Clinical management of pain requires a careful assessment of its history, including frequency, intensity, duration and quality of pain, as well as the impact of pain on daily activities. The accuracy and reliability of a patient’s recollection of pain are key in choosing treatment options, such as surgery, drug therapy or physical therapy. Unfortunately, clinicians have little choice but to rely almost entirely on their patients’ self-report of pain, which some worry could be too subjective. Dr. Najib Babul, a prominent developer of medicines to treat pain, has studied the accuracy of patients’ recall of the pain experience. His conclusion, as reported in peer-reviewed medical journals is that patient recollection of acute pain is generally quite reliable.
Dr. Babul’s study included 77 hospitalized patients who had undergone orthopedic surgery. After their surgery, under a nurse’s supervision, patients were asked to record their pain levels every hour for 48 hours, and were also asked to retrospectively rank their worst, least, and typical pain intensity at the 24 and 48-hour mark. His research showed that their recollection of pain levels correlated accurately with the log of their immediate experience of pain in the same period. Dr. Najib Babul’s publications assert that painful experiences, such as a shot at a doctor’s office, create powerful memories and that such memories are reliably recalled by patients.
Other clinical studies that have proven consistent with Dr. Babul’s findings, include one by Dr. Marta Meana, Dean and Professor of Psychology at University of Nevada Las Vegas, who examined the accuracy of pain recall over a month in women with endometriosis. The study is of particular importance because endometriosis diagnosis and treatment decisions continue to be guided by pain level, despite the inconsistent relationship between pain intensity and verifiable organic pathology. Dr. Marta Meana observed that women with endometriosis were “generally quite accurate in their recall of pain experienced over the previous 30 days” and that “physicians may rest assured that the report of pain they are obtaining from the majority of patients is relatively accurate”
“Even verbal stimuli lead to reactions in certain areas of the brain,” claims Prof. Dr. Thomas Weiss, a psychologist from the Friedrich Schiller University of Jena in Germany.
Dr. Weiss and colleagues were investigating the brain activation elicited by pain-related words. Using functional MRI neuroimaging, their research showed that pain-related words activated regions of the brain associated with the brain’s “pain matrix,” an extensive cortical network. “After such an experience it is enough to simply imagine a needle at the next vaccination appointment to activate our pain memory,” said Dr. Weiss. One explanation is that humans are biologically engineered to remember threatening scenarios so that they can be avoided in the future, an evolutionary advantage.
Dr. Najib Babul, PharmD, MBA, is an accomplished pharmaceutical scientist, drug developer, inventor, and biotech entrepreneur. A graduate of the University of British Columbia, the State University of New York, and the California Institute of Advanced Management, he has over two decades of experience in bringing new drugs to market. Dr. Babul is presently a drug development consultant to pharmaceutical companies, specializing in the areas of clinical pharmacology, dosage form design, clinical drug development for acute, chronic, cancer and neuropathic pain, rheumatology, and cancer supportive care. His services include assisting clients with licensing due diligence, orphan drug applications, scientific and regulatory support for FDA and EMA meetings, Risk Evaluation and Mitigation Strategies (REMS), pediatric exclusivity, and obtaining FDA fast track and breakthrough therapy designation. His expertise also extends to dosage form design, drug development planning, clinical trial design, contract research organization (CRO) selection and management, protocol development and data analysis. Dr. Babul is the author of over 170 abstracts and manuscripts published by leading medical journals and scientific proceedings, including the Lancet, the Journal of American Medical Association (JAMA), the Journal of Clinical Pharmacology, the Journal of Clinical Oncology, Cancer, Anesthesiology, Clinical Pharmacology & Therapeutics, and Anesthesia & Analgesia.
Najib Babul – Founder, CEO and CSO @ Relmada Therapeutics – crunchbase: https://www.crunchbase.com/person/najib-babul#/entity