (64%), sedentary lifestyle (43%) and multiple (n≥2) elevated metabolic risk factors (58%). Most considered lifestyle important for HRQoL (72%) and expressed moderate to very high motivation for changing lifestyle (92%). Poorer HRQoL in the study population was significantly associated with higher pain intensity in the most painful body site (β=−0.316, p=0.001) and very poor sleep quality (β=−0.410, p=0.024). Serious-to-extreme problems in usual activities were associated with significantly poorer health (β=−0.328, p=0.030). Conclusions Adults living with chronic pain participating in this survey had significantly lower self-evaluated HRQoL than the general population. Lower HRQoL was significantly associated with greater pain intensity and poor sleep quality. Serious-to-extreme problems in usual activities, such as work, study, housework, family and leisure, were associated with poorer self-evaluated health. We observed high frequencies of overweight, obesity, sedentary lifestyle, pain in multiple body sites and multiple lifestyle-related risk factors in the study population. Most participants felt motivated for changing lifestyle. Further interventions addressing pain alleviation, sleep quality, prevention of problems in usual activities and promotion of healthy lifestyle, e.g. physical activity and healthy eating, are needed to estimate the effect of a lifestyle-oriented approach on health and quality of life in people living with chronic pain. The results of this study will inform the research project reg. SJ-703, the Danish the Research Ethics Committee for Region Zealand, Denmark.

scholarly journals Preliminary evaluation of the efficacy, safety, and costs associated with the treatment of chronic pain with medical cannabis

2018 ◽  
Vol 8 (3) ◽  
pp. 110-115 ◽  
Author(s):  
Terrance Bellnier ◽  
Geoffrey W. Brown ◽  
Tulio R. Ortega
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Randomized Clinical Trials ◽  
New York State ◽  
The United States ◽  
Preliminary Evaluation ◽  
Medical Cannabis ◽  
Image Study ◽  
Post Therapy

Abstract Introduction: Medical cannabis (MC) is commonly claimed to be an effective treatment for chronic or refractory pain. With interest in MC in the United States growing, as evidenced by the 29 states and 3 US districts that now have public MC programs, the need for clinical evidence supporting this claim has never been greater. Methods: This was a retrospective, mirror-image study that investigated MC's effectiveness in patients suffering from chronic pain associated with qualifying conditions for MC in New York State. The primary outcome was to compare European Quality of Life 5 Dimension Questionnaire (EQ-5D) and Pain Quality Assessment Scale (PQAS) scores at baseline and 3 months post-therapy. The secondary outcomes included comparisons of monthly analgesic prescription costs and opioid consumption pre- and post-therapy. Tolerability was assessed by side effect incidence. Results: This investigation included 29 subjects. Quality of life and pain improved, measured by change in EQ-5D (Pre 36 – Post 64, P &lt; .0001) and change in PQAS paroxysmal (Pre 6.76 – Post 2.04, P &lt; .0001), surface (Pre 4.20 – Post 1.30, P &lt; .0001), deep (Pre 5.87 – Post 2.03, P &lt; .0001), unpleasant (Pre “miserable” – Post “annoying”, P &lt; .0001). Adverse effects were reported in 10% of subjects. Discussion: After 3 months treatment, MC improved quality of life, reduced pain and opioid use, and lead to cost savings. Large randomized clinical trials are warranted to further evaluate the role of MC in the treatment of chronic pain.

Prospective study evaluating the impact of severity of chronic pain on quality of life after inguinal hernioplasty

Hernia ◽  
2016 ◽  
Vol 21 (2) ◽  
pp. 199-205 ◽  
Author(s):  
C. Nikkolo ◽  
Ü. Kirsimägi ◽  
T. Vaasna ◽  
M. Murruste ◽  
J. Suumann ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Prospective Study ◽  
Inguinal Hernioplasty ◽  
The Impact
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