Guest edited by: Dr. Line Iden Berge, Dr. Emily Harrop, Prof. Bettina S. Husebø, Dr. Christina Liossi, Dr. Monica Patrascu
Submission Status: Open | Submission Deadline: 29 March 2024
Pain is “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage or described in terms of such damage” (IASP, 2020). Estimates suggest that at least one-quarter of people experience long-term persistent pain - an often invisible and misunderstood source of disability that affects one's ability to live, function and work. Healthcare systems are not set up or resourced to deal with such a prevalently overwhelming condition, so therapeutic advances are urgently required.
Pain does not discriminate by age, group or sex. We know biologically that inflammatory pathways differ by sex, hormonal state, or even during pregnancy. Effective opioids are analgesic yet have contributed destructively towards addictive epidemics. The United Nations Office of Drugs and Crime World Drug Report (2019) highlights the “global paradox of too much and not enough” and describes the difficulty of ensuring appropriate access to controlled substances for medical and scientific purposes while preventing diversion and misuse. There is also an increase in long-lasting usage of pain medication in vulnerable patient groups without proper clinical assessment. Even the use of nonsteroidal anti-inflammatory drugs may prolong recovery from acute inflammation. Psychosocial (e.g., patient education, cognitive behavioral therapy, clinical hypnosis) and non-pharmacological treatment approaches are increasingly prescribed despite limited evidence. Formerly established facts are being questioned, and the pain field faces a quandary.
Vulnerable groups, such as children, older adults or those with life-limiting conditions, are especially at risk to this complex condition. Pain in children differs from that in adults for physiological, cognitive, developmental, and social reasons. The child’s developmental processes, cognitive ability, and education level lead to essential differences in their perceptions of and ability to express pain. Meanwhile, persons with advanced cognitive impairment, such as dementia or Parkinson’s disease, cannot report the intensity, location, and duration of pain, the effect of pain treatment or its potential side effects. In these groups, pain assessment is now performed through proxy rating, which has low validity but high placebo effect in controlled trials. Moreover, untreated pain in people with neurological conditions may trigger behavioral and psychological disturbances (such as agitation, depression, psychosis, and sleep disturbances), leading to increased psychotropic drug prescriptions.
Ethnic, gender, and socioeconomic disparities exist in pain diagnostics management too. When experiencing pain, women wait longer to be assessed, are prescribed less effective painkillers, and wait longer to receive these medications than their male counterparts. Knowledge gaps and biases are prevalent, and better research is needed to address these long-existing healthcare inequalities.
Considering current controversies and unknowns, BMC Medicine launches this Call for Papers to welcome outstanding contributions on Pain in Vulnerable Groups. Five Guest Editors with diverse backgrounds and expertise ensemble to tackle this important cross-disciplinary topic. We’ll commission content from low-middle income and vulnerable population settings, so relevant communities are heard and served.
We are particularly interested in papers that fall under the following topics:
- Understand how internal/external factors influence pain in vulnerable populations
- Controversies in pain research and treatment
- Clinical interventions in at-risk groups including rheumatic, musculoskeletal, autoimmune, oncological, pediatric, neurological, and palliative care
- Reporting of healthcare inequalities in pain diagnosis and/or management
- Community care that humanizes and targets chronic pain
- Psychosocial and psychological aspects of pain
- Identifying novel mechanisms and strategies in nociception and analgesia
- Translational innovations linking mechanisms to therapies
- Tailored approaches to personalized medicine
- Novel methods or technologies to recognize and estimate pain and the effect of pain treatment
- Efficacy of non-pharmacological pain interventions based on large-scale controlled trials
- Digital phenotyping linking clinical and/or digital biomarkers to pain
- Systematic reduction of unnecessary pain medication investigated by controlled trials
- Systematic placebo-controlled or blinded pain medication reduction studies
Pain in particularly vulnerable groups of children, such as:
- vulnerable children such as those with developmental or intellectual disabilities, exposed to trauma or challenging life experiences, living in humanitarian settings, and with comorbid mental health conditions
- children with life-limiting conditions or those requiring end-of-life pain management both in inpatient settings and in the community
BMC Medicine encourages submissions of front matter articles and original research, including clinical trials (phase I - III, randomized-controlled, either positive or negative trials), epidemiological studies (retrospective or prospective), systematic reviews and meta-analyses, medical imaging or genomics studies, biomarkers, and translational research.
Patient perspectives and studies incorporating patient and public involvement (PPI) are particularly of interest. We also welcome outstanding mechanistic laboratory studies that provide superb translational insights into the future of pain diagnostics and management.
We welcome the direct submission of original research within the article collection's scope. Please submit directly to BMC Medicine, indicating in your cover letter that you are targeting this collection. Alternatively, you can email a pre-submission query to the editorial team at email@example.com. The collection will remain open and accept submissions up to one year after launch. Articles will be published as soon as they are proofed post-acceptance.
Guest Editors provide guidance on the scope of this collection, advice on commissioned content, and editorial recommendations. However, they are not involved in the final editorial decision-making on papers submitted to this collection. All final editorial decisions are with the Editor-in-Chief, Dr. Lin Lee.