“Challenges and facilitators—navigating in the landscape of spinal cord injury neuropathic pain”—a qualitative study on the use of prescribed drugs

Abstract

Study design

A qualitative study with an emergent design using semi-structured interviews in focus groups.

Objectives

To explore the expectations, experiences and desires among individuals who are prescribed drugs for spinal cord injury (SCI) neuropathic pain (NP).

Setting

SCI rehabilitation centre.

Methods

Eighteen informants with SCI and NP were enrolled. The informants originated from large and small cities in southern Sweden. Data were collected in focus groups consisting of 4–5 individuals in four separate sessions. An emergent design was employed using an interview guide containing open questions. The interviews were transcribed verbatim and data were analyzed according to qualitative content analysis.

Results

A model of three themes emerged: “Balancing between pain and side-effects” described the difficult choices the informants had to make between drugs and their unwanted side-effects and pain, “Desiring competence and structure in pain management” described the informants wishes regarding pain management and “From hope to personal solutions” described the process from hope of total pain relief from drugs to the development of personal strategies.

Conclusions

There is a great need for improvement of SCI-related neuropathic pain management since recommended drugs are insufficiently effective and accompanied by severe side-effects that impact quality of life but also due to structural limitations and physicians’ lack of competence in pain management.

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Fig. 1: The figure describes the inclusion process from the 58 volunteers to the final 18 included informants.
Fig. 2: This figure describes the process of the initial 17 categories that merged into 12, and then to 3 themes.
Fig. 3: The final model describes the parallel experiences and processes that could be shorter or longer in time or ongoing.

Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We gratefully acknowledge Neuro Sweden for their contribution.

Funding

This study was partly funded by Neuro Sweden.

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Authors

Contributions

All authors have contributed to all aspects of the stated criteria. Design: CN, KS, CH, FvK, and KW. Data collection: CN, KS, and KW. Analysis of collected data and the results interpretation of the result: CN, KS, FvK, and KW. Draft and or revision of paper: CN, KS, CH, FvK, and KW. Approved the final paper and agreed to be responsible for all aspects of the work: CN, KS, CH, FvK, and KW.

Corresponding author

Correspondence to Kerstin Wahman.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics

We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research. Ethical approval was given by The Regional Ethical Review Board in Stockholm with ref. no. 2018/1669-31.

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Norrbrink, C., Sörling, K., Hultling, C. et al. “Challenges and facilitators—navigating in the landscape of spinal cord injury neuropathic pain”—a qualitative study on the use of prescribed drugs. Spinal Cord (2020). https://doi.org/10.1038/s41393-020-00553-w

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