@article{Lovo2024,

title = {Effectiveness of an interprofessional assessment and management approach for people with chronic low back disorders delivered via virtual care: A randomized controlled trial pilot intervention},

author = {Stacey Lovo and Biaka Imeah and Nazmi Sari and Megan E O’Connell and Steve Milosavljevic and Adriana Angarita-Fonseca and Brenna Bath},

doi = {10.1177/20552076241260569},

issn = {2055-2076},

year  = {2024},

date = {2024-01-00},

urldate = {2024-01-00},

journal = {DIGITAL HEALTH},

volume = {10},

publisher = {SAGE Publications},

abstract = {\<jats:sec\>\<jats:title\>Objective\</jats:title\>\<jats:p\> Virtual care for chronic conditions has seen uptake due to COVID-19. Evaluation of virtual models is important to ensure evidence-based practice. There is a paucity of research in the use of virtual care for management of chronic back disorders. The objective of this study was to evaluate effectiveness of a team-based virtual care model for back disorder assessment where a physical therapist uses virtual care to join a nurse practitioner and patient in a rural Saskatchewan, Canada community. \</jats:p\>\</jats:sec\>\<jats:sec\>\<jats:title\>Methods\</jats:title\>\<jats:p\> Sixty-four rural adults with chronic back disorders were randomly allocated to receive either: (1) team-based virtual care ( n = 24); (2) care from an urban physical therapist travelling to community ( n = 20); or (3) care from a rural nurse practitioner ( n = 20). The team-based care group involved a nurse practitioner located with a rural patient, and a physical therapist joining using virtual care. The physical therapist alone and the nurse practitioner alone groups received in-person assessments. Groups with a physical therapist involved had follow-up treatments by in-person physical therapy. Outcomes over six months included pain, disability, back beliefs, satisfaction, quality-adjusted health status and management-related costs. \</jats:p\>\</jats:sec\>\<jats:sec\>\<jats:title\>Results\</jats:title\>\<jats:p\> There were no significant differences for pain, disability, back beliefs and satisfaction between groups. The average cost per patient for implementing in-person physical therapist assessment ($135) was higher compared with the team over virtual care ($118) and NP care ($59). \</jats:p\>\</jats:sec\>\<jats:sec\>\<jats:title\>Conclusion\</jats:title\>\<jats:p\> Primary outcomes were not different by group. Physical therapist alone was more costly than other groups. Future research should include more participants, longer follow-up time and refined cost parameters. \</jats:p\>\</jats:sec\>\<jats:sec\>\<jats:title\>Trial Registration\</jats:title\>\<jats:p\> ClinicalTrials.gov NCT02225535; https://clinicaltrials.gov/ct2/show/NCT02225535 (Archived by WebCite at http://www.webcitation.org/6lqLTCNF7 ). \</jats:p\>\</jats:sec\>},

keywords = {2024, Chronic Pain, Rehabilitation},

pubstate = {published},

tppubtype = {article}

}

@article{Angarita-Fonseca2024b,

title = {Trajectories of pain and depressive symptoms among people living with low back pain during the COVID-19 pandemic: a 24-month longitudinal study},

author = {Adriana Angarita-Fonseca and Mathieu Roy and Ana\"{i}s Lacasse and Guillaume L\'{e}onard and Pierre Rainville and Marie-France Marin and Iulia Tufa and Erika L. Gentile and M. Gabrielle Pag\'{e}},

doi = {10.1097/pr9.0000000000001165},

issn = {2471-2531},

year  = {2024},

date = {2024-00-00},

urldate = {2024-00-00},

journal = {PR9},

volume = {9},

number = {4},

publisher = {Ovid Technologies (Wolters Kluwer Health)},

abstract = {\<jats:title\>Abstract\</jats:title\>

          \<jats:p\>

                           \<jats:bold\>Introduction:\</jats:bold\> We explored trajectories of pain intensity and depressive symptoms over the first 24 months of the pandemic in people with low back pain.\</jats:p\>

          \<jats:p\>

                           \<jats:bold\>Methods:\</jats:bold\> This longitudinal study was conducted alongside the Quebec Low Back Pain Study. Starting in April 2020 and every 3 months until July 2022, 291 participants completed an online survey. Group-based trajectory modeling was used to identify patterns of pain intensity and depressive symptoms. Onset outbreak characteristics were then put in relation with trajectory groups using multivariate logistic regression.\</jats:p\>

          \<jats:p\>

                           \<jats:bold\>Results:\</jats:bold\> The analysis revealed 5 trajectories of pain intensity and depressive symptoms, respectively. The pain trajectories were stable mild (n = 17, 5.8%); stable moderate (n = 103, 35.4%); stable severe (n = 81, 27.8%); U-shape (n = 24, 8.3%), and inverted U-shape (n = 66, 22.7%). The trajectories of depressive symptoms were stable none (n = 58, 19.9%); stable very mild (n = 61, 21.0%); stable mild (n = 85, 29.2%); stable moderate (n = 59, 21.7%); and severe slightly improving (n = 24, 8.3%). Pre-COVID everyday/nearly everyday pain, average pain intensity, and widespread bodily pain were predictive of pain trajectory groups. Higher pre-COVID depression, acute stress disorder, and lockdown measures-related stress were associated with moderate/severe depressive trajectories.\</jats:p\>

          \<jats:p\>

                           \<jats:bold\>Discussion:\</jats:bold\> Our findings indicated relative stability of pain and depressive symptoms among participants during the COVID-19 pandemic but also highlighted subgroups of people who experienced temporary deterioration or improvement over the first months of the pandemic that then reverted back to baseline levels. Modifiable risk factors were identified before the onset of the pandemic, which could give preventive measures in targeted populations.\</jats:p\>},

keywords = {2024, Chronic Pain, COVID-19, Pain Measurement},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37800356,

title = {Trajectories of opioid consumption as predictors of patient-reported outcomes among individuals attending multidisciplinary pain treatment clinics},

author = {A. Angarita-Fonseca and A. Lacasse and M. Choini\`{e}re and J. L. Kabor\'{e} and M. P. Sylvestre and G. D. Tchouangue Dinkou and J. Bruneau and M. O. Martel and R. Hovey and A. Motulsky and E. Rahme and M. G. Pag\'{e}},

doi = {10.1002/pds.5706},

issn = {1099-1557},

year  = {2023},

date = {2023-10-01},

urldate = {2023-10-01},

journal = {Pharmacoepidemiol Drug Saf},

abstract = {PURPOSE: This study aimed to identify opioid consumption trajectories among persons living with chronic pain (CP) and put them in relation to patient-reported outcomes 6 months after initiating multidisciplinary pain treatment.nnMETHODS: This study used data from the Quebec Pain Registry (2008-2014) linked to longitudinal Quebec health insurance databases. We included adults diagnosed with CP and covered by the Quebec public prescription drug insurance plan. The daily cumulative opioid doses in the first 6 months after initiating multidisciplinary pain treatment were transformed into morphine milligram equivalents. An individual-centered approach involving principal factor and cluster analyses applied to longitudinal statistical indicators of opioid use was conducted to classify trajectories. Multivariate regression models were applied to evaluate the associations between trajectory group membership and outcomes at 6-month follow-up (pain intensity, pain interference, depression, and physical and mental health-related quality of life).nnRESULTS: We identified three trajectories of opioid consumption: "no or very low and stable" opioid consumption (n = 2067, 96.3%), "increasing" opioid consumption (n = 40, 1.9%), and "decreasing" opioid consumption (n = 39, 1.8%). Patients in the "no or very low and stable" trajectory were less likely to be current smokers, experience polypharmacy, use opioids or benzodiazepine preceding their first visit, or experience pain interference at treatment initiation. Patients in the "increasing" opioid consumption group had significantly greater depression scores at 6-month compared to patients in the "no or very low and stable" trajectory group.nnCONCLUSION: Opioid consumption trajectories do not seem to be important determinants of most PROs 6 months after initiating multidisciplinary pain treatment.},

keywords = {Chronic Pain, Epidemiology, Pain Measurement, Patient-important outcome, Treatment},

pubstate = {published},

tppubtype = {article}

}

@article{RN380,

title = {The Canadian version of the NIH minimum dataset for chronic low back pain research: reference values from the Quebec Low Back Pain Study},

author = {A. Angarita-Fonseca and M. G. Pag\'{e} and Carolina B. Meloto and Erika Lauren Gentile and Guillaume L\'{e}onard and Hugo Mass\'{e}-Alarie and Iulia Tufa and Jean-S\'{e}bastien Roy and Laura S. Stone and Manon Choini\`{e}re and Maryse Fortin and Mathieu Roy and Monica Sean and Pascal T\'{e}treault and Pierre Rainville and Simon Deslauriers and A. Lacasse},

url = {https://journals.lww.com/pain/Fulltext/2023/02000/The_Canadian_version_of_the_National_Institutes_of.15.aspx},

doi = {10.1097/j.pain.0000000000002703},

issn = {0304-3959},

year  = {2023},

date = {2023-01-21},

urldate = {2023-01-21},

journal = {PAIN},

volume = {64},

issue = {2},

pages = {325-335},

abstract = {The National Institutes of Health (NIH) minimum dataset for chronic low back pain (CLBP) was developed in response to the challenge of standardizing measurements across studies. Although reference values are critical in research on CLBP to identify individuals and communities at risk of poor outcomes such as disability, no reference values have been published for the Quebec (Canada) context. This study was aimed to: 1) provide reference values for the Canadian version of the NIH minimum dataset among individuals with CLBP in Quebec, both overall and stratified by gender, age, and pain impact stratification (PIS) subgroups; and 2) assess the internal consistency of the minimum dataset domains (pain interference (PI), physical function (PF), emotional distress/depression (EDD), sleep disturbance (SD), and PIS score). We included 2847 individuals living with CLBP who completed the baseline web survey of the Quebec Low Back Pain Study (age: 44.0±11.2 years, 48.1% women), and were recruited through social media and health care settings. The mean score was 6.1±1.8 for pain intensity. PI, PF, EDD, SD, and PIS scores were 12.9±4.1, 14.4±3.9, 9.8±4.4, 13.0±3.6, and 26.4±6.6, respectively. EDD showed floor effects. Good to excellent internal consistency was found overall and by language, gender, and age subgroups for all domains (alpha: 0.81-0.93) and poor to excellent internal consistency for PIS subgroups (alpha: 0.59\textendash0.91). This study presents reference values and recommendations for using the Canadian version of the NIH minimum dataset for CLBP that can be useful for researchers and clinicians. },

keywords = {Back pain, Chronic Pain, Low Back Pain, Pain Measurement},

pubstate = {published},

tppubtype = {article}

}

@article{JA0522,

title = {Gender differences in medication adverse effects experienced by people living with chronic pain},

author = {H. L. Nguena Nguefack and M. G. Pag\'{e} and L. Gu\'{e}nette and L. Blais and M. Diallo and M. Godbout-Parent and A. Angarita-Fonseca and A. Lacasse},

doi = {10.3389/fpain.2022.830153},

year  = {2022},

date = {2022-05-10},

journal = {Frontiers in Pain Research},

volume = {3},

number = {830153},

abstract = {Objectives: Understanding gender differences in chronic pain (CP) outcome research is essential to optimal treatment delivery. This study explored the associations between gender identity, gender roles, and the number of non-life-threatening pain medication adverse effects reported as severe by people living with CP.



Methods: The analyses were conducted using the COPE Cohort, a dataset generated through a web-based recruitment of adults with CP. Participants were asked how they identified themselves (women, men, unknown, unspecified) and gender roles were measured using the Bem Sex-Role Inventory (subgroups were formed applying the median split method). Pain medication adverse effects were assessed using a standardized checklist (none/mild/moderate/severe). A zero-inflated Poisson model was used to assess gender identity, gender roles and their interaction as potential predictors of the number of pain medication adverse effects.



Results: A total of 1,343 participants reported using pain medications. Adjusting for potential confounders, both gender identity (men vs. women: \ss = −0.32, p = 0.0024) and gender roles (androgynous vs. undifferentiated: \ss = 0.26, p = 0.0030) were associated with the number of pain medication adverse effects reported as severe, and they interacted with each other. The stratified analysis by gender roles showed that women reported a greater number of severe adverse effects than men among those classified as masculine and androgynous.



Discussion: Although we are unable to confirm whether the associations can be explained by differences in the experience or in the reporting of effects, gender identity and gender roles should both be explored when studying pain medication adverse effects.},

key = {sex, gender, chronic pain, adverse effects, side effects},

keywords = {Chronic Pain, Pharmacoepidemiology, Women's health},

pubstate = {published},

tppubtype = {article}

}

@article{JA0422,

title = {Prevalence of Cannabis Use for Pain Management in Quebec: A Post-Legalization Estimate Among Generations Living with Chronic Pain},

author = {M. Godbout-Parent and H. L. Nguena Nguefack and A. Angarita-Fonseca and C. Audet and A. Bernier and G. Zahlan and N. Julien and M. G. Pag\'{e} and L Guenette and L. Blais and A. Lacasse},

url = {https://www.tandfonline.com/doi/epub/10.1080/24740527.2022.2051112?needAccess=true, CJP},

doi = {https://doi.org/10.1080/24740527.2022.2051112},

year  = {2022},

date = {2022-03-30},

urldate = {2022-03-30},

journal = {Canadian Journal of Pain},

abstract = {Background

While medical cannabis has been legal in Canada since 2001, recreational cannabis was legalized in October 2018 which has led to a widespread increase in the accessibility of cannabis products.

Aims

This study aimed to estimate the prevalence of cannabis use among adults living with chronic pain (CP) and investigate the relationship between age and cannabis use for CP management.

Methods

A cross-sectional analysis of the COPE Cohort dataset, a large Quebec sample of 1,935 adults living with CP, was conducted. Participants completed a web-based questionnaire in 2019 that contained three yes/no questions about past-year use of cannabis (i.e., for pain management, management of other health-related conditions, recreational purposes).

Results

Among the 1,344 participants who completed the cannabis use section of the questionnaire, the overall prevalence of cannabis use for pain management was 30.1% (95%CI:27.7-32.7). Differences were found between age groups with the highest prevalence among participants aged ≤26 years (36.5%) and lowest for those aged ≥74 years (8.8%). A multivariable logistic model revealed that age, region of residence, generalized pain, use of medications or non-pharmacological approaches for pain management, alcohol/drug consumption, and smoking were associated with the likelihood of using cannabis for pain management.

Conclusions

Cannabis is a common treatment for the management of CP, especially in younger generations. The high prevalence of use emphasizes the importance of better knowledge translation for people living with CP, rapidly generating evidence regarding the safety and efficacy of cannabis, and clinicians’ involvement in supporting people who use cannabis for pain management.},

keywords = {Chronic Pain, Pharmacoepidemiology},

pubstate = {published},

tppubtype = {article}

}

@article{JA0322,

title = {Low back pain definitions: effect on patient inclusion and clinical profiles},

author = {H. Mass\'{e}-Alarie and A. Angarita-Fonseca and A. Lacasse and M. G. Pag\'{e} and P. T\'{e}treault and M. Fortin and L. S. Stone and Roy J. S. and Quebec Low Back Pain Consortium },

editor = {A. Angarita-Fonseca},

url = {https://journals.lww.com/painrpts/Fulltext/2022/04000/Low_back_pain_definitions__effect_on_patient.11.aspx, Pain Reports},

doi = {http://dx.doi.org/10.1097/PR9.0000000000000997},

year  = {2022},

date = {2022-03-22},

urldate = {2022-03-22},

journal = {Pain Reports},

volume = {7},

issue = {2},

pages = {e997},

abstract = {Introduction: 

Numerous definitions of acute low back pain (aLBP) exist. The use of different definitions results in variability in reported prevalence or incidence, conflicting data regarding factors associated with the transition to chronic LBP (cLBP), and hampers comparability among studies.



Objective: 

Here, we compare the impact of 3 aLBP definitions on the number of aLBP cases and participants' characteristics and explore the distribution of participants across definitions.



Methods: 

A sample of 1264 participants from the Quebec Low Back Pain Study was included. Three definitions of aLBP were used: (1) not meeting the National Institutes of Health (NIH) cLBP definition (“nonchronic”), (2) pain beginning \<3 months ago (“acute”), and (3) pain beginning \<3 months with a preceding LBP-free period (“new episode”).



Results: 

There were 847, 842, and 489 aLBP cases meeting the criteria for the 3 definitions, respectively. Participants included in the “nonchronic” had lower pain interference, greater physical function scores, and fewer participants reporting \>5 years of pain than in the other definitions. Half the participants meeting the “acute” definition and one-third of participants meeting the “new episode” definition were also classified as cLBP based on the NIH definition.



Conclusions: 

Our results highlight the importance of the definition used for aLBP. Different definitions influence the sample size and clinical profiles (group's characteristics). We recommended that cohort studies examining the transition from aLBP to cLBP ensure that the definitions selected are mutually exclusive (ie, participants included [aLBP] differ from the expected outcome [cLBP]).},

keywords = {Chronic Pain, Low Back Pain, Musculoskeletal system},

pubstate = {published},

tppubtype = {article}

}