The Irish Pain Research Network (IPRN)

Aim

• To bring together all active pain researchers on the island of Ireland (North and South) for the purposes of sharing research results and ideas and facilitating cross-institutional collaboration in the area of pain research

Origins of IPRN

• Discussions in late 2014 between NUI Galway pain researchers (Prof. David Finn and Dr. Brian McGuire) and UCD researchers (Dr. Brona Fullen, Dr. Catherine Doody and Dr. Catherine Blake)

• Idea advanced with the IPS Committee

• IPRN is a Special Interest Group (SIG) of the IPS

• Launched formally at the 15th Annual Scientific Meeting of the Irish Pain Society, 26th Sept 2015

Anticipated benefits of IPRN• Facilitate greater collaboration• Forum for presenting research results, sharing ideas,

networking• Multidisciplinary

– Neuroscience, Psychology, Physiotherapy, Nursing, Pain Medicine etc

• Easier access to expertise and methodologies– Training, lab visits, student exchanges– Website: repository of expertise

• Opportunities for junior researchers to present and network

• IPRN members better positioned to apply successfully for research grants (HRB, SFI etc)– Particularly multi-institute grant applications

• Raise the profile of pain and pain research in Ireland

Membership of IPRN• If you are active in pain research within Ireland (or would like to

become research active) then we would like to extend a very warm invitation to you to join IPRN

• Pain researchers at any level of seniority are welcome to join, and we particularly welcome students and early-career researchers.

• There is no fee to join IPRN but you must be a member of the IPS in good standing (to join the society see http://www.irishpainsociety.com/ ; all registered delegates at the Annual Scientific Meeting on Saturday 26th September 2015 will automatically become members of the IPS and are therefore eligible to join IPRN if they wish).

• If you wish to join IPRN, please complete the short application form enclosed and give to David Finn at end of today’s session or submit at registration desk. Alternatively submit by email to Orla Doran (ODoran@coa.ie). Please put “IPRN” in the subject field of your e-mail.

• Please join and spread the word!!

IPRN Inaugural Symposium

• Prof. David Finn and Dr. Michelle Roche (NUIG, Neuroscientists)

• Dr. Brian McGuire (NUIG, Psychologist)

• Dr. Brona Fullen (UCD, Physiotherapist)

• Dr. Catherine Blake (UCD, Physiotherapist)

• Dr. Siobhan O’Mahony, Prof. John Cryan and Prof. George Shorten (UCC, Neuroscience and Pain Medicine)

• John Nealon and Prof. Oliver Dolly (DCU, Neuroscientists )

• Eva Barrett (University of Limerick, Physiotherapy).

• Joanne O’Brien (RCSI and Beaumont Hospital, Pain Nurse)

• Dr. Deirdre Desmond (NUI Maynooth, Psychologist)

• Dr. Joseph Mcveigh (University of Ulster, Physiotherapist)

Centre for Pain Research NUI, Galway

Professor David Finn, PhD

Co-Director of the Centre for Pain Research

Director of the Galway Neuroscience Centre

Professor of Pharmacology and Therapeutics

SFI Principal Investigator

David.Finn@Nuigalway.ie

Tel: +353 (0)91 495280

Centre for Pain Research

• Founded 2007 - First pain research centre in Ireland

• Co-Directors: Prof. David Finn & Dr. Brian McGuire

Research Clusters/Themes:

Pre-clinical / basic science research

Psychological and neuropsychological aspects of pain

Pain treatment and pain management

Population and policy aspects of pain

Integration of pre-clinical pain research and clinical practice

http://www.nuigalway.ie/centre-for-pain-research/

– Analgesic and anti-inflammatory potential of novel drugs and associated neurochemical/molecular mechanisms of action• Cannabinoids, TRPV1, opioids, monoamines, antidepressants, GABA, glutamateimidazolines, Ca2+ channels,

– Exploring the relationship between negative affect and pain: the role of the endogenous cannabinoid and opioid receptor systems:• Fear-induced analgesia• Anxiety/depression-related hyperalgesia (rodents and humans)

– Assessment of the effects of neuropathic pain and its treatment on cognitive function (in rodents and humans)

– Novel drug delivery systems for analgesics, including cannabinoids

– Neuroimmune mechanisms and chronic pain• Cannabinoid regulation of neuroimmune function

– Development of new animal models • post-operative pain following inguinal hernia repair• Depression-Pain comorbidity

Key Research Questions/ProjectsDavid.Finn@Nuigalway.ie and Michelle.Roche@Nuigalway.ie

Key Research Findings

• The endocannabinoid system mediates fear-induced analgesia (Finn et al., 2004, Eur J Neurosci; Butler et al., 2008, Pain; Ford et al., 2010, Pain; Olango et al., 2013, Br J Pharmacol)

• Dysfunction of the endocannabinoid system in PAG/RVM circuitry may contribute to hyperalgesia associated with negative affect (Rea et al., 2014, Pain)

• Developed a novel rat model of postoperative pain associated with inguinal hernia repair (Bree et al., 2015, J Pain)

• Monoaminergic and neuroimmune alterations underpin altered nociceptive processing in animal models of depression (Burke et al., 2015, Behav Brain Res; 2014, Brain Behav Immun, 2013, Genes Brain Behav, 2013, J Pain)

• The endocannabinoid system modulates neuroinflammatoryprocesses (Roche et al., 2006 J Neuroimmunol; Kerr et al., 2012, Neuroscience; 2013, Br J Pharmacol; Henry et al., 2014, J Neuroimmunol)

Methodologies

Behavioural models/tests

Pain/Stress/

depression

Proteomics

Elisa, Mass spec, western blotting,

Molecular techniques

qRT-PCR, gene delivery,

radioligandbinding, GTPyS

Lipidomics

EC assay, AA, PGE2

NeurochemistryHPLC, LC-MS-MSIn vivo microdialysisELISA, IHC

In vitro screening assays

iPSc

Human and animal

Clinical Neuroimaging

Facility

Research Skillsets/Technical Expertise

Animal models/methodologies

• Behavioural models /tests Pain

• Acute: Hot Plate, Tail Flick, Hargreaves test, Acetone Drop Test, Von Frey test • Chronic/Persistent: Formalin test, Complete Freunds' Adjuvant induced arthritis/pain (CFA), Spinal

Nerve ligation, inguinal hernia repair post-operative pain

Inflammation LPS, Poly I:C, Formalin test , CFA

Depression Forced Swim Test (FST), Tail suspension test, Wistar Kyoto Rat, Olfactory bulbectomy,

Lipopolysaccaride (LPS)-induced depression.

Stress/Anxiety Elevated Plus Maze, Open Field, Home cage activity, FST, Restraint stress, Place Escape Avoidance

Paradigm, Social interaction/defeat test, Passive avoidance, Conditioned fear, marble burying test Cognition

Morris water maze, novel object recognition, T-maze, passive avoidance

Behavioural rating equipment: Opti-M3 locomotor activity monitors, Ethovision XT, Observer XT

• Surgery techniques i.c.v., i.c., IV cannulae Olfactory bulbectomy, spinal nerve ligation bioradiotelemetry

Psychological Aspects of Pain and Population Health Research in Pain

Dr. Brian McGuire

Dr. Line Caes

Dr. Jonathan Egan

HRB Interdisciplinary Capacity Enhancement (ICE) Award

• HRB funding call description/ focus: ‘Developing interdisciplinary research capacity at post-doctoral level’

• Application title: Chronic Pain in Ireland: Prevalence, Management and Professional Education

• PostDocs- Dr. Siobhan O’Higgins, Dr. Chris Dwyer– Psychology, Physiotherapy, Health economics

• Projects and focus of award:

WP1: Prevelance of CP in 5-12 year olds

WP2: Online ACT

Three main areas of output

WP3: Clinical Judgment

Annual Sciific

HRB Research Leaders Award

• HRB funding call description/ focus: ‘Investing in leadership capability in population health and health services research’

• Application title: Psychological therapies for chronic pain and adjustment difficulties in multimorbid health conditions: Development and delivery of eHealthsolutions.

• PostDoc- Dr. Brian Slattery, RA- Ms. Laura O’Connor

• RA- Health Science/Epidemiology RA- Health Economics

• Projects and focus of award:

WP1: Prevelance of MM WP2: eHealth interventions

Three main areas of output

Dissemination & Collaboration

Annual Scientific meeting

eHealth course

Research Programme

• Prevalence, Impact and Cost of Chronic Pain– PRIME 33% prevalence, cost: €4.8bn 2.8% GDP– PRIME-C 10% 5-12 year olds– PRIME-6

• Pain-ID • Pain in children and interactions with parents• Online pain treatments

– Online MBCT for chronic back pain in adults– Online MBCT for chronic headache in adults– Online hypnotherapy-based intervention for migraine in adults– Online MBCT for wellbeing in MS– Online CBT for cancer-related fatigue– Online ACT for adults with chronic pain– Online “Feeling Better” for children and parents

• KEDS “Pain hub”• Pain apps for children

Pain in childhood : parental and family factors

catastrophicthoughts

distress

protective behaviour

various samples & methodologies :

• self-report (Caes et al., 2011;2012, Pain)

• psychophysiological

assessment (Caes et al., 2012, Pain)

• observational assessment (Caes et al., 2014, Clin J Pain, J Ped Psychol)

children are highly dependent on their parents

parental responses critically important!

protective (e.g. comfort, reassure) : increase in child pain

coping–promoting (e.g. distracting, coping instructions) : decrease in child pain

lack of research on

• moderating influence of family functioning on parental behaviour

• bidirectional, mutual influence between parents and children from infancy

through adolescence

(e.g. changes in and transfer of responsibilities for pain management)

Collaboration and Networking

• Named research partner – HSE Health Intelligence Unit.

• New Annual Scientific Meeting in eHealth Research and Clinical Practice.

• HRB Clinical Trials Network in Chronic Musculoskeletal Pain (NUIG, UCD, UL) - Next time…!

UCD School of Public Health, Physiotherapy and Population Science

UCD Health Science Centre

University College Dublin

Belfield, Dublin 4, Ireland

UCD Centre for Translational Pain ResearchAdvancing Science Changing Pain

Brona M Fullen, BSc, MSc, PhD

UCD School of Public Health, Physiotherapy and Sports Science

Brona.fullen@ucd.ie, (01) 716-6516

Theme Key Research Projects / Themes

PAIN CLASSIFICATION

(Dr C Doody)

OA: Somatosensory profiles, NS sensitisation

PAIN MANAGEMENT &

REHABILITATION

(Dr B Fullen)

CBT, ACT, health literacy, PMP for spinal cord injury

Sub-classification of LBP (Startback)

PAIN MEASUREMENT &

OUTCOME ASSESSMENT

(Dr C. Blake)

Psychometric properties of measurement scales,

Measurement of NS sensitization using quantitative

sensory and clinical testing

BASIC SCIENCE PAIN

RESEARCH

(Prof. G. Wilson)

Biomarker profiling for pt. stratification & therapeutic

targeting (personalized medicine)

EVIDENCE BASED MEDICINE

(Prof. L. O’Connor)

Systematic reviews: health literacy, NP post SCI, pain

sensitisation

National Clinical Guideline on acute pain, chronic non

cancer pain

Theme Key Research Projects / Themes

PAIN CLASSIFICATION

(Dr C Doody)

Alterations in pain processing in people with chronic MSK pain

states are indicative of pain sensitization

The presence of pain sensitization may be linked to symptom

severity

PAIN MANAGEMENT &

REHABILITATION

(Dr B Fullen)

CBT-PMP – 6/12 - sig. CSC in patient outcome measures

Startback – Stratification demonstrated superior outcomes in high

risk patients, & equally good for medium & low risk groups –

effective model of care

PAIN MEASUREMENT &

OUTCOME ASSESSMENT

(Dr C. Blake)

People with knee OA show signs of neural mechanosensitivity

Less efficient exercise induced hypoalgesia in knee OA patients,

particularly with high pressure pain sensitivity

EVIDENCE BASED MEDICINE

(Prof. L. O’Connor)

NP post SCI- pooled prevalence is 54%; paraplegic 46%,

tetraplegic 52%

Health literacy – low scores associated with less engagement with

health services, more co-morbidities

Research Skillsets/Technical Expertise

• Grant writing

• Research methodologies

• Clinical trials methodologies & management

• Systematic review & meta-analyses

• Knowledge translation

• Advanced statistics

• Big data management

• Spatial and numerical modelling

UCD School of Public Health, Physiotherapy and Population Science

UCD Health Science Centre

University College Dublin

Belfield, Dublin 4, Ireland

Making sense of data in pain research

Catherine Blake, BPhysio, MMed Sc, MA Statistics, PhD

UCD Centre for Translational Pain Research

c.blake@ucd.ie, (01) 716-6525

Health analytics

• Clinical databases

– Biomarkers/radiology/epidemiology

– Genomics

• Wearable technology

– Biometrics

– Behaviour / activity /sleep / stress

• Patient reported outcomes

– Targeting questionnaires

– Computer Adaptive Testing

– Psychometrics

• eDiaries & Social media

– Behaviour, Beliefs, Preferences

– Text analytics

• Health gain

– Cost benefit

• ** Missing data

Big DataIntegration of data sources

Data mining and visualisation Provide answers

Generate new questions

Data sources and solutions

Health analytics

• Clinical databases

– Biomarkers/radiology/epidemiology

– Genomics

• Wearable technology

– Biometrics

– Behaviour / activity /sleep / stress

• Patient reported outcomes

– Targeting questionnaires

– Computer Adaptive Testing

– Psychometrics

• eDiaries & Social media

– Behaviour, Beliefs, Preferences

– Text analytics

• Health gain

– Cost benefit

• ** Missing data

Big DataIntegration of data sources

Data mining and visualisation Provide answers

Generate new questions

Data sources and solutions

Health decision making

• Classification

• Clustering

• Association rules

• Prediction and cross

validation

• Decision trees-

management

algorithms

• Bayesian networks

• Machine learning

Classical statistical approaches

Multivariate analysis Mediation / moderation

UCD Centre for Translational Pain Research

Multidisciplinary solutionsClinical / Academic

Health Professions, Bench Science, Statistics/Computer Science, Social science

Collaborative networks enhanced outcomes

Visceral Pain-altered gut to brain signalling?

Dr. Siobhain M. O’ Mahony

Department of Anatomy & Neuroscience and APC Microbiome Institute, University College Cork

Ireland.

somahony@ucc.ie

Pain StudiesClinical studies

– Microbiota– Intestinal

permeability– Gender

Pre-clinical Studies– Spinal cord – Glutamate system– Sex (cycle stage) – Microbiota– Stress (early-life,

antibiotics)

O’Mahony et al., 2012; Felice et al., 2015 (unpublished); Sajjad et al., 2015 (unpublished)

Efficiency of EAATs is determined by sex and cycle stage-implications for sex-differences in visceral pain

http://apc.ucc.ie

Research Skillsets/Technical Expertise

• Behavioural Pain assessments– Clinical-Quantitative Sensory Tests (in collaboration with Prof. George Shorten and Dr. Brian

McNamara, CUH)– Pre-clinical-visceral and somatic pain, anxiety, cognition, depression, germ-free ect

• Microbiota analysis– What bacteria are there and what are they doing (in collaboration with Dr. Paul Cotter and

Prof. Catherine Stanton, Teagasc

• Glutamate uptake assay-measure of clearance at synapse

• Assays– In situ hybridisation– PCR– Western blot– Immunohistochimistry– Ect

Perioperative Pain

G ShortenThe ASSERT Centre

UCCg.shorten@ucc.ie; + 353 21 4922135

Key research questions

• Which patients develop persistent pain after surgery?

• Why do some patients develop persistent pain after surgery?

• What interventions decrease the risk of developing persistent pain after surgery?

• How does one train to perform pain management interventions safely and effectively?

Recent Research Findings/Data

• The magnitude of acute postoperative pain is an important determinant of likelihood and severity of PPSP

• Effective regional anaesthesia decreases the incidence and severity of PPSP after breast surgery.

• Perioperative pregabalin administration decreases the incidence of PPSP after lumbar disc surgery.

Research Skillsets/Technical Expertise

• Clinical pain phenotyping

• Quantitative sensory testing

• Procedure characterisation

Next generation bio-therapeutics engineered to ameliorate neuropathic pain

John Nealon – Ph.D. studentInternational Centre for Neurotherapeutics

Dublin City Universityjohn.nealon5@mail.dcu.ie

01-700-7714

Inflammatory cells

Nociceptors

Dorsal root ganglion

Spinal cord

CGRPSubstance P

Brain

Molecular transducers(e.g. TRPV1, TRPA1)

Receptors for cytokines and transmitters

TNFα

NOXIOUS STIMULI

Peripheral hypersensitisation and susceptibility to botulinum neurotoxin (BoNT) based action

Local administration

of toxin

XX

BoNT: Structure and function

Crystal structure of /A3• Seven BoNT serotypes: A-G• Protease target of BoNT/A,E: SNAP-25

Rowland et al., N Engl J Med, 2002Rossetto et al., Nature rev. Microbio. 2014

BoNT/A structure:

Cleavage of SNAP-25 by BoNT/A in sensory neurons correlates with decreased CGRP release and blocks TNFα mediated relocation of

TRPV1

Meng et al. J Cell Sci 2007;120:2864–2874 Meng et al. submitted

Strategy to obtain a novel long-acting ‘composite’

anti-nociceptive endowed with synergistic activities

LC/E LC/A

BoNT/A

Most effective,

robust inhibitor of

exocytosis

Forms channel for

delivering proteases

Binds acceptors

on target cellsStabilises function of

attached cargo and

cleaves SNAP-25

HN/AHC/A

LC/E-BoNT/A

Patent published, 2015

0 5 10 15 20

0

50

100

150

200

Saline,

Sham + saline;

LC/E-BoNT/A (75 U/Kg), BoNT/A (15 U/Kg)Spared nerve injury:

- 4

***

**

**

***

**

†

†

ns

Days after injection

% P

os

t-in

jury

wit

hd

raw

al

du

rati

on

LC/E-BoNT/A significantly alleviates mechanical and cold hyper-sensitivity

in comparison with BoNT/A and Pregabalin in a spared nerve injury rodent

model of neuropathic pain

Data represent mean ± SEM. Statistical significance was calculated by 2-way ANOVA repeated

measures, Bonferroni post-tests: *** P < 0.001 vs saline; ns: non- significant vs Sham.

0 5 10 15 200.0

2.5

5.0

7.5

10.0

12.5

- 4

***

ns

ns

Days after injection

Me

ch

an

ica

l th

res

ho

ld(g

ram

s)

0 5 10 15 20

0

50

100

150

200

- 4

*** ns

Days after injection

% P

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wit

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Wang et al. In preparation

Research Skillsets/Technical Expertise• Rat models of chronic and acute pain: neuropathic and inflammatory

– Spared nerve injury - chronic pain– Models of arthritic inflammation– Varicella zoster virus induced post-herpetic neuralgia– Capsaicin elicited acute pain

• Assays of somatosensory behaviour:

– Mechanical, heat and cold sensitivity – von Frey, Hargreaves and acetone application tests– Weight bearing - pain induced incapacitation– Pressure administration method - for arthritic scoring

• Multi-photon in vivo Ca2+ imaging of Pirt-GCaMP3 mice

• Expertise in recombinant technologies

• GMP facility for production of toxin-based therapeutics

ICNT collaborators:

• Prof. Oliver Dolly, Dr. Jianghui Meng, Dr. Jiafu Wang, Dr. Omprakash Edupuganti, Dr. Laura Casals-Diaz, Dr. Tom Zurawski, Dr. Charles Metais, Dr. Gary Lawrence, Marc Nugent

External collaborators:

• Prof. D. Julius (UCSF), Dr. F.G. Scholl (Inst. de Biomed., Seville), Dr. M. Dong (Harvard Med. Sch.)

Musculoskeletal Pain ResearchUniversity of Limerick

Dept of Clinical Therapies

Dr Kieran O’Sullivan

Dr Karen McCreesh

Dr Katie Robinson

Key research questions

• Does providing a biopsychosocial, individualised treatment for LBP improve clinical outcomes? And if so, is it worth the extra costs?

• Musculoskeletal pain: is it what you do or the way that you do it? A study of therapeutic alliance in physiotherapy

• What factors are changed after an exercise programme for Achilles tendinopathy? – is it pain, tendon structure, muscle strength, fear, confidence?

• What is the role of spinal posture in shoulder pain?

• The Working with Arthritis program: Can an

occupational therapy-led vocational intervention support

people with musculoskeletal disorders to remain in,

or return to, work?

Recent research findings

• Group exercise for MSK pain is more effective than individual exercise (sys review)

• A mix of interpersonal, clinical and organisational factors influence the patient-therapist interaction (systematic review)

• Major predictors of injury in professional dancers are systemic factors (poor sleep and general health complaints), rather than physical or biomechanical factors (prospective study)

Research skill sets

• Methods: Systematic reviews and meta-analyses, Qualitative research

• Technical : motion analysis, EMG, Ultrasound imaging, algometry

• Clinical: Links with clinical partners to deliver physiotherapy interventions

• Knowledge translation: www.pain-ed.com, www.shouldercommunity.com

Joanne O’ BrienMSc (Pain Management), BSc, RNP, cANP, RGN

Hon. Teaching Associate, Faculty of Nursing, RCSI

Department of Pain Medicine

Beaumont Hospital

joanneobrien@beaumont.ie

Key research Questions/Projects

Treatment of Neuropathic Pain with Capsaicin 8%

1. To longitudinally examine patient outcomes following the treatment of NP with capsaicin 8%.

2. To assess the validity and reliability of a self-assessment tool on key patient reported outcomes with NP treatment using capsaicin 8%.

3. To investigation the requirement of physician supervision for nurses to apply Qutenza 8%

N = 24 1 Week 1 Month 3 Months

No Improvement 33.3% (n=8) 16.7% (n=4) 20.8% (n=5)

Slight / Moderate

Improvement

37.5% (n=9) 54.2% (n=13) 50% (n=12)

Much Better 29.2% (n=7) 29.2% (n=7) 29.2% (n=7)

Effect of Capsaicin 8% treatment on patients pain experience over three months

N = 24 1 Week 1 Month 3 Months

At least 30% reduction in pain score at rest. 54% (n=13) 54% (n=13) 62.5% (n=15)

At least 30% reduction in pain score on

movement

50% (n=12) 58% (n=14) 54% (n=13)

Percentage of patients who achieved at least 30% reduction in their pain scores

N = 24 Improvement at 1 Week 1 Month 3 Months

Self Care 59% (n=14) 75% (n=18) 79% (n=19)

Daily Activities 54% (n=13) 79%(n=19) 79% (n=19)

Physical Activity 54% (n=13) 85% (n=20) 79% (n=19)

Emotional Wellbeing 63% (n=15) 75% (n=18) 79% (n=19)

Ability to Sleep 50% (n=12) 59% (n=14) 62.5% (n=15)

Social Functioning 46% (n=11) 67% (n=16) 79% (n=19)

Improved Quality of Life following Capsaicin 8% treatment

•Capsaicin 8% is a beneficial addition to the medication armamentarium for the treatment of Neuropathic Pain (NP). •With 62.5% of patients experiencing at least a 30% reduction in pain at rest and 54% of patients on movement at 3 months, treatment with Capsaicin 8% should be considered to patients suffering NP as a first line treatment.•The results demonstrated that treatment of NP with Capsaicin 8% can be managed in a nurse led clinic, positive results are achieved and patients are happy with the treatment received.

Research Skillsets/Technical Expertise

Novice Researcher

Practice based research

REACH project (Research Excellence Across Clinical Healthcare Project)

The IPRN will provide the support and expertise to expand research ideas and practices.

Supporting work participation through early intervention in

patients with regional MSK pain

Dr Deirdre DesmondDeirdre.Desmond@nuim.ie

https://www.maynoothuniversity.ie/

Aims1. Profile levels of work related disability/instability in patients

in paid employment referred with RMSKP in Ireland;

2. Specify the content and delivery of an early integrated care intervention to improve work retention/participation, decrease distress, improve functional status, and increase health related quality of life among RMSKP patients;

3. Feasibility test, pilot and evaluate the intervention in terms of efficacy and economic impact.

Design• Phase 1:

– (a) Systematic review to collate the evidence on interventions to prevent work disability/instability in RMSKP

– (b) Quantitative study to document levels of work related disability/instability in patients referred for RMSKP in Ireland.

• Phase 2: Needs analysis of specific patient requirements to inform the intervention content.

• Phase 3:– (a) Specification of the content, components, mode and timing of the

intervention;– (b) Comprehensive feasibility and pilot testing with evaluation of

patient outcomes and economic impact.

specific core set of patient requirements that will comprise the early integrated care intervention;

identify key barriers and facilitators of work participation, associated support needs, and service expectations and priorities amongst patients with RMSKP

examine potential challenges in intervention delivery

identify optimal timing for delivery of the intervention

Research Management Team•Dr Andy Cochrane & Dr Niamh Higgins (MU)•Dr Oliver FitzGerald (DCU/St. Vincent’s)•Prof. Pamela Gallagher (Dublin City University)• Ms Roisin Breen (RCPI)• Ms Oriel Corcoran (Waterford Regional) • Ms Jennifer Ashton (Beaumont)• Ms Aisling Brennan (AMNCH)

Acknowledgement

HRB/Research Collaborative for Quality and Patient Safety (RCQPS) Award 2014-2016

Collaborators

ulster.ac.uk

Fibromyalgia Syndrome Joseph McVeigh PhD

Centre for Health and Rehabilitation Technologies

Institute of Nursing and Health Research

Ulster University

Northern Ireland

j.mcveigh@ulster.ac.uk

+44(0)2890368148

@mcveigh_joe

• Exercise and FMS

• The EASI-FIT Study: Exercise for fatigue and sleep dysfunction

in fibromyalgia: a feasibility study (ARUK, £356K)

• Exercise management of subacromial impingement syndrome

• Impact and extent of shoulder dysfunction post breast

reconstruction using LD

• Effectiveness of working wrist splinting in patients with RA

• CHaRT @Ulster

• Non-pharm interventions in long term conditions

• (LBP, Resp disease, Neuro conditions)

Key research Questions/Projects

The effectiveness of exercise in the management of fatigue and sleep dysfunction in fibromyalgia syndrome: a systematic review and meta-analysis (33 RCTs, n=2328)

Russell D, Álvarez Gallardo IC, Hughes CM, Davison GW, Sañudo B, McVeigh JG

Fatigue: Exercise vs control Sleep: Exercise vs control

23 RCTs

10 RCTs

Perceptions of fatigue, pain, sleep dysfunction and barriers to exercise in people with FMS: A focus group study

Russell D, Álvarez Gallardo IC, Wilson I, Hughes CM, Davison GW, Sañudo B, McVeigh JG

Fatigue / sleeplessness / pain / cognitive dysfunction: “I think the fatigue is worse than the pain, the pain you know what to do and what not to do…”

Exercise is a major challenge for patients: Household chores, ADLs exercise in themselves

“exercise to me is a scary word … “

“my exercise consists of getting out of bed…”

Lack of understanding:‘Doctors need to realize, we wouldn’t chose to live like this…”

Loss of self / role / function: “Life has been stolen.”

“Sometimes you just don’t go out at all, the person you were before this illness has totally changed.”

Research Skillset

• Systematic reviews / meta-analysis

• Clinical trials

• Focus groups

• Research ethics

• Editorial / peer review

• Supervision

• Grant writing

• Project management

j.mcveigh@ulster.ac.uk

IPRN – Next Steps?• Establish committee

– Expressions of interest to ODoran@coa.ie by 15th October 2015

• Grow membership• Set-up website and mailing list• Organise next meeting (Frequency? Format?)• Raise funds to support IPRN activities

– Meetings, invited speakers, administration etc

• Discuss research grant calls as they arise– E.g. HRB Clinical Trials Network, SFI centres etc.

• Any other comments or suggestions?