- Name: Dearbhla Burke
- Year of PhD: 2014-2017
- Supervisor(s): Dr Brona Fullen, Dr Olive Lennon
- Title of PhD: Neuropathic Pain after Spinal Cord Injury
PhD Summary
The programme of research considered the problem of NP after SCI injury using a Public Health Model Impact and epidemiology of NP post SCI were investigated by systematic review, which established the international pooled prevalence rate of NP as 53% and by national survey, which identified 71% of people with SCI in Ireland experience pain, with NP indicated in 37% of cases. Respondents with NP reported higher pain intensities, increased healthcare service utilisation and lower quality of life (QOL) (P<0.001) when compared to nociceptive pain presentations. Low rates of access to specialist pain management services were recorded. Factors associated with an increased odds of NP presentation were identified as non-traumatic aetiology (OR 2.0:95% CI 1.12-3.56; P=0.02), poorer psychological health (OR 1.0: 95% CI 0.96-0.98; P<0.001) and the presence of chronic pain prior to SCI (OR 1.8: 95% CI 1.03-3.05; P=0.04).
Feasibility of a five week, hospital-based cognitive behavioural therapy pain management programme (CBT-PMP) was tested with short term improvement in psychological QOL (p=0.03) and longer-term reduction in depression scores (p=0.01) noted. Transportation and health-system implementation difficulties were identified as barriers to roll-out. This CBT-PMP was adapted for online delivery using a holistic eHealth technology development framework. The internet-delivered programme, developed following prototype evaluation by key stakeholders including intended end-users, was tested by randomised controlled trial. This CBT-PMP was adapted for online delivery using a holistic eHealth technology development framework. In comparison to usual care, the intervention group demonstrated short term benefit in self-reported pain intensity (P<0.001), pain interference (P<.01)band depression (P<0.05) and continued benefit at 3 months in the activities, mood and sleep category of pain interference (P<0.05).
Publications
Burke D, Fullen BM, Stokes D, Lennon O. Neuropathic pain prevalence following spinal cord injury: A systematic review and meta-analysis. Eur J Pain. 2017 Jan;21(1):29-44. doi: 10.1002/ejp.905. IF:3.651
Burke D, Fullen BM, Lennon O. Pain profiles in a community dwelling population following spinal cord injury: a national survey. J Spinal Cord Med. 2019 Mar;42(2):201-211. doi: 10.1080./10790268.2017.1351051. IF:2.040
Burke D, Lennon O, Fullen BM. Quality of life after spinal cord injury: The impact of pain. Eur J Pain. 2018 Oct;22(9):1662-1672. doi: 10.1002/ejp.1248. Epub 2018 Jun 25. PMID: 29770520.
Burke D, Lennon O, Blake C, Nolan M, Barry S, Smith E, Maye F, Lynch J, O'Connor L, Maume L, Cheyne S, Ní Ghiollain S, Fullen BM. An internet-delivered cognitive behavioural therapy pain management programme for spinal cord injury pain: A randomized controlled trial. Eur J Pain. 2019 Aug;23(7):1264-1282. doi: 10.1002/ejp.1402. Epub 2019 Jun 13. PMID: 31002442.
Presentations
Conference Workshop
| Conference |
Year |
Title |
Authors |
| International Spinal Cord Society |
2017 |
How to deliver a Cognitive Behavioural Therapy Pain Management Programme for Spinal Cord Injury: Both Face to Face and Online. |
Burke D, Lennon O, Nolan M, Barry S, Smith E, Maye F, Fullen BM. |
Platform Presentations
| Conference |
Year |
Title |
Authors |
| Irish Pain Society |
2015 |
Pain post spinal cord injury in Ireland: Increased symptom severity and service utilisation in neuropathic pain presentations Third prize clinical research competition. |
Burke D, Lennon O, Fullen BM. |
| Irish Association of Rehabilitation Medicine |
2016 |
The implementation of a cognitive behavioural therapy pain management programme (CBT-PMP) for neuropatic pain following spinal cord injury: a feasibility study. First prize Oral Competition. |
Burke D, Lennon O, Nolan M, Barry S, Smith E, Maye F, Fullen BM. |
| CTPR |
2016 |
Pain Profiles Following Spinal Cord Injury: A National Survey |
Burke D, Lennon O, Fullen BM. |
| CTPR |
2017 |
The development of spire: an internet-delivered cognitive behavioural therapy pain management programme for people with chronic pain after spinal cord injury. First Prize Oral Competition. |
Burke D, Lennon O, Nolan M, Barry S, Lynch J, Smith E, Cheyne, S, Maume L, O’Connor L, Maye F, Ní Ghiollain S, Fullen BM. |
| CTPR |
2017 |
Participant perspectives of a cognitive behavioural therapy pain management programme post spinal cord injury. |
Burke D, Lennon O, Nolan M, Barry S, Smith E, Maye F, Fullen BM. |
| CTPR |
2017 |
Developing and implementing a spinal cord injury cognitive behavioural therapy pain management programme from the clinician’s perspective. |
Burke D, Lennon O, Nolan M, Barry S, Smith E, Maye F, Fullen BM. |
Poster Presentations
| Conference |
Year |
Title |
Authors |
| EFIC |
2015 |
The prevalence and management of neuropathic pain following spinal cord injury in ireland |
Burke D, Lennon O, Fullen BM. |
| EFIC |
2015 |
Neuropathic pain following traumatic and non-traumatic spinal cord injury: a systematic review and meta-analysis |
Burke D, Fullen BM, Lennon O |
| EFIC |
2015 |
The profile of neuropathic pain following spinal cord injury: a systematic review and meta-analysis |
Burke D, Fullen BM, Lennon O |
| ISCP |
2015 |
Neuropathic pain following spinal cord injury: a systematic review and meta-analysis |
Burke D, Fullen BM, Lennon O |
| British Pain Society |
2016 |
The effect of pain on health related quality of life after spinal cord injury. |
Burke D, Lennon O, Fullen BM. |
| CTPR |
2016 |
Neuropathic pain prevalence following spinal cord injury: a systematic review and meta-analysis First prize poster competition. |
Burke D, Fullen BM, Lennon O |
| CTPR |
2016 |
The implementation of a cognitive behavioural therapy pain management programme (CBT-PMP) for neuropatic pain following spinal cord injury: a feasibility study. |
Burke D, Lennon O, Nolan M, Barry S, Smith E, Maye F, Fullen BM. |
| CTPR |
2016 |
The effect of pain on health related quality of life after spinal cord injury. |
Burke D, Lennon O, Fullen BM. |
| ISCOS |
2016 |
Participant perspectives of a cognitive behavioural therapy pain management programme post spinal cord injury. |
Burke D, Lennon O, Nolan M, Barry S, Smith E, Maye F, Fullen BM. |
| ISCOS |
2016 |
Developing and implementing a spinal cord injury cognitive behavioural therapy pain management programme from the clinician’s perspective. |
Burke D, Lennon O, Nolan M, Barry S, Smith E, Maye F, Fullen BM. |
| CTPR |
2017 |
Participant perspectives of a cognitive behavioural therapy pain management programme post spinal cord injury. |
Burke D, Lennon O, Nolan M, Barry S, Smith E, Maye F, Fullen BM. |
| CTPR |
2017 |
Developing and implementing a spinal cord injury cognitive behavioural therapy pain management programme from the clinician’s perspective. |
Burke D, Lennon O, Nolan M, Barry S, Smith E, Maye F, Fullen BM. |
| International Spinal Cord Society |
2017 |
Pain profiles Following Spinal Cord Injury in Ireland: A National Survey. First prize poster presentation. |
Burke D, Lennon O, Nolan M, Barry S, Smith E, Maye F, Fullen BM. |
| International Spinal Cord Society |
2017 |
The development of spire: an internet-delivered cognitive behavioural therapy pain management programme for people with chronic pain after spinal cord injury. |
Burke D, Lennon O, Nolan M, Barry S, Smith E, Maye F, Fullen BM. |