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Wang T, Wang Q, Li X, Wang C, Wang R, Wang C, Ding H, Qian L, Wan X, Tian X, Hou Z, Liu F, Liu J, Cheng X, Zhang J. A control study on pain characteristics and influencing factors in patients with depressive disorders-based on a 5-year follow-up report from the epidemiological survey of mental disorders in Shandong Province, China. J Affect Disord 2024; 355:290-298. [PMID: 38556095 DOI: 10.1016/j.jad.2024.03.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 02/26/2024] [Accepted: 03/23/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND This study extends from the 2015 Shandong Province Epidemiological Survey of Mental Disorders in adults aged 18 and above. Over five years, it investigates pain characteristics and influencing factors in individuals with depressive disorders in Shandong Province. METHODS The study encompasses 871 individuals who met DSM-IV criteria for depressive disorders in 2015. Using 1:1:1 matching by gender, age, and residence, 825 non-afflicted individuals were selected as high-risk controls, and 825 screening-negative individuals became low-risk controls. A follow-up study in 2020 involved 1848 participants. Survey tools included a general information questionnaire, General Health Questionnaire-12 (GHQ-12), SCID-I/P, Global Pain Scale (GPS), Quality of Life Questionnaire (QLQ), PSQI, MoCA, and clinical data questionnaire. RESULTS GPS scores in the current depressive group were higher than in non-current depressive group (Z = 14.36, P < 0.01). GPS scores in study group exceeded those in high-risk and low-risk control groups (H = 93.71, P < 0.01). GPS scores in non-remission group were higher than in the remission group (Z = 8.90, P < 0.01). Regression analysis revealed positive correlations between GPS scores and physical illnesses, current depression, incumbency, GHQ-12 total score, and PSQI total score. Negative correlations were observed with QLQ total score and MoCA total score. LIMITATIONS The study could not assess pain during the 2015 survey, limiting controlled pain analysis before and after five years. CONCLUSION Depression sufferers may experience prolonged heightened pain, potentially relieved when depression subsides. Individual pain is influenced by depression, physical illnesses, sleep quality, quality of life, cognitive function, gender, residence, and occupation.
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Affiliation(s)
- Tao Wang
- Department of Psychiatry, School of Mental Health, Jining Medical University, China
| | - Qian Wang
- Shandong Province Hospital of Occupational Diseases, China
| | | | - Can Wang
- Shandong Mental Health Center, China
| | | | | | - Hao Ding
- Zibo Mental Health Center, China
| | - Liju Qian
- Daizhuang Hospital, Shandong Province, China
| | | | - Xue Tian
- Linyi Mental Health Center, China
| | | | - Fengjie Liu
- The Fourth People's Hospital of Liaocheng, China
| | | | - Xiaojing Cheng
- Shandong Academy of Occupational Health and Occupational Medicine, China.
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2
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Pham TV, Doorley J, Kenney M, Joo JH, Shallcross AJ, Kincade M, Jackson J, Vranceanu AM. Addressing chronic pain disparities between Black and White people: a narrative review of socio-ecological determinants. Pain Manag 2023; 13:473-496. [PMID: 37650756 PMCID: PMC10621777 DOI: 10.2217/pmt-2023-0032] [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: 03/27/2023] [Accepted: 08/10/2023] [Indexed: 09/01/2023] Open
Abstract
A 2019 review article modified the socio-ecological model to contextualize pain disparities among different ethnoracial groups; however, the broad scope of this 2019 review necessitates deeper socio-ecological inspection of pain within each ethnoracial group. In this narrative review, we expanded upon this 2019 article by adopting inclusion criteria that would capture a more nuanced spectrum of socio-ecological findings on chronic pain within the Black community. Our search yielded a large, rich body of literature composed of 174 articles that shed further socio-ecological light on how chronic pain within the Black community is influenced by implicit bias among providers, psychological and physical comorbidities, experiences of societal and institutional racism and biomedical distrust, and the interplay among these factors. Moving forward, research and public-policy development must carefully take into account these socio-ecological factors before scaling up pre-existing solutions with questionable benefit for the chronic pain needs of Black individuals.
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Affiliation(s)
- Tony V Pham
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - James Doorley
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Martha Kenney
- Department of Anesthesiology, Duke University Medical Centre, Durham, NC 27710, USA
| | - Jin Hui Joo
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Amanda J Shallcross
- Wellness & Preventative Medicine, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Michael Kincade
- Center for Alzheimer's Research & Treatment, Massachusetts Alzheimer's Disease Research Centre, Boston, MA 02129, USA
| | - Jonathan Jackson
- Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
| | - Ana-Maria Vranceanu
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
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3
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Kazi K, Ali SM, Selby DA, McBeth J, van der Veer S, Dixon WG. Examining the variability of multiple daily symptoms over time among individuals with multiple long-term conditions (MLTC-M/multimorbidity): An exploratory analysis of a longitudinal smartwatch feasibility study. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2023; 13:26335565221150129. [PMID: 36698685 PMCID: PMC9869202 DOI: 10.1177/26335565221150129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 12/13/2023] [Indexed: 01/20/2023]
Abstract
Introduction People living with multiple long-term conditions (MLTC-M) (multimorbidity) experience a range of inter-related symptoms. These symptoms can be tracked longitudinally using consumer technology, such as smartphones and wearable devices, and then summarised to provide useful clinical insight. Aim We aimed to perform an exploratory analysis to summarise the extent and trajectory of multiple symptom ratings tracked via a smartwatch, and to investigate the relationship between these symptom ratings and demographic factors in people living with MLTC-M in a feasibility study. Methods 'Watch Your Steps' was a prospective observational feasibility study, administering multiple questions per day over a 90 day period. Adults with more than one clinician-diagnosed long-term condition rated seven core symptoms each day, plus up to eight additional symptoms personalised to their LTCs per day. Symptom ratings were summarised over the study period at the individual and group level. Symptom ratings were also plotted to describe day-to-day symptom trajectories for individuals. Results Fifty two participants submitted symptom ratings. Half were male and the majority had LTCs affecting three or more disease areas (N = 33, 64%). The symptom rated as most problematic was fatigue. Patients with increased comorbidity or female sex seemed to be associated with worse experiences of fatigue. Fatigue ratings were strongly correlated with pain and level of dysfunction. Conclusion In this study we have shown that it is possible to collect and descriptively analyse self reported symptom data in people living with MLTC-M, collected multiple times per day on a smartwatch, to gain insights that might support future clinical care and research.
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Affiliation(s)
- Khalid Kazi
- Northern Care Alliance NHS Foundation Trust, Salford, UK
| | - Syed Mustafa Ali
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- Centre for Health Informatics, Division of Informatics, Imaging and Data Science, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - David A Selby
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - John McBeth
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester NHS Foundation Trust, Manchester, UK
| | - Sabine van der Veer
- Centre for Health Informatics, Division of Informatics, Imaging and Data Science, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - William G Dixon
- Northern Care Alliance NHS Foundation Trust, Salford, UK
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester NHS Foundation Trust, Manchester, UK
- William G Dixon, Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
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4
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Flowers KM, Colebaugh CA, Hruschak V, Azizoddin DR, Meints SM, Jamison RN, Wilson JM, Edwards RR, Schreiber KL. Introversion, Extraversion, and Worsening of Chronic Pain Impact during Social Isolation: A Mediation Analysis. J Clin Psychol Med Settings 2022:10.1007/s10880-022-09901-9. [PMID: 36076147 PMCID: PMC9458303 DOI: 10.1007/s10880-022-09901-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 11/29/2022]
Abstract
COVID-19 social distancing mandates increased social isolation, resulting in changes in pain severity and interference among individuals with chronic pain. Differences in personality (e.g., introversion/extraversion) may modulate responses to social isolation. We examined the influence of introversion on reported social distancing-related increases in pain interference and assessed for mediators of this relationship. Individuals with chronic pain (n = 150) completed validated questionnaires 4–8 weeks after implementation of social distancing mandates. Introversion/extraversion was measured using a subscale of the Myers-Briggs Type Indicator and changes in pain and psychosocial variables were calculated by comparing participants’ recalled and current scores. Association between introversion/extraversion and other variables were assessed using linear regression. A parallel mediation was used to examine mediators of the association between introversion and change in pain interference. Higher introversion was associated with a decrease in pain interference after social distancing (Rho = − .194, p = .017). Parallel mediation analysis revealed that the relationship between introversion/extraversion and change in pain interference was mediated by changes in sleep disturbance and depression, such that higher introversion was associated with less isolation-induced sleep disruption and depression, and thereby less worsening of pain interference. These findings suggest that personality factors such as introversion/extraversion should be considered when personalizing treatment of chronic pain.
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Affiliation(s)
- K Mikayla Flowers
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 45 Francis St, MRB 611, Boston, MA, 02115, USA.
| | - Carin A Colebaugh
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 45 Francis St, MRB 611, Boston, MA, 02115, USA
| | - Valerie Hruschak
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 45 Francis St, MRB 611, Boston, MA, 02115, USA
| | - Desiree R Azizoddin
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Samantha M Meints
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 45 Francis St, MRB 611, Boston, MA, 02115, USA
| | - Robert N Jamison
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 45 Francis St, MRB 611, Boston, MA, 02115, USA
| | - Jenna M Wilson
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 45 Francis St, MRB 611, Boston, MA, 02115, USA
| | - Robert R Edwards
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 45 Francis St, MRB 611, Boston, MA, 02115, USA
| | - Kristin L Schreiber
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 45 Francis St, MRB 611, Boston, MA, 02115, USA
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5
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Ceniza-Bordallo G, Fraile AG, Martín-Casas P, López-de-Uralde-Villanueva I. Validity and reliability of Spanish PROMIS pediatric pain interference short form. J Pediatr Nurs 2022; 66:79-85. [PMID: 35687928 DOI: 10.1016/j.pedn.2022.05.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/12/2022] [Accepted: 05/20/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The goal of this study was to analyze psychometric properties of the Spanish PROMIS Pediatric Pain Interference short form (PROMIS-PPI) in a sample of Spanish children and adolescents. METHODS In a hospital pediatric sample it was studied the structure scale (exploratory and confirmatory analysis), construct validity, convergent validity, and reliability (internal consistency). FINDINGS 163 children and adolescents (mean age 13.3 years; SD 2.01; 39.26% female) with and without chronic pain completed measures pertaining to their pain experience. Psychometric analysis showed the PROMIS-PPI Spanish version maintains the original one-factor model of the scale, excellent internal consistency (Cronbach's α coefficient 0.90 (95% CI 0.88-0.92)), and convergent validity (showed a positive, significant, and moderate magnitude correlation [r from 0.330 to 0.604] with pediatric quality of life, child and parent pain intensity, and showed a low correlation with the number of medical consultations in the last year). DISCUSSION The Spanish PROMIS-PPI scale is a valid and reliable tool. It is recommended for research and clinical care in pediatric populations. APPLICATION TO PRACTICE The results provide evidence that the Spanish version of PROMIS-PPI is valid and reliable tool. Health professionals who work with children in risk to develop persistent pain, will have access to short tool with highest evidence, for assess pain interference.
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Affiliation(s)
- Guillermo Ceniza-Bordallo
- Doctoral Program in Healthcare, Faculty of Nursing, Physiotherapy and Podiatry. University Complutense of Madrid, 28040 Madrid, Spain; Department of Radiology, Rehabilitation and Physiotherapy. Faculty of Nursing, Physiotherapy and Podiatry, University Complutense of Madrid, 28040 Madrid, Spain
| | - Andrés Gómez Fraile
- Head of Service, Surgery and Urology Pediatric Unit, University hospital 12 octubre of Madrid, 28041 Madrid, Spain
| | - Patricia Martín-Casas
- Department of Radiology, Rehabilitation and Physiotherapy. Faculty of Nursing, Physiotherapy and Podiatry, University Complutense of Madrid, 28040 Madrid, Spain.
| | - Ibai López-de-Uralde-Villanueva
- Department of Radiology, Rehabilitation and Physiotherapy. Faculty of Nursing, Physiotherapy and Podiatry, University Complutense of Madrid, 28040 Madrid, Spain
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6
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Wiersema C, Oude Voshaar RC, van den Brink RHS, Wouters H, Verhaak P, Comijs HC, Jeuring HW. Determinants and consequences of polypharmacy in patients with a depressive disorder in later life. Acta Psychiatr Scand 2022; 146:85-97. [PMID: 35435249 PMCID: PMC9321061 DOI: 10.1111/acps.13435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 03/27/2022] [Accepted: 04/03/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Polypharmacy and late-life depression often congregate in the geriatric population. The primary objective is to identify determinants of polypharmacy in patients with depression, and second to examine polypharmacy in relation to various clinical phenotypes of depression and its course. METHODS A longitudinal observational study using data of the Netherlands Study of Depression in Older persons (NESDO) including 375 patients with depression ≥ 60 years and 132 non-depressed comparisons. Linear and logistic regression were used to analyze both polypharmacy (dichotomous: ≥5 medications) and number of prescribed drugs (continuous) in relation to depression, various clinical phenotypes, and depression course. RESULTS Polypharmacy was more prevalent among patients with depression (46.9%) versus non-depressed comparisons (19.7%). A lower level of education, lower cognitive functioning, and more chronic diseases were independently associated with polypharmacy. Adjusted for these determinants, polypharmacy was associated with a higher level of motivational problems, anxiety, pain, and an earlier age of onset. A higher number of drugs was associated with a worse course of late-life depression (OR = 1.24 [95% CI: 1.03-1.49], p = 0.022). CONCLUSION Older patients with depression have a huge risk of polypharmacy, in particular among those with an early onset depression. As an independent risk factor for chronic depression, polypharmacy needs to be identified and managed appropriately. Findings suggest that depression moderates polypharmacy through shared risk factors, including motivational problems, anxiety, and pain. The complex interaction with somatic health burden requires physicians to prescribe medications with care.
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Affiliation(s)
- Carlijn Wiersema
- Department: University Center of Psychiatry, University of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Richard C. Oude Voshaar
- Department: University Center of Psychiatry, University of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Rob H. S. van den Brink
- Department: University Center of Psychiatry, University of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Hans Wouters
- Department of General PracticeUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Peter Verhaak
- Department of General PracticeUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands,Research Department, NIVEL, Netherlands Institute for Health Services ResearchUtrechtThe Netherlands
| | - Hannie C. Comijs
- Department Psychiatry, Amsterdam Public Health Research InstituteVU University Medical CenterAmsterdamThe Netherlands
| | - Hans W. Jeuring
- Department: University Center of Psychiatry, University of Groningen, University Medical Center GroningenGroningenThe Netherlands
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7
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Mallon T, Schäfer I, Fuchs A, Gensichen J, Maier W, Riedel-Heller S, König HH, Mergenthal K, Schön G, Wegscheider K, Weyerer S, Wiese B, van den Bussche H, Scherer M. The moderating effects of social support and depressive symptoms on pain among elderly multimorbid patients-data from the multicentre, prospective, observational cohort study MultiCare. Aging Ment Health 2022; 26:803-809. [PMID: 33949271 DOI: 10.1080/13607863.2021.1916882] [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: 10/21/2022]
Abstract
OBJECTIVES Depressive symptoms and chronic pain are common among patients with multimorbidity creating a complex medical condition for both the patient and the general practitioner. Perceived social support may function as a protective measure. UNLABELLED To examine the impact of perceived social support as a potential moderator between depressive symptoms and pain intensity and pain disability in daily activities in multimorbid patients aged 75+. METHOD Data from 3,189 patients of the German longitudinal cohort study MultiCare were obtained at baseline and follow-ups during 5 years. Multilevel linear mixed-effects analyses were conducted for pain intensity (model 1) and pain disability in daily activities (model 2). The interaction term social support by depression score was included to test for moderation. RESULTS The interaction between social support and depressive symptoms was significantly associated with the pain intensity score 0.41 (SE=.17; 95-CI[.08;.74]) but not with the pain disability score 0.35 (SE=.19; 95-CI[-.01;.72]). Additionally, men and individuals with medium or higher educational level showed reduced pain intensity and disability scores. Pain disability scores increased with age and depressive symptoms. Increased pain scores were also found for body mass index and burden of multimorbidity. CONCLUSION Perceived social support amplified the association of depressive symptoms on pain intensity and did not show a protective function. The high scores of perceived social support among the participants may point to the practice of secondary gain due to the patients immense health burden.
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Affiliation(s)
- Tina Mallon
- Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Ingmar Schäfer
- Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Angela Fuchs
- Institute of General Practice, University Düsseldorf, Düsseldorf, Germany
| | - Jochen Gensichen
- Institute of General Practice and Family Medicine, University Hospital of Ludwig-Maximilians-University Munich, Munich, Germany
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University Bonn, Bonn, Germany
| | - Steffi Riedel-Heller
- Institute for Social Medicine, Occupational Health and Public Health, University Leipzig, Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Karola Mergenthal
- Institute of General Practice, Goethe University Frankfurt Am Main, Frankfurt Am Main, Germany
| | - Gerhard Schön
- Department of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Karl Wegscheider
- Department of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Birgitt Wiese
- Institute of General Practice, WG Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany
| | - Hendrik van den Bussche
- Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Scherer
- Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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8
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Choi HY, Graetz I, Shaban-Nejad A, Schwartzberg L, Vidal G, Davis RL, Shin EK. Social Disparities of Pain and Pain Intensity Among Women Diagnosed With Early Stage Breast Cancer. Front Oncol 2022; 12:759272. [PMID: 35211396 PMCID: PMC8861323 DOI: 10.3389/fonc.2022.759272] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 01/14/2022] [Indexed: 11/22/2022] Open
Abstract
Background Breast cancer is one of the most commonly diagnosed cancers among women in the United States and pain is the most common side effect of breast cancer and its treatment. Yet, the relationships between social determinants of pain and pain experience/intensity remain under-investigated. We examined the associations between social determinants of pain both at the individual level and the neighborhood level to understand how social conditions are associated with pain perception among early stage breast cancer patients. Methods We conducted integrated statistical analysis of 1,191 women with early stage breast cancer treated at a large cancer center in Memphis, Tennessee. Combining electronic health records, patient-reported data and census data regarding residential address at the time of first diagnosis, we evaluated the relationships between social determinants and pain perception. Pain responses were self-reported by a patient as a numerical rating scale score at the patient’s initial diagnosis and follow-up clinical visits. We implemented two sets of statistical analyses of the zero-inflated Poisson model and estimated the associations between neighborhood poverty prevalence and breast cancer pain intensity. After adjustment for demographic characteristics, cancer stage, and chemotherapy, pain perception was significantly associated with poverty and blight level of the neighborhood. Results Among women living in the highest-poverty areas, the odds of reporting pain were 2.48 times higher than those in the lowest-poverty area. Women living in the highest-blight area had 5.43 times higher odds of reporting pain than those in the lowest-blight area. Neighborhood-level social determinants were significantly associated with pain intensity among women diagnosed with early-stage breast cancer. Conclusions Distressed neighborhood conditions are significantly associated with higher pain perception. Breast cancer patients living in socio-economically disadvantaged neighborhoods and in poor environmental conditions reported higher pain severity compared to patients from less distressed neighborhoods. Therefore, post-diagnosis pain treatment design needs to be tailored to the social determinants of the breast cancer patients.
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Affiliation(s)
- Hyo Young Choi
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, United States.,Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Ilana Graetz
- Department of Health Policy & Management, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Arash Shaban-Nejad
- UTHSC-Oak Ridge National Lab (ORNL) Center for Biomedical Informatics, Department of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Lee Schwartzberg
- Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States.,West Cancer Center, Memphis, TN, United States.,Department of Hematology/Oncology, University of Tennessee Health Science Center, Memphis, TN, United States
| | | | - Robert Lowell Davis
- UTHSC-Oak Ridge National Lab (ORNL) Center for Biomedical Informatics, Department of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Eun Kyong Shin
- Department of Sociology, Korea University, Seoul, South Korea
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9
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Hayajneh AA, Hammouri H, Rababa M, Al-Rawashedeh S, Wallace DC, Alsatari ES. Frailty and Its Correlates in Cognitively Intact Community-Dwelling Older Adults. Dement Geriatr Cogn Disord 2021; 50:357-363. [PMID: 34569493 DOI: 10.1159/000519054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 08/15/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Frailty syndrome is characterized by a decline in physiological and psychological reserve and may be associated with poor health outcomes. OBJECTIVES The current study explored frailty and its correlates among cognitively intact community-dwelling older adults. METHODS A secondary analysis of data collected from 109 community-dwelling older adults who are cognitively intact was conducted for the purpose of this study. The Arabic versions of the culturally adapted Tilburg Frailty Indicator, the Montreal Cognitive Assessment, the Geriatric Depression Scale, and the Short Form-36 Quality of Life (QOL) survey. Multiple linear regression was used to examine the relationships between frailty and depression. RESULTS The results indicated a high prevalence of frailty (78%) and depression (38%) among cognitively intact community-dwelling older adults. Frailty was found to be associated with increased age, being single or illiterate, living alone, having a high number of comorbid conditions, having high rate of depression, and having poor QOL. CONCLUSION High prevalence of frailty is associated with high depression scores, a high number of comorbid conditions, and poor QOL among cognitively intact community-dwelling older adults.
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Affiliation(s)
- Audai A Hayajneh
- Adult Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Hanan Hammouri
- Department of Mathematics and Statistics, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Rababa
- Adult Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Sami Al-Rawashedeh
- Department of Community and Mental Health, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Debra C Wallace
- Department of Family and Community Nursing, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Eman S Alsatari
- Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
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10
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Ong AD, Goktas S, Reid MC. More than Hurt Feelings: The Wear and Tear of Day-to-Day Discrimination in Adults with Chronic Pain. PAIN MEDICINE (MALDEN, MASS.) 2021; 22:2925-2930. [PMID: 33830245 PMCID: PMC8665997 DOI: 10.1093/pm/pnab135] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To examine the extent to which self-reported experiences of discrimination are associated with pain interference among men and women with chronic non-cancer pain. METHODS Data are from the Study of Midlife in the United States (MIDUS) Refresher Cohort. The analytic sample consisted of 207 adults with chronic pain (54.2 ± 12.8 years; 53.6% female) who completed the Major Experiences of Discrimination and Everyday Discrimination scales. Regression analyses examined cross-sectional relations between discrimination and pain interference. RESULTS On average, the level of pain interference was moderate in the sample (mean = 3.46, standard deviation = 2.66; observed range 0-10). Approximately a third of respondents reported at least one major discriminatory event in their lifetime, while 22% reported three or more discriminatory lifetime events. Everyday discrimination scores averaged 14.19 ± 5.46 (observed range 0-33). With adjustment for sociodemographics, physical health, cognitive and psychological factors, social isolation, and loneliness, everyday discrimination was associated with increased pain interference (B = 0.099; 95% confidence interval [CI]: 0.02 to 0.17). CONCLUSION These findings add weight to the importance of day-to-day experiences of interpersonal discrimination by documenting independent associations with functional interference in adults with chronic pain.
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Affiliation(s)
- Anthony D Ong
- Department of Human Development, Cornell University, Ithaca, New York, USA
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Selin Goktas
- Department of Human Development, Cornell University, Ithaca, New York, USA
| | - M Carrington Reid
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, New York, USA
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11
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Honda H, Ashizawa R, Kiriyama K, Take K, Yoshimoto Y. Depression Is Associated with Chronic Pain in Disabled Older Adults. Exp Aging Res 2021; 48:287-294. [PMID: 34545772 DOI: 10.1080/0361073x.2021.1979346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The association between depression and chronic pain has been clearly demonstrated in healthy older adults, but not in older adults with disabilities. This study thus aimed to clarify the association between depression and chronic pain in older adults with disabilities. METHODS In total, 92 older adults aged 65 years or older subscribed to Japanese long-term care insurance services were included in this study. Depression was assessed using the Geriatric Depression Scale-Short Version-Japanese (GDS-S-J) and was diagnosed among respondents who scored 6 or more points. Chronic pain was assessed using a questionnaire and defined as a "pain that persists in the present and has lasted for more than three months." RESULTS Chronic pain was associated with depression in older adults with disabilities (odds ratio: 3,355, 95% confidence interval: 1,232-9,135, p = 0,018). There was a strong association between severe chronic pain and depression (odds ratio: 3,699, 95% confidence interval: 1,345-10,173, p = 0,011). CONCLUSION Our findings suggest that it is necessary to focus on intensity of chronic pain to improve depression in older adults with disabilities who are more difficult to treat than healthy older adults.
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Affiliation(s)
- Hiroya Honda
- Division of Rehabilitation Science, Seirei Christopher University Graduate School, Hamamatsu-City, Japan
| | - Ryota Ashizawa
- Division of Rehabilitation Science, Seirei Christopher University Graduate School, Hamamatsu-City, Japan
| | - Kazuya Kiriyama
- Division of Rehabilitation Science, Seirei Christopher University Graduate School, Hamamatsu-City, Japan
| | - Koki Take
- Visiting Nurse Station Takaoka, Seirei Care Center Takaoka, Hamamatsu-City, Japan
| | - Yoshinobu Yoshimoto
- Division of Rehabilitation, Seirei Christopher University, Hamamtsu-City, Japan
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12
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Cary MA, Gyurcsik NC. Differences in adaptive and maladaptive psychosocial responses to chronic pain among adults with varying physical activity levels. Br J Pain 2021; 15:259-269. [PMID: 34381611 PMCID: PMC8339946 DOI: 10.1177/2049463720942535] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
AIM Chronic pain is a global public health problem that detrimentally impacts people's health and well-being. Physical activity is beneficial and a recommended self-management strategy for adults living with chronic pain. Yet, many of them struggle to meet the public health recommendation of 150+ minutes/week of moderate-vigorous physical activity. Identifying modifiable factors related to physical activity participation is needed. Adaptive (i.e., self-regulatory efficacy to overcome pain and related barriers [SRE-pain], psychological flexibility) and maladaptive (i.e. pain anxiety) responses were the modifiable factors examined in the present study. The purpose was to investigate whether adults living with chronic pain who were sufficiently active, insufficiently active or inactive significantly differed in their adaptive and maladaptive responses to chronic pain. METHODS Adults with self-reported chronic pain for 6+ months (N = 318) completed an online survey that measured physical activity, psychological flexibility, SRE-pain and pain anxiety. Sufficiently active (n = 139), insufficiently active (n = 91) and inactive (n = 88) groups were identified. RESULTS A significant multivariate analysis of covariance (MANCOVA) (p < .001) with univariate follow-up tests illustrated that the sufficiently active individuals reported the highest psychological flexibility and SRE-pain compared to insufficiently active and inactive individuals (p's < .001). Overall, sufficiently active participants responded the most adaptively and least maladaptively to their pain, followed by the insufficiently active. Inactive participants responded the most maladaptively. CONCLUSION Identifying differences in adaptive and maladaptive responses to pain highlights possible modifiable factors to target in future physical activity intervention research that focuses on improving chronic pain self-management.
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Affiliation(s)
- Miranda A Cary
- School of Health and Exercise Sciences,
The University of British Columbia Okanagan, Kelowna, BC, Canada
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13
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Jin Y, Si H, Qiao X, Tian X, Liu X, Xue QL, Wang C. Relationship Between Frailty and Depression Among Community-Dwelling Older Adults: The Mediating and Moderating Role of Social Support. THE GERONTOLOGIST 2021; 60:1466-1475. [PMID: 32556208 DOI: 10.1093/geront/gnaa072] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Frailty is associated with depression in older adults and reduces their social support. However, the mechanism underlying such relationship remains unclear. We aim to examine whether social support acts as a mediator or moderator in the relationship between frailty and depression. RESEARCH DESIGN AND METHODS This cross-sectional study was conducted among 1,779 community-dwelling older adults aged 60 and older. Frailty, social support, and depressive symptoms were measured by the Physical Frailty Phenotype, Social Support Rating Scale, and five-item Geriatric Depression Scale, respectively. Data were also collected on age, gender, years of schooling, monthly income, cognitive function, number of chronic diseases, physical function, and pain. RESULTS Linear regression models showed that subjective support and support utilization, but not objective support, mediated and moderated the relationship between frailty and depressive symptoms. The Johnson-Neyman technique determined a threshold of 30 for subjective support, but not for support utilization, beyond which the detrimental effect of frailty on depressive symptoms was offset. DISCUSSION AND IMPLICATIONS Social support underlies the association of frailty with depression, and its protective role varies by type. Interventions on depression should address improving perceptions and utilization of social support among frail older adults rather than simply providing them with objective support.
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Affiliation(s)
- Yaru Jin
- School of Nursing, Peking University, Beijing, China
| | - Huaxin Si
- School of Nursing, Peking University, Beijing, China
| | - Xiaoxia Qiao
- School of Nursing, Peking University, Beijing, China
| | - Xiaoyu Tian
- School of Nursing, Shandong University, Jinan Shandong, China
| | - Xinyi Liu
- School of Nursing, Shandong University, Jinan Shandong, China
| | - Qian-Li Xue
- School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Cuili Wang
- School of Nursing, Peking University, Beijing, China
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14
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Li Y, Tse MYM. An Online Pain Education Program for Working Adults: Pilot Randomized Controlled Trial. J Med Internet Res 2020; 22:e15071. [PMID: 31934865 PMCID: PMC6996734 DOI: 10.2196/15071] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 09/01/2019] [Accepted: 10/22/2019] [Indexed: 11/17/2022] Open
Abstract
Background Pain is a common public health concern, and the pain situation among the general population is serious in mainland China. Working adults commonly experience pain because of long sitting times, a lack of free time, and exercise. A lack of pain-related knowledge is also a significant factor. Educational and therapeutic programs delivered online were used more often in Western countries, and accessible programs in China are limited, especially for pain management. Therefore, we carried out an online pain education program for working adults to self-manage pain. The program was delivered through WeChat, a popular and secure social media with a large population base in China. Objective This study aimed to (1) provide pain-related knowledge and self-relief strategies, (2) help participants reduce pain and improve pain-related emotional well-being, and (3) explore participants’ learning performance and the acceptability of the online pain education program. Methods This was a randomized controlled trial. Chinese adults aged between 16 and 60 years with full-time employment, with pain in the past 6 months, and without any mental illness were recruited using snowball sampling through the internet and were randomly allocated to an experimental group and a control group in 1:1 ratio after the baseline assessment. The 4-week educational program that included basic knowledge of pain, pharmacological and nonpharmacological treatments, and related resources was provided only to the experimental group. Outcomes of pain, depression, anxiety, stress, and pain self-efficacy were measured at baseline (T0), posttreatment (T1), and 1-month follow-up (T2). Participants’ acceptability and satisfaction were explored after completing the educational program. Results In total, 95 eligible participants joined in the program: 47 in the experimental group and 48 in the control group. Neck and shoulder, head, and back were most commonly reported pain sites with high pain scores. Pain intensity and interference of the experimental group were significantly reduced after the educational program. Depression, anxiety, and stress clinically improved and pain self-efficacy improved after the educational program. The difference in depression, anxiety, stress, and pain self-efficacy within a group or between groups was not statistically significant; however, clinical improvements were demonstrated. A significant correlation between dosage of the intervention and pain intensity and depression was demonstrated. After completing the educational program, more than half of the participants showed acceptance of and satisfaction with the program, and they were willing to recommend the program to others. Conclusions Our findings highlight the significant potential of this online education program in the treatment of pain. Trial Registration ClinicalTrials.gov NCT03952910; https://clinicaltrials.gov/ct2/show/NCT03952910
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Affiliation(s)
- Yajie Li
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Mun Yee Mimi Tse
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
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Miaskowski C, Blyth F, Nicosia F, Haan M, Keefe F, Smith A, Ritchie C. A Biopsychosocial Model of Chronic Pain for Older Adults. PAIN MEDICINE 2019; 21:1793-1805. [DOI: 10.1093/pm/pnz329] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Abstract
Population
Comprehensive evaluation of chronic pain in older adults is multifaceted.
Objective and Methods
Research on chronic pain in older adults needs to be guided by sound conceptual models. The purpose of this paper is to describe an adaptation of the Biopsychosocial Model (BPS) of Chronic Pain for older adults. The extant literature was reviewed, and selected research findings that provide the empiric foundation for this adaptation of the BPS model of chronic pain are summarized. The paper concludes with a discussion of specific recommendations for how this adapted model can be used to guide future research.
Conclusions
This adaptation of the BPS model of chronic pain for older adults provides a comprehensive framework to guide future research in this vulnerable population.
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Affiliation(s)
| | - Fiona Blyth
- School of Medicine, The University of Sydney, Sydney, Australia
| | - Francesca Nicosia
- School of Medicine, University of California, San Francisco, California
| | - Mary Haan
- School of Medicine, University of California, San Francisco, California
| | - Frances Keefe
- School of Medicine, Duke University, Durham, North Carolina, USA
| | - Alexander Smith
- School of Medicine, University of California, San Francisco, California
| | - Christine Ritchie
- School of Medicine, University of California, San Francisco, California
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16
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C Evans M, Bazargan M, Cobb S, Assari S. Pain Intensity among Community-Dwelling African American Older Adults in an Economically Disadvantaged Area of Los Angeles: Social, Behavioral, and Health Determinants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3894. [PMID: 31615105 PMCID: PMC6843192 DOI: 10.3390/ijerph16203894] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/01/2019] [Accepted: 10/08/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Although social, behavioral, and health factors influence prevalence and intensity of pain, very few studies have investigated correlates of pain among economically disadvantaged older African American (AA) adults. OBJECTIVE This study explored social, behavioral, and health correlates of pain intensity among community-dwelling AA older adults in an economically disadvantaged area of Los Angeles. METHODS A cross-sectional study on 740 AA older adults (age ≥ 55 years) was conducted in South Los Angeles between 2015 and 2018. Exploratory variables were age, gender, educational attainment, financial difficulties, living alone, marital status, smoking, drinking, pain-related chronic medical conditions (CMCs), and depressive symptoms. Dependent variable was pain intensity. Linear regression was used for data analysis. RESULTS Age, financial difficulties, living alone, smoking, pain-related chronic medical conditions, and depressive symptoms were associated with pain intensity. Individuals with lower age, higher financial difficulties, those who lived alone, those with a higher number of pain-related chronic medical conditions, more depressive symptoms, and nonsmokers reported more pain intensity. Gender, educational attainment, marital status, and drinking were not associated with pain intensity. CONCLUSION The results may help with the health promotion of economically disadvantaged AA older adults in urban areas.
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Affiliation(s)
- Meghan C Evans
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90095, USA.
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90095, USA.
- Department of Family Medicine, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA.
| | - Sharon Cobb
- School of Nursing, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90095, USA.
| | - Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90095, USA.
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17
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Li Y, Tse MMY. Pain situations among working adults and the educational needs identified: an exploratory survey via WeChat. BMC Public Health 2019; 19:1149. [PMID: 31438930 PMCID: PMC6704659 DOI: 10.1186/s12889-019-7503-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 08/15/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The aim of this study is to 1) investigate the pain situation among working adults in China; 2) explore the self-initiate pain reliving strategies applied by working adults; and 3) collect people's interests and suggestions to the topics of the online pain education program. METHODS This is an exploratory survey through WeChat. The study was conducted from May 2018 to December 2018. Participants were recruited following the snowball sampling. In total of 664 people were recruited and 502 satisfied the criteria. SPSS was used for data analysis. Descriptive statistical analysis were used to present the utilization of pain treatments and suggested topics. Chi-square test, independent multiple logistic regression and Spearman's correlation were used to analysis the data. RESULTS The overall incidence of pain among the participants is 45% and higher among female (63%) than male (37%). Neck (68.72%, 4.10 ± 2.31), shoulder (62.56%, 3.78 ± 2.41) and head (49.34%, 4.23 ± 2.52) are reported as the most common and severe pain sites. Working is affected by pain and the results show that there is a negative correlation between pain intensity and work (rs = - 0.194) among the working population. Non-pharmacological treatments (55.77%) were chosen more by pain suffers. Totally 63.39% of participants show interests in the online pain education program and physical and psychological impact of pain is the most suggested topic (22.51%). CONCLUSION The pain prevalence is high among working adults in China. Impact of pain on work is a significant problem for the working adults. It is important to identify people at risk and deliver timely intervention to reduce pain. People showed their willingness in joining the online program. Therefore, future online pain education program can be developed.
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Affiliation(s)
- Yajie Li
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Mimi M Y Tse
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China.
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Abstract
PURPOSE OF REVIEW Chronic noncancer pain is an increasing problem in elderly because of rising life expectancy together with an increase of potentially painful medical conditions. Concomitantly, adequate treatment of elderly is often limited by coexisting diseases and polypharmacy.This review summarizes the most important specifics presented by elderly patients and discusses the pharmacological and nonpharmacological options of pain management. RECENT FINDINGS A comprehensive pain assessment is a prerequisite for effective pain management. However, this can be a major challenge in patients who are unable to communicate adequately, that is, in patients with dementia. A recently developed electronic tool assessing automated facial expression and clinical behavioral indicators may help to solve this problem. The discussion about benefits and harms of opioids in elderly goes on. Although some authors underline the lack of efficacy together with the potential problems, such as, abuse, others report a beneficial effect in terms of pain relief, functional activities and disability. In addition, opioids have become an important treatment option in patients with restless legs syndrome. Various topical treatment options (i.e. capsaicin patch) and nonpharmacological interventions have been proven to be beneficial in elderly. SUMMARY Adequate pain management of elderly patients constitutes numerous pharmacological options including nonopioids, opioids, coanalgesics and topical agents. Due to age-related characteristics, all systemic analgesics have to be given very cautiously ('start low, go slow'). Whenever possible, treatment should be performed as a multimodal approach based on the biopsychosocial model of chronic pain.
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Boggero IA, Sturgeon JA, Arewasikporn A, Castro SA, King CD, Segerstrom SC. Associations of Pain Intensity and Frequency With Loneliness, Hostility, and Social Functioning: Cross-Sectional, Longitudinal, and Within-Person Relationships. Int J Behav Med 2019; 26:217-229. [PMID: 30809770 PMCID: PMC10585610 DOI: 10.1007/s12529-019-09776-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND The current studies investigated associations between pain intensity and pain frequency with loneliness, hostility, and social functioning using cross-sectional, longitudinal, and within-person data from community-dwelling adults with varying levels of pain. METHOD Secondary analysis of preexisting data was conducted. Study 1 investigated cross-sectional (baseline data: n = 741) and longitudinal (follow-up data: n = 549, observed range between baseline and follow-up: 6-53 months) associations. Study 2 tested within-person associations using daily diaries across 30 days from a subset of the participants in Study 1 (n = 69). RESULTS Cross-sectionally, pain intensity and frequency were associated with higher loneliness (βintensity = 0.16, βfrequency = 0.17) and worse social functioning (βintensity = - 0.40, βfrequency = - 0.34). Intensity was also associated with higher hostility (β = 0.11). Longitudinally, pain intensity at baseline predicted hostility (β = 0.19) and social functioning (β = - 0.20) at follow-up, whereas pain frequency only predicted social functioning (β = - 0.21). Within people, participants reported higher hostility (γ = 0.002) and worse social functioning (γ = - 0.013) on days with higher pain, and a significant average pain by daily pain interaction was found for loneliness. Pain intensity did not predict social well-being variables on the following day. CONCLUSION Pain intensity and frequency were associated with social well-being, although the effects were dependent on the social well-being outcome and the time course being examined.
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Affiliation(s)
- Ian A Boggero
- Department of Psychology, University of Kentucky, Lexington, KY, USA.
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 231 Albert Sabin Way, Cincinnati, OH, 45229, USA.
| | - John A Sturgeon
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Anne Arewasikporn
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA
- Multiple Sclerosis Center of Excellence-West, VA Puget Sound Health Care System, Seattle, WA, USA
| | - Saul A Castro
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Christopher D King
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 231 Albert Sabin Way, Cincinnati, OH, 45229, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Hanssen DJC, Lucassen PLBJ, Naarding P, de Waal MWM, Oude Voshaar RC. Pain characteristics of older persons with medically unexplained symptoms, older persons with medically explained symptoms and older persons with depression. Aging Ment Health 2018; 22:1642-1649. [PMID: 29019415 DOI: 10.1080/13607863.2017.1387762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The main objective of the current study is to compare chronic pain characteristics of older patients with Medically Unexplained Symptoms (MUS), to those of patients with Medically Explained Symptoms (MES), and to those of patients with Major Depressive Disorder (MDD). METHOD By combining data from the OPUS and NESDO study, we compared pain characteristics of 102 older (>60 years) MUS-patients to 145 older MES-patients and 275 older MDD-patients in a case-control study design. Group differences were analyzed using ANCOVA, adjusted for demographic and physical characteristics. Linear regression was applied to examine the association between pain characteristics and somatization (BSI-53 somatization scale) and health anxiety (Whitely Index). RESULTS Older MUS-patients have approximately two times more chance of having chronic pain when compared to older MES-patients (OR = 2.01; p = .013) but equal chances as opposed to MDD-patients. After adjustments, MUS-patients report higher pain intensity and disability scores and more pain locations when compared to MES-patients, but equal values as MDD-patients. Health anxiety and somatization levels were positively associated with the number of pain sites in MUS-patients, but not with pain severity or disability. CONCLUSION Older MUS-patients did not differ from MDD-patients with respect to any of the chronic pain characteristics, but had more intense and disabling pain, and more pain locations when compared to older MES-patients.
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Affiliation(s)
- Denise J C Hanssen
- a University Center for Psychiatry and Interdisciplinary Center for Psychopathology and Emotion Regulation , University Medical Center Groningen , Groningen , The Netherlands
| | - Peter L B J Lucassen
- b Department of Primary and Community Care, Radboud Institute For Health Sciences , Radboud University Medical Centre , Nijmegen , The Netherlands
| | - Paul Naarding
- c Department of Old-Age psychiatry , GGNet , Apeldoorn , The Netherlands
| | - Margot W M de Waal
- d Department of Public Health and Primary Care , Leiden University Medical Center , Leiden , The Netherlands
| | - Richard C Oude Voshaar
- a University Center for Psychiatry and Interdisciplinary Center for Psychopathology and Emotion Regulation , University Medical Center Groningen , Groningen , The Netherlands
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Morete MC, Solano JPC, Boff MS, Filho WJ, Ashmawi HA. Resilience, depression, and quality of life in elderly individuals with chronic pain followed up in an outpatient clinic in the city of São Paulo, Brazil. J Pain Res 2018; 11:2561-2566. [PMID: 30464576 PMCID: PMC6209073 DOI: 10.2147/jpr.s166625] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE In this study, we assessed resilience, depression, and quality of life in a group of elderly individuals with or without chronic pain. PATIENTS AND METHODS A cross-sectional study assessing elderly individuals followed up at a geriatrics outpatient clinic and divided into two groups: 54 elderly patients with chronic pain and 54 elderly with no chronic pain. RESULTS The sample comprised mainly women (67.6%), with mean age 79.9 years. The mean resilience index in the group with pain was 69.4 and, in the group with no pain, 80.1 (P<0.001). Depression was observed in 35.2% of patients with chronic pain; there was no case of depression in those without chronic pain. Quality of life of the elderly with chronic pain was worse in all the domains assessed: physical, mental, emotional, social, vitality, and pain. CONCLUSION In the study sample, resilience was lower, depression was more frequent, and quality of life was worse in the group of elderly with chronic pain.
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Affiliation(s)
- Marcia C Morete
- School of Medicine, University of São Paulo, Santos, São Paulo, Brazil,
| | | | - Mario S Boff
- School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Wilson J Filho
- School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Hazem A Ashmawi
- School of Medicine, University of São Paulo, São Paulo, Brazil
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22
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Tai LW, Yeung SC, Cheung CW. Enriched Environment and Effects on Neuropathic Pain: Experimental Findings and Mechanisms. Pain Pract 2018; 18:1068-1082. [PMID: 29722923 DOI: 10.1111/papr.12706] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/04/2018] [Accepted: 04/22/2018] [Indexed: 12/16/2022]
Abstract
Neuropathic pain inflicts tremendous biopsychosocial suffering for patients worldwide. However, safe and effective treatment of neuropathic pain is a prominent unmet clinical need. Environmental enrichment (EE) is an emerging cost-effective nonpharmacological approach to alleviate neuropathic pain and complement rehabilitation care. We present here a review of preclinical studies in ascertaining the efficacy of EE for neuropathic pain. Their proposed mechanisms, including the suppression of ascending nociceptive signaling to the brain, enhancement of the descending inhibitory system, and neuroprotection of the peripheral and central nervous systems, may collectively reduce pain perception and improve somatic and emotional functioning in neuropathic pain. The current evidence offers critical insights for future preclinical research and the translational application of EE in clinical pain management.
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Affiliation(s)
- Lydia Wai Tai
- Laboratory and Clinical Research Institute for Pain, Department of Anaesthesiology, The University of Hong Kong, Hong Kong, Special Administrative Region, China.,Department of Anaesthesiology, The University of Hong Kong, Hong Kong, Special Administrative Region, China
| | - Sung Ching Yeung
- Laboratory and Clinical Research Institute for Pain, Department of Anaesthesiology, The University of Hong Kong, Hong Kong, Special Administrative Region, China.,Department of Anaesthesiology, The University of Hong Kong, Hong Kong, Special Administrative Region, China
| | - Chi Wai Cheung
- Laboratory and Clinical Research Institute for Pain, Department of Anaesthesiology, The University of Hong Kong, Hong Kong, Special Administrative Region, China.,Department of Anaesthesiology, The University of Hong Kong, Hong Kong, Special Administrative Region, China.,Research Centre of Heart, Brain, Hormone & Healthy Aging, The University of Hong Kong, Hong Kong, Special Administrative Region, China
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24
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Avian A, Messerer B, Meissner W, Sandner-Kiesling A, Kammel J, Labugger M, Weinberg A, Berghold A. Using a worst pain intensity measure in children and adolescents. J Adv Nurs 2017; 73:1873-1883. [DOI: 10.1111/jan.13271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Alexander Avian
- Institute for Medical Informatics Statistics and Documentation; Medical University of Graz; Graz Austria
| | - Brigitte Messerer
- Division of Anesthesiology for Cardiovascular Surgery and Intensive Care Medicine; Medical University of Graz; Graz Austria
| | - Winfried Meissner
- Department of Anesthesiology and Intensive Care; Jena University Hospital; Germany
| | - Andreas Sandner-Kiesling
- Division of Anesthesiology for Cardiovascular Surgery and Intensive Care Medicine; Medical University of Graz; Graz Austria
| | - Julian Kammel
- Institute for Medical Informatics Statistics and Documentation; Medical University of Graz; Graz Austria
| | - Marlies Labugger
- Division of Anesthesiology for Cardiovascular Surgery and Intensive Care Medicine; Medical University of Graz; Graz Austria
| | - Annelie Weinberg
- Department of Orthopedics and Orthopedic Surgery; Medical University of Graz; Austria
| | - Andrea Berghold
- Institute for Medical Informatics Statistics and Documentation; Medical University of Graz; Graz Austria
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Collard RM, Arts MHL, Schene AH, Naarding P, Oude Voshaar RC, Comijs HC. The impact of frailty on depressive disorder in later life: Findings from the Netherlands Study of depression in older persons. Eur Psychiatry 2017; 43:66-72. [PMID: 28365469 DOI: 10.1016/j.eurpsy.2017.01.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 01/09/2017] [Accepted: 01/10/2017] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Physical frailty and depressive symptoms are reciprocally related in community-based studies, but its prognostic impact on depressive disorder remains unknown. METHODS A cohort of 378 older persons (≥60 years) suffering from a depressive disorder (DSM-IV criteria) was reassessed at two-year follow-up. Depressive symptom severity was assessed every six months with the Inventory of Depressive Symptomatology, including a mood, motivational, and somatic subscale. Frailty was assessed according to the physical frailty phenotype at the baseline examination. RESULTS For each additional frailty component, the odds of non-remission was 1.24 [95% CI=1.01-1.52] (P=040). Linear mixed models showed that only improvement of the motivational (P<001) subscale and the somatic subscale (P=003) of the IDS over time were dependent on the frailty severity. CONCLUSIONS Physical frailty negatively impacts the course of late-life depression. Since only improvement of mood symptoms was independent of frailty severity, one may hypothesize that frailty and residual depression are easily mixed-up in psychiatric treatment.
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Affiliation(s)
- R M Collard
- Department of Psychiatry, Radboud university medical center, Nijmegen, The Netherlands.
| | - M H L Arts
- Mental Health Center Friesland, Department of Old Age Psychiatry, Leeuwarden, The Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Groningen, The Netherlands
| | - A H Schene
- Department of Psychiatry, Radboud university medical center, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - P Naarding
- GGNet, Department of Old-age Psychiatry, Apeldoorn/Zutphen, The Netherlands
| | - R C Oude Voshaar
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Groningen, The Netherlands
| | - H C Comijs
- GGZinGeest, Amsterdam, The Netherlands; Department Psychiatry/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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Dragioti E, Larsson B, Bernfort L, Levin LÅ, Gerdle B. Prevalence of different pain categories based on pain spreading on the bodies of older adults in Sweden: a descriptive-level and multilevel association with demographics, comorbidities, medications, and certain lifestyle factors (PainS65+). J Pain Res 2016; 9:1131-1141. [PMID: 27942232 PMCID: PMC5138042 DOI: 10.2147/jpr.s119845] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background and objective There is limited knowledge about the prevalence of pain and its relation to comorbidities, medication, and certain lifestyle factors in older adults. To address this limitation, this cross-sectional study examined the spreading of pain on the body in a sample of 6611 subjects ≥65 years old (mean age = 75.0 years; standard deviation [SD] = 7.7) living in southeastern Sweden. Methods Sex, age, comorbidities, medication, nicotine, alcohol intake, and physical activity were analyzed in relation to the following pain categories: local pain (LP) (24.1%), regional pain medium (RP-Medium) (20.3%), regional pain heavy (RP-Heavy) (5.2%), and widespread pain (WSP) (1.7%). Results RP-Medium, RP-Heavy, and WSP were associated more strongly with women than with men (all p<0.01). RP-Heavy was less likely in the 80–84 and >85 age groups compared to the 65–69 age group (both p<0.01). Traumatic injuries, rheumatoid arthritis/osteoarthritis, and analgesics were associated with all pain categories (all p<0.001). An association with gastrointestinal disorders was found in LP, RP-Medium, and RP-Heavy (all p<0.01). Depressive disorders were associated with all pain categories, except for LP (all p<0.05). Disorders of the central nervous system were associated with both RP-Heavy and WSP (all p<0.05). Medication for peripheral vascular disorders was associated with RP-Medium (p<0.05), and hypnotics were associated with RP-Heavy (p<0.01). Conclusion More than 50% of older adults suffered from different pain spread categories. Women were more likely to experience greater spreading of pain than men. A noteworthy number of common comorbidities and medications were associated with increased likelihood of pain spread from LP to RP-Medium, RP-Heavy, and WSP. Effective management plans should consider these observed associations to improve functional deficiency and decrease spreading of pain-related disability in older adults.
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Affiliation(s)
| | | | - L Bernfort
- Division of Health Care Analysis, Department of Medical and Health Sciences (IMH), Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - L Å Levin
- Division of Health Care Analysis, Department of Medical and Health Sciences (IMH), Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - B Gerdle
- Pain and Rehabilitation Medicine
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Abstract
Pharmacologic management of chronic pain in older adults is one component of the multimodal, interdisciplinary management of this complex condition. In this article, we summarize several of the key barriers to effective pharmacologic management in older adults and review the existing (albeit limited) evidence for its effectiveness and safety, especially in a medically complex population with multimorbidity. This review covers topical formulations, acetaminophen, oral nonsteroidal antiinflammatory drugs, and adjuvant therapies. The article concludes with a suggested approach to managing chronic pain in the older patient, incorporating goals and expectations for treatment as well as careful monitoring of medication adjustments.
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Affiliation(s)
- Zachary A Marcum
- Department of Pharmacy, University of Washington School of Pharmacy, 1959 Northeast Pacific Avenue, Box 357630, Seattle, WA 98195, USA
| | - Nakia A Duncan
- Texas Tech University Health Sciences Center School of Pharmacy, 4500 South Lancaster Street, Building 7, Room 215, Dallas, TX, USA
| | - Una E Makris
- Division of Rheumatic Diseases, Department of Internal Medicine, VA North Texas Health Care System, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9169, USA.
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28
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Choi NG, Snow AL, Kunik ME. Pain severity, interference, and prescription analgesic use among depressed, low-income homebound older adults. Aging Ment Health 2016; 20:804-13. [PMID: 25923452 DOI: 10.1080/13607863.2015.1037244] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Disabled, homebound individuals tend to suffer both chronic pain and depression; however, low-income, homebound older adults have been underexposed in pain and depression research. We examined the extent of pain frequency, intensity, and interference; the relationship between pain and depressive symptoms; and prescription analgesic use and its association with use of antidepressant and anxiolytic medications among these older adults. METHOD The data came from the baseline assessment of 215 homebound individuals aged 50+ who were referred to a clinical trial of depression treatment. Bivariate and multivariate analyses were used to examine the research questions. RESULTS Almost 87% (n = 186) of the participants reported having had chronic pain in the preceding three months. Of the pain reporters, the mean frequency, intensity, and interference of pain were 8.65 ± 2.05, 7.71 ± 2.10, and 7.80 ± 2.82, respectively, on a 1-10 scale, and 61% were taking a prescription analgesic. Analgesic users and nonusers did not differ in depressive symptoms and in pain frequency and intensity, but analgesic users reported higher pain interference than nonusers (8.22 ± 2.46 vs. 7.14 ± 3.22; t = 2.44, df = 184, p = .016). Pain frequency and interference were significantly associated with depressive symptoms, and pain interference was significantly associated with analgesic use in multivariate analysis. Anxiolytic medication use was also correlated with analgesic use. CONCLUSION The findings underscore the significant pain-related problems in these vulnerable individuals and the need for recognizing and treating both pain and depression more effectively using both pharmacologic and nonpharmacologic interventions.
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Affiliation(s)
- Namkee G Choi
- a The University of Texas at Austin School of Social Work , Austin , TX , USA
| | - A Lynn Snow
- b Department of Psychology , University of Alabama Center for Mental Health and Aging , Tuscaloosa , AL , USA
| | - Mark E Kunik
- c The Center for Innovations in Quality, Effectiveness and Safety (#CIN 13-413) , Michael E. DeBakey VA Medical Center , Houston , TX , USA.,d Houston VA Health Services Research and Development Center of Excellence , Houston , TX , USA.,e Department of Psychiatry , Baylor College of Medicine , Houston , TX , USA
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29
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de Waal MWM, Hegeman JM, Gussekloo J, Verhaak PFM, van der Mast RC, Comijs HC. The effect of pain on presence and severity of depressive disorders in older persons: The role of perceived control as mediator. J Affect Disord 2016; 197:239-44. [PMID: 26995467 DOI: 10.1016/j.jad.2016.03.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 02/19/2016] [Accepted: 03/07/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND The relation between pain and depression is reported repeatedly. It is suggested that pain by itself is not sufficient for the development of depression. We aim to study the role of perceived control as mediating factor in the relation between pain and depressive disorders at old age. METHODS Baseline data of the Netherlands Study of Depression in Older Persons (NESDO) were used, including 345 persons with DSM-IV depressive disorders (CIDI) and 125 control persons without depressive disorders, aged 60 years and over. Measures included severity of depression (Inventory of Depressive Symptomatology), presence and intensity of pain and pain-related disability (Chronic Graded Pain scale), and a general measure of perceived control over life (Pearlin Mastery Scale). In mediation analyses direct and indirect effects were estimated. RESULTS Older persons with depressive disorders reported pain more frequently with higher intensity than controls. After controlling for confounding, the direct effect of pain intensity and the indirect effect through perceived control on depression were OR=1.10 (CI 95% .98;1.25) and OR=1.24 (1.15;1.35). For pain-related disability these were OR=1.14 (1.02;1.29) and OR=1.21 (1.13;1.29). In depressed persons there was a strong direct effect of pain intensity and disability and a smaller indirect effect through perceived control on severity of depressive symptoms. LIMITATIONS This cross-sectional study cannot give evidence on causal direction. CONCLUSIONS Perceived control plays an important role as mediator in the association between pain and presence of depression. In depressed persons however, the direct role of pain seems more important in the association with depression severity.
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Affiliation(s)
- M W M de Waal
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
| | - J M Hegeman
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - J Gussekloo
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - P F M Verhaak
- University of Groningen, University Medical Center Groningen, Department of General Practice, Groningen, The Netherlands; NIVEL, Netherlands Institute of Health Services Research, The Netherlands
| | - R C van der Mast
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands; Department of Psychiatry, CAPRI-University of Antwerp, Belgium
| | - H C Comijs
- Department of Psychiatry/GGZ in Geest and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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30
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Bonin-Guillaume S, Jouve E, Lauretta R, Nalin C, Truillet R, Capriz F, Rat P. Algoplus performance to detect pain in depressed and/or demented old patients. Eur J Pain 2016; 20:1185-93. [DOI: 10.1002/ejp.844] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2015] [Indexed: 11/10/2022]
Affiliation(s)
- S. Bonin-Guillaume
- Geriatric and Internal Medicine Department; University Hospital of Marseille; France
- Neurosciences Institute Timone; UMR-CNRS8279; Aix Marseille University; France
| | - E. Jouve
- Neurosciences Institute Timone; UMR-CNRS8279; Aix Marseille University; France
| | - R. Lauretta
- Geriatric and Medicine Department; General Hospital; Salon France
| | - C. Nalin
- Centre Hospitalier du Pays d'Avesnes; Avesnes-sur-Help France
| | - R. Truillet
- Neurosciences Institute Timone; UMR-CNRS8279; Aix Marseille University; France
| | - F. Capriz
- Pôle Gérontologique SSR-C2; CHU de Nice; France
- Doloplus Collective Team; Centre de Soins Palliatifs; CHR Metz-Thionville; France
| | - P. Rat
- Doloplus Collective Team; Centre de Soins Palliatifs; CHR Metz-Thionville; France
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31
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Duncan NA, Mahan RJ, Turner SJ. Non-opiate pharmacotherapy options for the management of pain in older adults. Ment Health Clin 2015. [DOI: 10.9740/mhc.2015.05.091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Pain is highly prevalent, costly, and disabling in later life, especially when undertreated. In this article, we aim to describe the risks and benefits of non-opioid medication options for the management of pain in adults aged 65 years and older in order to provide additional options in a practitioner's tool box when designing a pain management regimen for an older adult. Non-opiate pharmacologic therapies, such as acetaminophen, nonsteroidal anti-inflammatory drugs, topicals, and antidepressants have an important role in pain management of older adults. When designing a pain regimen, taking an individualized approach that considers the patient's functional status, comorbidities, and treatment goals will maximize pain management.
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McCormick ZL, Kennedy DJ. Truth in Medicine: Why Most Reviews and Commentaries on Spine Treatments are Flawed. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2015. [DOI: 10.1007/s40141-015-0080-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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