Such interventions would have the potential to reduce the prevalence of chronic pain in the population .
Although certain risk factors can identify individuals who are most likely to develop chronic pain , few interventions to prevent chronic pain have been identified .
To facilitate the identification of preventive interventions , an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain .
We present general design considerations for prevention trials in population s that are at relatively high risk for developing chronic pain .
Antidepressant therapy in patients undergoing coronary artery bypass grafting: the MOTIV-CABG trial.
BACKGROUND The efficacy of antidepressant therapy in patients undergoing coronary artery bypass grafting ( CABG ) is not clearly established . METHODS This double-blind trial was conducted at University Hospital , Besançon , France . Adult CABG patients were r and omized ( 1:1 ) to receive escitalopram ( 10 mg daily ) or placebo from 2 to 3 weeks before to 6 months after surgery , including 12 months post-surgery follow-up . The primary composite endpoint was the occurrence of mortality or predefined morbidity events . Secondary endpoints included measures of depression , mental and physical health using Beck Depression Inventory Short Form ( BDI ) , and quality of life 36-Item Short Form ( SF-36 ) self assessment s. RESULTS The treated cohort contained 361 patients with mean age 67 years . At 12 months , the proportions of patients with the composite morbidity and mortality endpoint were not different between escitalopram and placebo ( 110 of 182 [ 60.4 % ] vs 108 of 179 [ 60.3 % ] , p = 0.984 ) . However , over the 6 months postoperative period , the BDI and SF-36 Mental Component Summary scores were better overall in the escitalopram group than in the placebo group for all patients ( p = 0.015 and p = 0.014 , respectively ) and preoperatively depressed ( BDI > 3 ) patients ( p = 0.002 and p = 0.005 , respectively ) . Moreover , the SF-36 Pain score was better overall in the escitalopram group than in the placebo group in the preoperatively-depressed subset ( p = 0.026 ) . CONCLUSIONS Antidepressant therapy had no effect on morbidity and mortality events up to 1 year after CABG . However , antidepressant therapy may provide faster improvements to mental health aspects of quality of life and reduce postoperative pain in patients with preoperative depression . Subject to contra-indications , we recommend antidepressant therapy in coronary revascularization patients who are preoperatively depressed
Such interventions would have the potential to reduce the prevalence of chronic pain in the population .
Although certain risk factors can identify individuals who are most likely to develop chronic pain , few interventions to prevent chronic pain have been identified .
To facilitate the identification of preventive interventions , an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain .
We present general design considerations for prevention trials in population s that are at relatively high risk for developing chronic pain .