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المؤلفون: Kevin Berry, Cindy Crawford, Courtney Boyd, Patricia A. Deuster
المصدر: Pain Medicine: The Official Journal of the American Academy of Pain Medicine
مصطلحات موضوعية: medicine.medical_specialty, Evidence-based practice, media_common.quotation_subject, Health Personnel, Review Article, Dietary Ingredients, law.invention, Decision Support Techniques, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Musculoskeletal Pain, Health care, medicine, Humans, Quality (business), 030212 general & internal medicine, media_common, 030203 arthritis & rheumatology, Evidence-Based Medicine, business.industry, Administrative Personnel, General Medicine, INTEGRATIVE MEDICINE SECTION, Diet, Meta-analysis, Anesthesiology and Pain Medicine, Systematic review, Harm, Family medicine, Pill, Dietary Supplements, Neurology (clinical), Systematic Review, Chronic Pain, business
الوصف: A series of systematic reviews and meta-analyses were conducted to evaluate whether current research on dietary ingredients for chronic musculoskeletal pain provides sufficient evidence for practice and self-care, specifically for Special Operations Forces personnel. Nineteen dietary ingredients were critically evaluated for their overall quality, efficacy, and safety. Evidence-based recommendations were made for practice and self-care use. This article details the evidence and factors leading to the resulting recommendations for practice.
Objective Approximately 55–76% of Service members use dietary supplements for various reasons; although such use has become popular for a wide range of pain conditions, decisions to use supplements are often driven by information that is not evidence-based. This work evaluates whether the current research on dietary ingredients for chronic musculoskeletal pain provides sufficient evidence to inform decisions for practice and self-care, specifically for Special Operations Forces personnel. Methods A steering committee convened to develop research questions and factors required for decision-making. Key databases were searched through August 2016. Eligible systematic reviews and randomized controlled trials were assessed for methodological quality. Meta-analysis was applied where feasible. GRADE was used to determine confidence in the effect estimates. A decision table was constructed to make evidence-informed judgments across factors required for decision-making, and recommendations were made for practice and self-care use. Results Nineteen dietary ingredients were included. Conditional evidence-based recommendations were made for the use of avocado soybean unsaponifiables, capsaicin, curcuma, ginger, glucosamine, melatonin, polyunsaturated fatty acids, and vitamin D. In these cases, desirable effects outweighed undesirable effects, but there was uncertainty about the trade-offs, either because the evidence was low quality or because benefits and downsides were closely balanced. Conclusions The evidence showed that certain dietary ingredients, when taken as part of a balanced diet and/or as a supplement (e.g., pill, tablet, capsule, cream), may alleviate musculoskeletal pain with no to minimal risk of harm. This finding emphasizes and reinforces the critical importance of shared decision-making between Operators and their health care providers.
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