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Adolescents (and their families) in the UK and around the world are now better able to cope with chronic pain because of the unique work carried out at the University of Bath Centre for Pain Research (BCPR), directed by Professor Christopher Eccleston.
The BCPR produced the first multidimensional `one-stop' tool to assess the impact of pain on children's lives, which has now been adopted in at least 12 countries. Pioneering treatments from Bath have influenced therapeutic approaches worldwide.
The Bath team also manage the evidence base for chronic pain, giving access through the Cochrane Library, advising internationally on clinical service development and improvement.
The Glasgow Composite Measure Pain Scale (CMPS) has provided the first validated pain questionnaire for the rapid assessment of acute pain in dogs in surgical and clinical settings. Developed by the University of Glasgow School of Veterinary Medicine, the scale aids clinical decisions on appropriate pain relief intervention and has been freely downloaded by over 3,000 clinical users since its launch in 2008. In addition, it has been used extensively by veterinary healthcare companies to successfully obtain regulatory approval for analgesic drugs and in marketing support materials. The University of Glasgow researchers have been instrumental in developing international pain guidelines with the World Small Animal Veterinary Association, which represent more than 180,000 veterinarians worldwide, and has thereby promoted awareness of pain management in companion animals.
A high quality clinical trial, systematic reviews and meta-analyses performed by a team at Brunel University have directly informed key international clinical practice guidelines, policies and on the management of low back pain and neuropathic pain and have been cited by users (NHS Trusts: Addenbrookes) in response to such guidelines. In this way our research is directly informing clinical practice.
Newcastle University research has changed policy and practice relating to the provision of pain relief to rodents and rabbits. This has impacted on up to 35 million animals worldwide during the REF period. Having established the under-use of analgesics in laboratory rodents, Newcastle researchers developed objective pain scoring systems. These established that analgesics should be administered to rodents and rabbits, and that the efficacy of this treatment should be assessed objectively. The research resulted in changes to policy statements, institutional policies (both academic and industrial) and individual research worker practices in the USA, Canada, Australia, Europe and the UK. This has produced clear benefits to the welfare of animals used in biomedical research, helps to satisfy public concerns that animals used in research should experience the minimum pain and distress, and improves scientific outcomes of research, since pain is an uncontrolled experimental variable, that can adversely affect study results.
Our research has produced a paradigm shift in the primary care management for back pain, by expanding traditional diagnostic approaches to attending to physical and psychosocial factors shown to influence future outcome (`prognosis'). We have developed screening tools (freely available, widely accessed, translated and adopted), to distinguish groups at low or high risk of long-term disability, and developed primary care interventions tailored to these groups. Through improved clinical outcomes and cost-effectiveness, we have changed back care at national and international levels, evidenced by inclusion in official guidelines, into training of health professionals, adoption by spine and pain services, and active engagement of health care commissioners, clinicians and educators.
Having recognised the relative under-use of analgesics (painkillers) in animal research and veterinary practice, a programme of research at Newcastle led to the development of a behaviour-based pain scoring system. This system provided an objective way of establishing effective doses of analgesics to reduce post-operative pain and discomfort in animals. This work led to changes to a range of policy statements, institutional policies (both academic and industrial) and individual research worker practices. It is now established that analgesics should be administered to rodents and rabbits, and that the efficacy of this treatment should be assessed objectively, in both the laboratory and in veterinary practice.
This case study focuses on impacts that have arisen from research on the economics of pain and pain management established by Phillips on his arrival in Swansea in 1997. The impact of the research programme has been multifaceted, encompassing economic, public awareness, policy and practice dimensions and a reframing of priorities. It is exemplified by:
Around half of older people, aged 65 and over, experience persistent pain; it can be isolating and seriously affect quality of life. This research, much of it done by service users, has produced tools and information for older people themselves, and for the professionals who work with them, to correctly assess and treat chronic pain. It is setting national standards, being adopted by the key national charities and NHS pain clinics, and garnering international interest. Specifically the work has:
McCluskey and Burton at the University of Huddersfield's Centre for Health and Social Care Research (CHSCR) have made significant contributions to bringing about a cultural shift in how back pain is viewed and treated. Our research has underpinned a new approach which replaces rest and reliance on healthcare with activity, positive attitudes and remaining at, or returning early to, work as the preferred responses to back pain. We have demonstrated that prompt recovery from back pain and continued work participation can best be addressed from a biopsychosocial perspective. Innovative interventions aimed at overcoming biopsychosocial obstacles have been based on evidence from our research which shows that key stakeholders, including individuals, employers, healthcare practitioners and members of the wider society, need to work together in order to support the occupational rehabilitation of people living with back pain.