Chronic pain treatment preferences change following participation in N-of-1 trials, but not always in the expected direction
2021

Changes in Chronic Pain Treatment Preferences After N-of-1 Trials

Sample size: 87 publication Evidence: moderate

Author Information

Author(s): Richard L. Kravitz, Maria Marois, Ida Sim, Deborah Ward, Samika S. Kanekar, Allison Yu, Peach Dounias, Jiabei Yang, Youdan Wang, Christopher H. Schmid

Primary Institution: UC Davis

Hypothesis

How do chronic pain patients' treatment preferences change after participating in N-of-1 trials?

Conclusion

Many patients undergoing N-of-1 trials for chronic pain changed their treatment preferences, but not always in line with the trial results.

Supporting Evidence

  • 40% of participants changed their treatment preferences after the trial.
  • Patients often retained their initial preferences despite trial results.
  • Treatment superiority varied significantly based on how it was defined.

Takeaway

When people with chronic pain try out personalized treatment trials, about 40 out of 100 of them might change their minds about what treatment they want, but sometimes they stick with their original choice even if the trial suggests a different option.

Methodology

This observational study analyzed chronic pain patients' treatment preferences before and after N-of-1 trials, focusing on changes in preferences and the influence of trial results.

Potential Biases

Potential biases may arise from patients' prior experiences and expectations influencing their treatment preferences.

Limitations

The study design is observational and may not definitively establish causality between N-of-1 trial participation and changes in treatment preferences.

Participant Demographics

The mean age of participants was 55 years, with 45% female and 30% non-white.

Statistical Information

P-Value

0.26

Statistical Significance

p=0.26

Digital Object Identifier (DOI)

10.1016/j.jclinepi.2021.08.007

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