Development of an evidence-based pain management protocol and its application in patients with postherpetic neuralgia

Postherpetic neuralgia (PHN), the most prevalent complication of herpes zoster, severely compromises patients' quality of life. This study developed and evaluated an evidence-based nursing framework for a comprehensive PHN pain management program.

Guided by evidence-based principles, we systematically synthesized optimal evidence-including 2 clinical guidelines, 2 decision support tools, and 6 evidence summaries-to draft a PHN management program refined through expert consultations; using convenience sampling, 80 PHN patients from a tertiary hospital in Suzhou, China, were allocated to a control group (n = 40, January-June 2023, conventional nursing) or an intervention group (n = 40, July-December 2023, conventional nursing plus the evidence-based program), with pain levels (numeric rating scale) assessed at admission, discharge, and 1-month post-discharge and analyzed via repeated-measures analysis of variance.

The finalized PHN program comprised 5 first-level domains (e.g., multidimensional assessment, stepped pharmacotherapy), 12 second-level subdomains, and 28 third-level interventions; the intervention group showed significantly greater pain reduction versus controls (mean Δnumeric rating scale: -3.8 vs -1.2 at 1-month; P < .001), with significant group-time interaction (F = 15.32, P < .001).

This evidence-based PHN pain management program significantly alleviates neuralgia, demonstrating robust scientific validity and clinical utility.