A Systematic review and Network Meta-analysis of pharmaceutical interventions used to manage chronic pain

Abstract

AbstractBackgroundIt is estimated 1.5 billion of the global population suffer from chronic pain with prevalence increasing with demographics including age. It is suggested long-term exposure to chronic could cause further health challenges reducing people’s quality of life. Therefore, it is imperative to use effective treatment options.PurposeWe explored the current pharmaceutical treatments available for chronic pain management to better understand drug efficacy and pain reduction.MethodsA systematic methodology was developed and published in PROSPERO (CRD42021235384). Keywords of opioids,acute pain, pain management, chronic pain, opiods, NSAIDs, and analgesicswere used across PubMed, Science direct, ProQuest, Web of science, Ovid Psych INFO, PROSPERO, EBSCOhost, MEDLINE,ClinicalTrials.govand EMBASE. All randomised controlled clinical trials (RCTs), epidemiology and mixed-methods studies published in English between the 1stof January 1990 and 30thof April 2022 were included.Data synthesisA total of 119 studies were included. The data was synthesised using a tri-partied statistical methodology of a meta-analysis (24), pairwise meta-analysis (24) and network meta-analysis (34).LimitationsSmall sample sizes, lack of uniformity with pain assessments and sub-optimal clinical trial designs were observed within the pooled data.ConclusionChronic pain is a public health problem that requires far more effective pharmaceutical interventions with minimal better side-effect profiles which will aid to develop better clinical guidelines. The importance of understanding ubiquity of pain by clinicians, policy makers, researchers and academic scholars is vital to prevent social determinant which aggrevates issues.