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Type: Journal article
Title: Australian and New Zealand evidence-based recommendations for pain management by pharmacotherapy in adult patients with inflammatory arthritis
Author: Richards, B.L.
Whittle, S.
Buchbinder, R.
Barrett, C.
Lynch, N.
Major, G.
Littlejohn, G.
Taylor, A.
Zochling, J.
Citation: International Journal of Rheumatic Diseases, 2014; 17(7):738-748
Publisher: Wiley
Issue Date: 2014
ISSN: 1756-185X
Statement of
Bethan L. Richards, Samuel Whittle, Rachelle Buchbinder, Claire Barrett, Nora Lynch, Gabor Major, Geoffrey Littlejohn, Andrew Taylor, and Jane Zochling
Abstract: Aim: To develop Australian and New Zealand evidence-based recommendations for pain management by pharmacotherapy in adult patients with optimally treated inflammatory arthritis (IA). Methods: Four hundred and fifty-three rheumatologists from 17 countries including 46 rheumatologists from Australia and New Zealand participated in the 2010 3e (Evidence, Expertise, Exchange) Initiative. Using a formal voting process, rheumatologists from 15 national scientific committees 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 EULAR/ACR abstracts. Relevant studies were retrieved for data extraction and risk of bias assessment. Rheumatologists from Australia and New Zealand used the evidence to develop a set of national recommendations. These recommendations were then formulated and assessed for agreement and the potential impact on clinical practice. The Oxford Levels of Evidence and Grade of Recommendation were applied to each recommendation. Results: The systematic reviews identified 49 242 references, from which 167 studies which met the pre-specified inclusion criteria. Combining this evidence with expert opinion led to the development of 10 final Australian and New Zealand recommendations. The recommendations relate to pain measurement, and the use of analgesic medications in patients with and without co-morbidities and during pregnancy and lactation. The recommendations reflect the clinical practice of the majority of the participating rheumatologists (mean level of agreement 7.24–9.65). Conclusions: Ten Australian and New Zealand evidence-based recommendations regarding the management of pain by pharmacotherapy in adults with optimally treated IA were developed. They are supported by a large panel of rheumatologists, thus enhancing their utility in everyday clinical practice.
Keywords: analgesics; evidence-based medicine; inflammatory arthritis
Rights: © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd
DOI: 10.1111/1756-185X.12388
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