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Ruiz-Vilchez D, Ladehesa-Pineda L, Puche-Larrubia MÁ, Ábalos-Aguilera MC, Font-Ugalde P, Escudero-Contreras A, Collantes-Estévez E, López-Medina C. The socioeconomic status of patients with ankylosing spondylitis and its association with the burden of the disease and permanent disability: a cross-sectional cluster analysis. Ther Adv Musculoskelet Dis 2024; 16:1759720X241272947. [PMID: 39247912 PMCID: PMC11378180 DOI: 10.1177/1759720x241272947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 07/10/2024] [Indexed: 09/10/2024] Open
Abstract
Background Few studies have been conducted to investigate the socioeconomic profiles of patients with ankylosing spondylitis (AS) and their associations with disease severity and disability. Objectives The objectives of this study were to identify clusters of patients with AS according to their socioeconomic characteristics and to evaluate the associations between these clusters and the severity of the disease and permanent disability. Design This was a cross-sectional and multicentre study. Methods Patients with AS from the REGISPONSER study were included in this analysis. A cluster analysis was conducted using information on sociodemographic (age, sex, race, marital status, education) and socioeconomic (employment, profession, housing conditions and social level) characteristics. Disease burden and permanent disability were compared between the different clusters using logistic regression adjusted for disease duration and disease activity. Results A total of 866 patients with AS were included. Two clusters were identified according to socioeconomic characteristics: Cluster 1 (n = 476), with a predominantly low socioeconomic profile, and Cluster 2 (n = 390), with a predominantly high socioeconomic profile. After adjusting for disease duration, patients in Cluster 1 had a longer diagnosis delay, greater body mass index and greater structural damage than those in Cluster 2. Access to biologic disease-modifying anti-rheumatic drugs (bDMARDs) was similar for both groups. However, patients in Cluster 1 had a greater prevalence of permanent disability than those in Cluster 2 after adjusting for disease duration and disease activity (30.8% vs 13.2%, odds ratio 2.58 (95% confidence interval 1.76-3.83)). Conclusion This study suggests that the socioeconomic status of patients with AS may have implications for disease severity and permanent disability, despite the similar use of bDMARDs.
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Affiliation(s)
- Desirée Ruiz-Vilchez
- Department of Rheumatology, Reina Sofia University Hospital, Cordoba, Spain
- GC05 Group, Maimonides Biomedical Research Institute of Cordoba, Cordoba, Spain
- Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain
| | - Lourdes Ladehesa-Pineda
- Department of Rheumatology, Reina Sofia University Hospital, Cordoba, Spain
- GC05 Group, Maimonides Biomedical Research Institute of Cordoba, Cordoba, Spain
- Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain
| | - María Ángeles Puche-Larrubia
- Department of Rheumatology, Reina Sofia University Hospital, Avda. Menendez Pidal s/n, Cordoba 14004, Spain
- GC05 Group, Maimonides Biomedical Research Institute of Cordoba, Cordoba, Spain
- Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain
| | - María Carmen Ábalos-Aguilera
- Department of Rheumatology, Reina Sofia University Hospital, Cordoba, Spain
- GC05 Group, Maimonides Biomedical Research Institute of Cordoba, Cordoba, Spain
- Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain
| | - Pilar Font-Ugalde
- GC05 Group, Maimonides Biomedical Research Institute of Cordoba, Cordoba, Spain
- Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain
| | - Alejandro Escudero-Contreras
- Department of Rheumatology, Reina Sofia University Hospital, Cordoba, Spain
- GC05 Group, Maimonides Biomedical Research Institute of Cordoba, Cordoba, Spain
- Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain
| | - Eduardo Collantes-Estévez
- GC05 Group, Maimonides Biomedical Research Institute of Cordoba, Cordoba, Spain
- Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain
| | - Clementina López-Medina
- Department of Rheumatology, Reina Sofia University Hospital, Cordoba, Spain
- GC05 Group, Maimonides Biomedical Research Institute of Cordoba, Cordoba, Spain
- Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain
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Zamout P, Exarchou S, Sharma A, Turesson C. The prevalence of chronic obstructive pulmonary disease in patients with spondyloarthritis compared to the general population in the southernmost region of Sweden: a case-control study. Clin Exp Med 2024; 24:75. [PMID: 38598034 PMCID: PMC11006728 DOI: 10.1007/s10238-024-01335-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/20/2024] [Indexed: 04/11/2024]
Abstract
Spondyloarthritis (SpA) has been associated with comorbidities, e.g., cardiovascular disease. However, little is known about the relation between SpA and chronic obstructive pulmonary disease (COPD). The aim of the study was to compare the prevalence of COPD in SpA to the general population. Patients with prevalent SpA in Skåne, Sweden, on December 31, 2018, were identified based on diagnostic codes in a regional register on primary care, secondary outpatient care and inpatient care. Population-based controls (5 per SpA case) were matched for age, sex and municipality. The base case definition for COPD required at least two prior visits with a registered COPD diagnosis. Stricter definitions included dispensed prescriptions for COPD and a COPD diagnosis made by a specialist in lung medicine. The prevalence of COPD in patients with SpA and controls, overall and stratified by sex and age, and the corresponding prevalence ratios, were estimated. A total of 3571 patients with SpA (51% male, mean age 53 years) were compared to 17,855 matched controls. The prevalence of COPD in patients with SpA was 37.8/1000, with a prevalence ratio compared to controls of 1.03 (95% CI 0.85-1.24). There were no significant differences in COPD prevalence between patients with SpA and controls in men or women, in any of the age groups, or in analyses using stricter definitions of COPD. In this regional study including data from primary care, the prevalence of COPD was not increased in patients with SpA compared to the background population.
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Affiliation(s)
- Petros Zamout
- Section of Rheumatology, Örnsköldsvik Hospital, Örnsköldsvik, Sweden
| | - Sofia Exarchou
- Rheumatology, Department of Clinical Sciences, Malmö, Lund University, Jan Waldenströms Gata 1B, 205 02, Malmö, Sweden
| | - Ankita Sharma
- Rheumatology, Department of Clinical Sciences, Malmö, Lund University, Jan Waldenströms Gata 1B, 205 02, Malmö, Sweden
| | - Carl Turesson
- Rheumatology, Department of Clinical Sciences, Malmö, Lund University, Jan Waldenströms Gata 1B, 205 02, Malmö, Sweden.
- Department of Rheumatology, Skåne University Hospital, Malmö, Sweden.
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Atkins N, Mukhida K. The relationship between patients’ income and education and their access to pharmacological chronic pain management: A scoping review. Can J Pain 2022; 6:142-170. [PMID: 36092247 PMCID: PMC9450907 DOI: 10.1080/24740527.2022.2104699] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Nicole Atkins
- Department of Anesthesiology, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Karim Mukhida
- Department of Anesthesiology, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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Four Variables Were Sufficient for Low Back Pain: Determining Which Patient-Reported Tools Pain and Disability Improvements. J Orthop Sports Phys Ther 2022; 52:685-693. [PMID: 35960508 DOI: 10.2519/jospt.2022.11018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE: To predict 30- and 180-day improvements in disability and pain for patients seeking physical therapy care for low back pain (LBP). DESIGN: Longitudinal cohort. METHODS: Baseline assessment was completed by 259 patients with chief complaint of LBP, and the assessment includes psychosocial measures (Keele STarT Back Screening [SBST] and the Optimal Screening for Prediction of Referral and Outcome Yellow Flag [OSPRO-YF] tools), the Optimal Screening for Prediction of Referral and Outcome Review of Symptoms (OSPRO-ROS) and the Review of Symptoms Plus (OSPRO-ROS+) tools, the Charlson Comorbidity Index (CCI), the Area Deprivation Index (ADI), and the National Institute of Health Chronic Pain Criteria (NIH-CP). Using the Modified Low Back Disability Questionnaire (MDQ) and the Numeric Pain Rating Scale (NPRS) as primary outcomes, statistical analysis determined multiple sets of predictor variables with similar model performance. RESULTS: The parsimonious "best model" for prediction of the 180-day MDQ change included 3 predictors (Admit MDQ, NIH-CP, and OSPRO ROS+) because it had the lowest penalized goodness-of-fit statistic (BIC = -35.21) and the highest explained variance (R2 = 0.295). The parsimonious "best model" for 180-day NPRS change included 2 variables (Admit NPRS and OSPRO-ROS+) with the lowest penalized goodness-of-fit statistic (BIC = -18.2) and the highest explained variance (R2 = 0.190). CONCLUSION: There were many model options with similar statistical performance when using established measures to predict MDQ and NPRS outcomes. A potential variable set for a standard predictive model that balances statistical performance with pragmatic considerations included the OSPRO-ROS+, OSPRO-YF, NIH-CP definition, and admit MDQ and NPRS scores. J Orthop Sports Phys Ther 2022;52(10):685-693. Epub: 12 August 2022. doi:10.2519/jospt.2022.11018.
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5
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de Oliveira JL, Maciel da Silva GF, Nogueira IA, Azevedo AQ, Baraliakos X, Rocha FAC. Prevalence of Inflammatory Back Pain in a Low-Income Population. J Clin Rheumatol 2022; 28:170-173. [PMID: 35067510 DOI: 10.1097/rhu.0000000000001829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Inflammatory back pain (IBP) is a major criterion in identifying axial spondyloarthritis. Whether socioeconomic issues impact prevalence of IBP assessed using standardized questionnaires has not been assessed. We determined IBP prevalence and performance of IBP questionnaires in a low-income, low-literacy population. METHODS Individuals were interviewed in Fortaleza, Brazil, for the prevalence of IBP using Calin's, Berlin, and ASAS IBP questionnaires; monthly family income (US dollars), literacy (>/≤8 school years [SYs]), and smoking habit (present/absent) were registered. RESULTS Two hundred nineteen individuals were included (mean age, 38.2 ± 12.9 years), 110 (50.2%) men, 58 (26.4%) White, and 38 (17.3%) smokers. Overall, 152 (69.4%) declared CONCLUSIONS This is the first report on IBP prevalence in a low-income, low-literacy population. Chronic back pain was highly prevalent with almost 15% having IBP using ASAS criteria. Inflammatory back pain prevalence looked similar using ASAS and Berlin criteria; values were higher using Calin's criteria. Literacy or income did not influence IBP prevalence in this population, which was higher among women. The higher prevalence of IBP using Calin's criteria in this population should be taken into account as it might impact studies aiming to determine prevalence of axial spondyloarthritis in clinical studies in this scenario.
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Affiliation(s)
- Jobson Lopes de Oliveira
- From the Department of Internal Medicine, Faculty of Medicine, Universidade Federal do Ceará, Fortaleza, Brazil
| | | | - Igor Albuquerque Nogueira
- From the Department of Internal Medicine, Faculty of Medicine, Universidade Federal do Ceará, Fortaleza, Brazil
| | - Artur Queirós Azevedo
- From the Department of Internal Medicine, Faculty of Medicine, Universidade Federal do Ceará, Fortaleza, Brazil
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6
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Does osteoarthritis modify the association between NSAID use and risk of comorbidities and adverse events? OSTEOARTHRITIS AND CARTILAGE OPEN 2022; 4:100253. [DOI: 10.1016/j.ocarto.2022.100253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 02/04/2022] [Accepted: 02/28/2022] [Indexed: 11/24/2022] Open
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Ekholm O, Diasso PDK, Davidsen M, Kurita GP, Sjøgren P. Increasing prevalence of chronic non-cancer pain in Denmark from 2000 to 2017: A population-based survey. Eur J Pain 2021; 26:624-633. [PMID: 34748254 DOI: 10.1002/ejp.1886] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 10/29/2021] [Accepted: 11/06/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND This investigation comprised information from the Danish population to analyse the development of chronic non-cancer pain (CNCP) prevalence according to sex, age, physical job demand and educational level. METHODS Data derives from the Danish Health and Morbidity Surveys based on random samples of adults living in Denmark. The analysed samples were composed by 10,457 in 2000 (response rate: 62.7%), 5686 in 2005 (52.1%), 15,165 in 2010 (60.1%), 14,265 in 2013 (57.1%) and 14,022 in 2017 (56.1%). CNCP was defined as pain lasting 6 months or more. Individuals with a self-reported history of cancer were excluded. Calibration weighting was applied to reduce the impact of potential non-response bias. The Relative and the Absolute Concentration Index were calculated to measure educational inequalities. RESULTS CNCP prevalence has increased 8.3 percentage points during 2000-2017 (19.5%-27.8%) and is highest among women (22.1% to 30.8%). Higher CNCP prevalence among men aged 45-64 years exceeded the men aged >65 years in 2017 (31.9% and 29.8%, respectively). There was a continuous increase in CNCP prevalence in individuals with sedentary work or low physical demand at job from 2000 to 2017; among those with moderate or high physical demand at job the prevalence increased sharply from 2000 to 2010 after which the prevalence remained stable. Higher CNCP prevalence persisted among individuals with lower level of education regardless of gender and the inequalities remained stable over time. CONCLUSION The Danish prevalence of chronic pain has increased in the last two decades and higher numbers are observed in some sociodemographic groups. SIGNIFICANCE This study provides an overview of the development of chronic non-cancer pain in a country and analyses the trends with socioeconomic inequalities. The continuous increasing prevalence may have huge social and economic implications. This study reveals an urgent need for measures to attenuate the increasing prevalence, which should be a priority for public health policy.
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Affiliation(s)
- Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | - Michael Davidsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Geana Paula Kurita
- Department of Oncology, Rigshospitalet-Copenhagen University Hospital, Copenhagen, Denmark.,Multidisciplinary Pain Centre, Rigshospitalet-Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Per Sjøgren
- Department of Oncology, Rigshospitalet-Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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8
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Cook WK, Li X, Sundquist K, Kendler KS, Sundquist J, Karriker-Jaffe KJ. Drinking cultures and socioeconomic risk factors for alcohol and drug use disorders among first- and second-generation immigrants: A longitudinal analysis of Swedish population data. Drug Alcohol Depend 2021; 226:108804. [PMID: 34216865 PMCID: PMC8355220 DOI: 10.1016/j.drugalcdep.2021.108804] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Few longitudinal studies investigate predictors of substance use incidence among immigrants. The current study describes substance use disorders in immigrants to Sweden, focusing on drinking culture in the country of origin and socioeconomic status (SES), and how these intersect with generational status to influence risk. METHODS Using pseudonymized Swedish population registry data, we track onset of alcohol use disorder and drug use disorder in a longitudinal study of 815,778 first-generation immigrants and 674,757 second-generation immigrants from 64 countries over a 6-year period. Cox regression analysis estimated risks of alcohol and drug use disorders in second-generation immigrants compared to first-generation, and moderation analyses assessed interactions of generational status with country-of-origin per capita alcohol consumption and SES. RESULTS Immigrants and second-generation immigrants originating from countries with high levels of alcohol consumption had higher risks for alcohol and drug use disorders. Immigrants with high SES had lower risks for alcohol and drug use disorders. The interaction between generational status and country-of-origin alcohol consumption was significant for drug use disorder (not for alcohol use disorder), with drug use disorder risk for second-generation immigrants being highest for those from countries with the lowest level of country-of-origin per capita alcohol consumption. The interaction between generational status and SES was significant for alcohol use disorder, with low-SES second-generation immigrants showing markedly higher risk than first-generation immigrants with comparable SES. CONCLUSIONS Among immigrants in Sweden, second-generation immigrants are at increased risk of developing alcohol and drug use disorders, particularly if they have lower SES. Policy and community attention to these high-risk subgroups in immigrant communities is warranted.
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Affiliation(s)
- Won Kim Cook
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA.
| | - Xinjun Li
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | | | - Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics and Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Katherine J Karriker-Jaffe
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA; Community Health and Implementation Research Program, RTI International, Berkeley, CA, USA
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9
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Prego-Domínguez J, Khazaeipour Z, Mallah N, Takkouche B. Socioeconomic status and occurrence of chronic pain: a meta-analysis. Rheumatology (Oxford) 2021; 60:1091-1105. [PMID: 33276382 DOI: 10.1093/rheumatology/keaa758] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/10/2020] [Accepted: 10/07/2020] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE To examine the association between socioeconomic status (SES) and the occurrence of chronic pain, defined as pain that persists or recurs for >3 months. METHODS We performed a structured search in Medline, Embase, WHO Global Index Medicus and Conference Proceedings Citation Index-Science databases to identify cohort and case-control studies on chronic pain and SES and its subgroups (SES combined index, educational level, income and occupational status). We extracted study characteristics, outcome measures and measures of association and their 95% CIs. Literature search, data extraction and risk of bias assessment were conducted by two independent researchers. We performed main and subgroup meta-analyses using random-effects model, and formally assessed heterogeneity and publication bias. RESULTS A total of 45 studies, covering a population of ∼175 000 individuals, were meta-analysed, yielding a pooled Odds Ratio (OR) of 1.32 (95% CI: 1.21, 1.44) and 1.16 (95% CI: 1.09, 1.23) for low and medium SES levels, respectively, compared with high level. We obtained similar results in all the subgroup analyses. Heterogeneity was generally moderate to high across strata, and some evidence of publication bias for low socioeconomic status was found. CONCLUSION Our results support a moderate increase in the risk of chronic pain for low and medium SES when compared with high SES, a feature that remained constant in all measures of exposure or outcome used. Further prospective research on populations from developing countries are needed to confirm our findings as the studies available for this meta-analysis were carried out exclusively in developed countries.
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Affiliation(s)
- Jesús Prego-Domínguez
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Zahra Khazaeipour
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Narmeen Mallah
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain
| | - Bahi Takkouche
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain.,Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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10
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Yu T, Wei Z, Xu T, Gamber M, Han J, Jiang Y, Li J, Yang D, Sun W. The association between the socioeconomic status and body pain: A nationwide survey. Medicine (Baltimore) 2020; 99:e19454. [PMID: 32195941 PMCID: PMC7220486 DOI: 10.1097/md.0000000000019454] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Pain is a significant burden among different communities, but little is known regarding the epidemiology of pain, particularly with respect to socioeconomic status (SES).The aim of the study was to estimate the prevalence of body pain and to identify risk factors of pain in middle-aged and older Chinese.The data were extracted from the 2008 Chinese Suboptimal Health Study that consisted of 18,316 Chinese subjects aged 18 to 65 years. Information on SES including occupation and education levels and body pain were collected. A Likert scale was used to evaluate reported body pain. We used the multiple logistic regression model to examine the association between SES and body pain.Overall, 65.34% reported body pain (male: 60.93%; female: 69.73%). After adjustments based on sex, age, education, area of residence, marital status, smoking, drinking and health status, the results showed that students (odds ratio [OR] = 1.51; 95% confidence interval [CI]: 1.32-1.74) and professionals (OR = 1.22; 95% CI: 1.08-1.37) had significant high risk for body pain, compared with civil servants and farmers (OR = 0.64; 95% CI: 0.55-0.75) who significantly lower risk of body pain. The study demonstrates there is a significant negative association between education and reported body pain.The results indicated an association between SES and body pain within the Chinese community. Body pain varied among different Chinese occupation-related population and people with higher education level are less like to have body pain.
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Affiliation(s)
- Tong Yu
- Department of Medical Insurance, School of Humanities and Management, Wannan Medical College, Wuhu
| | - Zhen Wei
- The Second Affiliated Hospital of Fujian Traditional Chinese Medical University, Fuzhou
| | - Tan Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Michelle Gamber
- School of Health Professions, Division of Public Health, Shenandoah University, Winchester, VA
| | - Jingnan Han
- Department of Medicine, The University of Alabama at Birmingham Hospital, Birmingham, AL
| | - Yan Jiang
- Texas Health and Science University, Austin, TX
| | - Jian Li
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Daihe Yang
- The Second Affiliated Hospital of Fujian Traditional Chinese Medical University, Fuzhou
| | - Wenjie Sun
- The Second Affiliated Hospital of Fujian Traditional Chinese Medical University, Fuzhou
- Robert Stempel College of Public and Social Work, Florida international University, Miami, FL
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11
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Banafa A, Suominen AL, Sipilä K. Factors associated with signs of temporomandibular pain: an 11-year-follow-up study on Finnish adults. Acta Odontol Scand 2020; 78:57-63. [PMID: 31401930 DOI: 10.1080/00016357.2019.1650955] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Pain in the temporomandibular region is a main complaint causing disability and distress among temporomandibular disorders sufferers.Objectives: The aim of the study was, over an 11-year follow-up on Finnish adult population, to investigate the prevalence of clinically assessed pain-related temporomandibular disorder (TMD) signs, i.e. temporomandibular joint (TMJ) and masticatory muscles (MM) pain on palpation, and their association with sociodemographic background and denture status.Methods: The data were based on the nationally representative Finnish Health 2000 and Health 2011 Surveys (BRIF8901). The sample comprised 1210 adults who underwent clinical oral examinations including TMD signs assessment. Statistical evaluations included chi-square tests and logistic regressions.Results: The prevalence of palpatory MM pain decreased from 9.5% at baseline to 4.6% in the follow-up. Cross-sectionally, presence of palpatory MM pain significantly associated with gender (p < .001, p = .002) and educational level (p < .001, p = .001) in both years, and with age (p = .006) and denture status (p = .022) at baseline. The prevalence of palpatory TMJ pain increased from 2.1% at baseline to 3.5% in the follow-up. Presence of palpatory TMJ pain significantly associated with gender in both years (p = .012, p = .032). Female gender, lower education and palpatory MM pain at baseline predicted palpatory MM pain in the follow-up.Conclusion: Palpatory MM pain is relatively prevalent in adults, yet with a favourable prognosis. Women and people with low education are more susceptible groups. Previous experience of palpatory MM pain increases the risk of exhibiting it later in life.
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Affiliation(s)
- Aisha Banafa
- Faculty of Health Sciences, School of Medicine, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
- Public Health Evaluation and Projection Unit, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Kirsi Sipilä
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Oral and Maxillofacial Department, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
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12
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Löfvendahl S, Schelin MEC, Jöud A. The value of the Skåne Health-care Register: Prospectively collected individual-level data for population-based studies. Scand J Public Health 2019; 48:56-63. [PMID: 31814536 DOI: 10.1177/1403494819868042] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Aims: This study aimed to examine the population-based Skåne Health-care Register (SHR) regarding feasibility for scientific research and also strengths and weaknesses. Methods: To analyse the feasibility of the SHR, we performed a bibliographic search for peer-reviewed articles based on SHR data from 2000 to 2018. To analyse strengths and weaknesses, we used original SHR data about coverage and validity. Results: We identified 58 articles based on SHR data, covering different study designs and disorders. Most studies focused on musculoskeletal disorders with a cohort design. The majority of all consultations recorded in the SHR have an assigned diagnosis. However, this differs between the levels of care and between types of consultation. For inpatient care, the proportion of consultations with an assigned diagnosis was close to 100% between 1998 and 2017. The proportion of consultations with an assigned diagnosis was lowest within primary care, although the proportion markedly increased in 2004 when the prerequisite for consultation reimbursement was linked to the requirement for an assigned diagnosis. Limitations are that the SHR does not cover health-care provided within nursing homes and equivalent facilities or treatments received by the population of Skåne outside the region. Conclusions: The SHR may be used as a reliable data source for analyses of clinical changes and improvements. Extended use of the SHR in a research context may highlight important shortcomings within the register and thus serve as a way of indirect quality control. To enhance the use of the SHR further, better harmonisation between registers, within and outside of the region and internationally, is of crucial importance.
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Affiliation(s)
- Sofia Löfvendahl
- Department of Clinical Sciences Lund, Orthopaedics, Lund University, Faculty of Medicine, Sweden.,Health Technology Assessment Skåne, Skåne University Hospital, Sweden
| | - Maria E C Schelin
- Department of Clinical Sciences Lund, Institute for Palliative Care, Lund University, Sweden.,Department for Research and Development, Skåne University Hospital, Sweden
| | - Anna Jöud
- Department of Clinical Sciences Lund, Orthopaedics, Lund University, Faculty of Medicine, Sweden.,Department for Research and Development, Skåne University Hospital, Sweden.,Division of Occupational and Environmental Medicine, Department of Laboratory Medicine Lund, Lund University, Sweden
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Kiadaliri A, Englund M. Intersectional Inequalities and Individual Heterogeneity in Chronic Rheumatic Diseases: An Intersectional Multilevel Analysis. Arthritis Care Res (Hoboken) 2019; 73:296-304. [PMID: 31733042 DOI: 10.1002/acr.24109] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 11/12/2019] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To examine how intersections of multiple sociodemographic variables explain the individual heterogeneity in risk of being diagnosed with any of following chronic rheumatic diseases (CRDs): osteoarthritis (OA), gout, rheumatoid arthritis (RA), or spondyloarthritis (SpA). METHODS We identified individuals ages 40-65 years residing in Skåne, Sweden by December 31, 2013 and having done so from January 1, 2000 (n = 342,542). We used a Skåne health care register to identify those with a diagnosis of the CRD of interest between January 1, 2014 and December 31, 2015, with no previous such diagnosis during 2000-2013. We created 144 intersectional social strata (ISS) using categories of age, sex, education, income, civil status, and immigration. For individuals nested within ISS, we applied multilevel logistic regression models to estimate the variance partition coefficient (VPC) as a measure of discriminatory accuracy of the ISS and the predicted absolute risks and 95% credible intervals for each stratum. RESULTS Overall, 3.5%, 0.5%, 0.2%, and 0.2% of the study population were diagnosed with OA, gout, RA, and SpA, respectively. The VPC ranged from 16.2% for gout to 0.5% for SpA. Sex explained the largest proportion of between-strata variation in risk of RA, gout, and SpA, while age was the most important factor for OA. The most between-strata differences in risk of these CRDs were due to the additive main effects. CONCLUSION Despite meaningful between-strata inequalities in the risk of being diagnosed with CRDs (except SpA), there were substantial within-strata heterogeneities that remain unexplained. There was limited evidence of intersectional interaction effects.
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Affiliation(s)
| | - Martin Englund
- Lund University, Lund, Sweden, and Boston University School of Medicine, Boston, Massachusetts
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Larrosa Pardo F, Bondesson E, Schelin MEC, Jöud A. A diagnosis of rheumatoid arthritis, endometriosis or IBD is associated with later onset of fibromyalgia and chronic widespread pain. Eur J Pain 2019; 23:1563-1573. [PMID: 31131959 DOI: 10.1002/ejp.1432] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 05/15/2019] [Accepted: 05/19/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Widespread pain is a common comorbidity in several chronic diseases and is suspected to be caused by pain resulting from the underlying disease that has provoked a state of central sensitization. However, this argument is currently limited by evidence that has insufficiently captured the temporal nature of the relationship between diagnosis of the underlying disease and onset of widespread pain. The aim of this study was to investigate if patients with rheumatoid arthritis (RA), endometriosis or inflammatory bowel disease (IBD), have a higher risk of developing widespread pain (fibromyalgia or chronic widespread pain [CWP]). METHODS Using the Swedish Skåne Healthcare register on health care consultation, a cohort of 889,938 adult patients were followed from 2007 to 2016 and incident cases of RA, endometriosis or IBD and of fibromyalgia and CWP were identified by registered diagnoses. Using Poisson regression, we calculated incidence rate ratios (IRR) adjusted for sex, age, education and propensity to seek health care. RESULTS For patients with RA the IRR for later fibromyalgia was 3.64 (95% CI: 2.75-4.81) compared to patients without RA, for CWP it was 2.96 (95% CI: 1.81-4.86). For endometriosis patients the IRR for fibromyalgia was 2.83 (95% CI: 1.96-4.08) and for CWP 5.02 (95% CI: 3.10-8.13). IBD patients had an IRR = 2.32 (95% CI: 1.58-3.42) for fibromyalgia and 1.42 (95% CI: 0.93-2.17) for CWP. CONCLUSIONS This study shows that RA, endometriosis and IBD are all risk factors for later fibromyalgia and CWP, consistent with a hypothesis of central sensitization as an effect of a painful underlying condition. SIGNIFICANCE We show that RA, endometriosis and IBD predisposes for later fibromyalgia and CWP, a common hypothesis previously difficult to verify due to lack of longitudinal data. The results inform further research regarding the aetiology of fibromyalgia and CWP and stress the need of clinical focus on the pain itself in chronic diseases with pain as a symptom.
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Affiliation(s)
- Fabian Larrosa Pardo
- Faculty of Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden.,Department of Neurosurgery, Skåne University Hospital, Lund, Sweden
| | - Elisabeth Bondesson
- Faculty of Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden.,Department of Pain Rehabilitation, Skåne University Hospital, Lund, Sweden
| | - Maria E C Schelin
- Department of Neurosurgery, Skåne University Hospital, Lund, Sweden.,Department of Clinical Sciences, Institute for Palliative Care, Lund University, Lund, Sweden
| | - Anna Jöud
- Department of Neurosurgery, Skåne University Hospital, Lund, Sweden.,Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
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A grounded theory of attitudes towards online psychological pain management interventions in chronic pain patients. COMPUTERS IN HUMAN BEHAVIOR 2017. [DOI: 10.1016/j.chb.2017.07.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Familial Risk of Chronic Musculoskeletal Pain and the Importance of Physical Activity and Body Mass Index: Prospective Data from the HUNT Study, Norway. PLoS One 2016; 11:e0153828. [PMID: 27082110 PMCID: PMC4833298 DOI: 10.1371/journal.pone.0153828] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 04/03/2016] [Indexed: 02/02/2023] Open
Abstract
The main objectives of the current study was i) to prospectively examine if chronic musculoskeletal pain in parents is associated with risk of chronic musculoskeletal pain in their adult offspring, and ii) to assess if these parent-offspring associations are modified by offspring body mass index and leisure time physical activity. We used data on 4,742 adult offspring linked with their parents who participated in the population-based HUNT Study in Norway in 1995–97 and in 2006–08. Family relations were established through the national Family Registry. A Poisson regression model was used to estimate relative risk (RR) with 95% confidence interval (CI). In total, 1,674 offspring (35.3%) developed chronic musculoskeletal pain during the follow-up period of approximately 11 years. Both maternal (RR: 1.26, 95% CI: 1.03, 1.55) and paternal chronic musculoskeletal pain (RR: 1.29, 95% CI: 1.06, 1.57) was associated with increased risk of offspring chronic musculoskeletal pain. Compared to offspring of parents without chronic musculoskeletal pain, the adverse effect of parental pain was somewhat stronger among offspring who reported a low (RR: 1.82, 95% CI: 1.32, 2.52) versus high (RR: 1.32, 95% CI: 0.95, 1.84) level of leisure time physical activity. Offspring of parents with chronic musculoskeletal pain and who were classified as obese had more than twofold increased risk (RR: 2.33, 95% CI: 1.68, 3.24) of chronic musculoskeletal pain compared to normal weight offspring of parents without pain. In conclusion, parental chronic musculoskeletal pain is positively associated with risk of chronic musculoskeletal pain in their adult offspring. Maintenance of normal body weight may reduce the risk of chronic musculoskeletal pain in offspring of pain-afflicted parents.
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Liang En W, Sin D, Wen Qi C, Zong Chen L, Shibli S, Choon-Huat Koh G. Chronic Pain in a Low Socioeconomic Status Population in Singapore: A Cross-Sectional Study. PAIN MEDICINE 2016; 17:864-876. [PMID: 26893120 DOI: 10.1093/pm/pnv115] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE . The authors sought to determine the prevalence of chronic pain in a low socioeconomic-status rental-flat community in Singapore and its associations. In Singapore, ≥85% own homes; public rental flats are reserved for the low-income. METHODS . Chronic pain was defined as pain ≥3 months. From 2009-2014, residents aged ≥ 40 years in five public rental-flat enclaves were surveyed for chronic pain, as well as sociodemographic factors. Subsequently, the authors conducted an additional study among elderly (aged ≥60) in two public rental-flat enclaves in 2012. The authors compared against residents staying in adjacent owner-occupied public housing. RESULTS . Prevalence of chronic pain in the rental-flat population was 14.2% (133/936) compared with 14.4% (158/1101) in the owner-occupied population (p = 0.949). On multivariate analysis, among those aged 40-59 years, staying in the rental flat community was independently associated with higher prevalence of leg/ankle/foot pain, compared to staying in the owner-occupied flat community (aOR = 2.35, CI = 1.24-7.35, p = 0.008). In the rental-flat population, unemployment was associated with chronic pain (aOR = 1.92, 95%, CI = 1.05-2.78, p = 0.030); among the elderly, dependency in instrumental-activities-of-daily-living (iADLs) was associated with chronic pain (aOR = 2.38, CI = 1.11-5.00, p = 0.025), as well as female gender, being single, and having higher education (all p > 0.05). CONCLUSIONS . In this low socioeconomic-status population, chronic pain associated with unemployment and functional limitation. There was no difference in pain prevalence between the rental-flat population and adjacent owner-occupied precincts.
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Affiliation(s)
- Wee Liang En
- *Department of Internal Medicine, Singapore General Hospital, Singhealth, Singapore
| | - David Sin
- Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
| | - Cher Wen Qi
- Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
| | - Li Zong Chen
- Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
| | - Sabina Shibli
- Department of Anaesthesia, Ng Teng Fong General Hospital, JurongHealth, Singapore
| | - Gerald Choon-Huat Koh
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore
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