Authors: Jeffrey Gudin, Derek Dietze, Peter Hurwitz.
Background and Aims: The Global Burden of Disease Study 2016 confirmed that the high prevalence of pain and pain-related diseases is the leading cause of disability and disease burden globally. Pain is the most common reason patients consult primary care providers in the United States. According to recent literature, over 40% of adult Americans, an estimated 100 million people, live with chronic or recurrent pain. Of these, approximately 11 million adults in the US have high-impact chronic pain, or pain that lasts 3 months or longer and is accompanied by at least one major activity restriction. Ongoing research is needed to identify alternative strategies to existing treatment approaches as a means to reduce pain severity, pain interference with function, and to improve patients’ overall quality of life.
Optimal treatment strategies employ multimodal approaches that provide optimal benefit and minimal harm. Chronic pain is often categorized as either nociceptive (caused by damage to tissue or inflammatory stimuli) or neuropathic (damage to somatosensory nervous system). Mainstay therapies for pain include anti-inflammatory agents, opioids, and other oral and topical analgesics. Despite this approach, a large percentage of pain patients do not achieve adequate pain relief, and these traditional medication approaches are often associated with undesirable and potentially dangerous adverse effects. Alternative evidence-based multimodal approaches of pain management are therefore needed. Potential therapies include use of combination pharmacotherapies, which target both central and peripheral nociceptive mechanisms, and nonpharmacological interventions. Incorporation of micro and nanotechnologies into the development of novel treatment formulations has shown to have positive effects on patients. Topical analgesics, including pain relief patches, are a potentially valuable strategy in the management of a variety of conditions associated with musculoskeletal and various neuropathic pain disorders.
The purpose of this minimal risk, observational study was to evaluate patients with mild or moderate pain and evaluate perceptions of pain treatment and associated symptoms with the use of a novel, non-drug and micro/nanotechnology-based topical pain-relieving patch via validated scales over the course of 30 days.
Methods: This analysis of the PREVENT IRB-approved study evaluated the efficacy of a topical pain-relieving patch (Kailo Pain Relieving Patch (Pain Relief Technologies, USA) in reducing Brief Pain Inventory (BPI) scores in patients experiencing mild, moderate, or severe pain. The Treatment Group (TG) of 128 adult patients (89 females,39 males) with arthritic, neuropathic, or musculoskeletal pain received patches for 30 days. A Control Group (CG) of 20 adult patients (15 females, 5 males) did not initially receive the patch, and then crossed over to the Crossover Treatment Group (CROSSG), Surveys were administered to all patients at baseline, 14 days, and 30 days to assess changes in pain severity and interference by BPI Short Form. Changes in oral pain medication use, side effects and satisfaction with patch use were also assessed.
Results: Over 30 days, treatment group mean BPI Severity score decreased 61% (4.9 to 1.9/10?P< .001) and mean BPI Interference score decreased 61% (3.8 to 1.5/10?P< .001) The control group showed an increase in both BPI Severity of 23% (3.0 to 3.7/10) and BPI Interference Score of 58% (1.2 to 1.9/10). After crossing over to treatment, patients in the crossover group reported a decrease in BPI Severity score of 76% (3.7 to .9/10) and a decrease in BPI Interference score of 79% (1.9 to .4/10). No side effects of treatment were reported. After 30 days, 91% of patients reported “less” or “a lot less” usage of oral medications. 86% of patients were very/extremely satisfied with the patch and preferred the pain-relieving patch to oral medications. Results also showed improvements in Quality of Life (QoL), mood, and relations with other people, sleep, walking ability, and enjoyment of life.
Conclusions: Study results indicate that this novel, micro/nanotechnology-based topical pain-relieving patch can reduce BPI pain severity and interference scores and related pain for adult patients with arthritic, neuropathic, and musculoskeletal pain. Options such as this should be considered by healthcare clinicians and patients as part of a multimodal treatment approach. Patient outcomes further encourage more research to be conducted to confirm these results.
View/Download pdf