title: Advancing Nursing Practice: Management of Neuropathic Pain With Capsaicin 8% Without Physician Supervision.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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 (χ3 = 20.54, P = .001) and on movement (χ3 = 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Author Affiliations: Registered Advanced Nurse Practitioner (Ms O'Brien) and Consultant (Drs Keaveny and Pollard), Department of Pain Medicine, Beaumont Hospital, Dublin, Ireland; and Lecturer (Dr Nugent), RCSI School of Nursing And Midwifery, Royal College of Surgeons in Ireland, Dublin.
authors.forename: Joanne
authors.initials: J
authors.lastname: O'Brien
authors.forename: Joseph
authors.initials: J
authors.lastname: Keaveny
authors.forename: Valerie
authors.initials: V
authors.lastname: Pollard
authors.forename: Linda Elizabeth
authors.initials: LE
authors.lastname: Nugent
mesh_terms: D000328:Adult; D057179:Advanced Practice Nursing; D000368:Aged; D002211:Capsaicin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy* / Q000451:nursing*; D059408:Pain Management / Q000451:nursing*; D010147:Pain Measurement; D019555:Physician-Nurse Relations; D057184:Practice Patterns, Nurses'; D011788:Quality of Life; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002211:Capsaicin