Keywords

advanced nurse practitioner, advanced practice, capsaicin 8%, neuropathic pain, nurse-led clinic, nursing

 

Authors

  1. O'Brien, Joanne MSc, BSc (Hons), RANP, RNP, RGN, FFNMRCSI
  2. Keaveny, Joseph MB, BCh, FFARCSI, FFPMCAI
  3. Pollard, Valerie MB, BCh, BAO, FFARCSI, FFPMCAI
  4. Nugent, Linda Elizabeth PhD, MSc, RGN, BSc (Hons)

Abstract

Purpose/Aims: The purpose of this study was to examine the management of patient's neuropathic pain with capsaicin 8% in a nurse-led clinic when administered by 1 registered advanced nurse practitioner without physician supervision.

 

Design: A longitudinal, single-group, descriptive research design was used to assess pain scores and quality of life 3 times over 3 months after treatment.

 

Methods: Patients with a diagnosis of neuropathic pain were assessed and treated with capsaicin 8% by 1 advanced nurse practitioner with prescriptive authority in a nurse-led clinic. Pain scores were collected at baseline, and self-assessed pain, activity level, and quality of life were assessed at 1 week, 4 weeks, and 3 months after treatment. Twenty-four patients were recruited, and data were analyzed using Friedman's test. In post hoc analysis, Wilcoxon signed-rank test was used with Bonferroni correction.

 

Results: Pain scores differed from pretreatment to posttreatment at each of the 3 time points, at rest ([chi]23 = 20.54, P = .001) and on movement ([chi]23 = 23.644, P = .001), and remained significant after Bonferroni correction. Overall, 62.5% (n = 15) of patients achieved at least a 30% reduction in self-reported pain at rest from pretreatment to 3 months, and 54% (n = 13) achieved the same reduction in pain on movement. Most improvements in patient's quality of life occurred between 1 and 4 weeks. Patient satisfaction was high, with 83% stating that they would be happy to have the treatment repeated.

 

Conclusion: Single-dose capsaicin 8% decreased neuropathic pain after being administered in an outpatient setting by an experienced registered advanced nurse practitioner. Further multicenter research led by advanced nurse practitioners is needed to support high-quality, safe treatment of neuropathic pain with high-concentration capsaicin in nurse-led chronic pain clinics.