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Systematic Review of Pain in Clinical Practice Guidelines for Management of COPD: A Case for Including Chronic Pain?

1
Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, Division of Health Sciences, University of South Australia, Adelaide 5001, Australia
2
Australian Centre for Precision Health, School of Health Sciences, Division of Health Sciences, University of South Australia, Adelaide 5001, Australia
*
Author to whom correspondence should be addressed.
Healthcare 2019, 7(1), 15; https://doi.org/10.3390/healthcare7010015
Received: 17 December 2018 / Revised: 10 January 2019 / Accepted: 19 January 2019 / Published: 22 January 2019
(This article belongs to the Special Issue Chronic Obstructive Pulmonary Disease: Updates in Lung Health)
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Abstract

Chronic pain is highly prevalent and more common in people with chronic obstructive pulmonary disease (COPD) than people of similar age/sex in the general population. This systematic review aimed to describe how frequently and in which contexts pain is considered in the clinical practice guidelines (CPGs) for the broad management of COPD. Databases (Medline, Scopus, CiNAHL, EMbase, and clinical guideline) and websites were searched to identify current versions of COPD CPGs published in any language since 2006. Data on the frequency, context, and specific recommendations or strategies for the assessment or management of pain were extracted, collated, and reported descriptively. Of the 41 CPGs (English n = 20) reviewed, 16 (39%) did not mention pain. Within the remaining 25 CPGs, pain was mentioned 67 times (ranging from 1 to 10 mentions in a single CPG). The most frequent contexts for mentioning pain were as a potential side effect of specific pharmacotherapies (22 mentions in 13 CPGs), as part of differential diagnosis (14 mentions in 10 CPGs), and end of life or palliative care management (7 mentions in 6 CPGs). In people with COPD, chronic pain is common; adversely impacts quality of life, mood, breathlessness, and participation in activities of daily living; and warrants consideration within CPGs for COPD. View Full-Text
Keywords: chronic obstructive pulmonary disease; pain; chronic pain; symptom palliation; clinical guideline chronic obstructive pulmonary disease; pain; chronic pain; symptom palliation; clinical guideline
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Lewthwaite, H.; Williams, G.; Baldock, K.L.; Williams, M.T. Systematic Review of Pain in Clinical Practice Guidelines for Management of COPD: A Case for Including Chronic Pain? Healthcare 2019, 7, 15.

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