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Segura-Jiménez V, Tsiarleston G, Donoso B, Gil-Gutiérrez YM, Delgado-Fernández M. Association of Muscle Strength, Psychological Factors, and Central Sensitization With Movement-Evoked Pain in Patients With Nonspecific Chronic Low Back Pain: The BACKFIT Project. Sports Health 2024:19417381241235152. [PMID: 38566303 DOI: 10.1177/19417381241235152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND People with chronic pain might evade certain movements to prevent their experience of pain. Movement-evoked pain (MEP) might induce lower functionality during daily activities. HYPOTHESIS (1) MEP after physical fitness tests would vary depending on the main musculature involved in the test; (2) physical and psychological factors would be associated with MEP in patients with NSCLBP. STUDY DESIGN Cross-sectional design. LEVEL OF EVIDENCE Level 3. METHODS A total of 104 (69 women) patients aged 51.0 ± 10.3 years with NSCLBP participated. MEP was measured with a visual analog scale (VAS) at baseline and immediately after performing each physical fitness test, that is, the Biering-Sørensen, prone bridging, handgrip, chair-stand, and 8-foot time-up-and-go tests, measuring back extensor, back flexor, upper- and lower-body muscle strength, and motor agility, respectively. Global muscle strength was calculated with normalized index (z-score) procedure. Depression, anxiety, pain catastrophizing, and central sensitization were assessed with the Beck Depression Inventory II, State Trait Anxiety Inventory I, Pain Catastrophizing Scale, and Central Sensitization Inventory (CSI), respectively. RESULTS Patients showed greater pain after completion of the Biering-Sørensen (mean difference 95% CI, 0.02, 1.11), prone bridging (0.15, 1.21), lower pain after handgrip (-1.46, -0.52), and the 8-foot time-up-and-go (-1.43, 0.46) tests (all P ≤ 0.04). Lower global muscular strength (β between -0.18 and -0.30), and greater pain catastrophizing (β = 0.16), and CSI scoring (β between 0.18 and 0.27) were associated with greater MEP (all P ≤ 0.04). CONCLUSION Greater MEP was observed after tests measuring core musculature strength than after tests measuring distal (limbs) strength and agility. Greater MEP was overall associated with lower muscle strength, greater pain catastrophizing, and central sensitization. CLINICAL RELEVANCE Fitness testing might be implemented as a complementary tool for the monitoring of NSCLBP in clinical settings.
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Affiliation(s)
- Víctor Segura-Jiménez
- UGC Neurotraumatología y Rehabilitación, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. Granada, Granada, Spain
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
| | - Gavriella Tsiarleston
- Physical Activity for Health Promotion (PA-HELP) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Belén Donoso
- Department of Psychology, Faculty of Education Sciences and Psychology, University of Córdoba, Córdoba, Spain
| | | | - Manuel Delgado-Fernández
- Physical Activity for Health Promotion (PA-HELP) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Sport and Health University Research Institute (iMUDS), Granada, Spain
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Alrawaili SM, Alkhathami KM, Elsehrawy MG, Obaidat SM, Alhwoaimel NA, Alenazi AM. Multisite Pain and Intensity were Associated with History Fall among Older Adults: A Cross-Sectional Study. J Multidiscip Healthc 2024; 17:1241-1250. [PMID: 38524864 PMCID: PMC10960544 DOI: 10.2147/jmdh.s449531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/11/2024] [Indexed: 03/26/2024] Open
Abstract
Purpose This study examined the independent associations among multisite pain, pain intensity, and the risk of falls, including a history of falls in the previous 12 months and frequent falls (≥ two falls vs one or two falls) among community-dwelling older adults. Methods A cross-sectional design from Wave 2 of the National Social Life, Health, and Aging Project was used. Data on pain intensity and location (45 sites) over the past 4 weeks were collected. Multisite pain was categorized into four groups: none, one, two, and three or more sites. The main outcomes of falls were a history of falls and frequent falls. The covariates included age, sex, race, body mass index, education, medications, and comorbidities. Results Among 3,196 participants in Wave 2, 2,697 were included because of missing key variables related to pain and fall history. The prevalence of falls and frequent falls were 30.3% (n = 817) and 12.6% (n = 339), respectively. Multisite pain at ≥ three sites (odds ratio (OR) 2.04, confidence interval (CI) [1.62, 2.57]; p < 0.001) and two sites (OR 1.72, 95% CI [1.30, 2.27]; p < 0.001) was significantly associated with an increased risk of falls. An increase in pain intensity was significantly associated with an increased risk of fall (OR 1.28, 95% CI [1.15, 1.44], p < 0.001), independent of multisite pain. Multisite pain at ≥3 sites (OR 2.19, 95% CI [1.56, 3.07], p < 0.001) and 2 sites (OR 1.54, 95% CI [1.01, 2.34], p = 0.045) was associated with an increased risk of frequent falls. An increase in pain intensity was associated with risk of frequent falls (OR 1.64, 95% CI [1.40, 1.91], p < 0.001), independent of multisite pain. Conclusion Multisite pain and pain intensity were associated with a history of falls and frequent falls among older adults, emphasizing the need for routine pain evaluation to develop fall prevention strategies in this population.
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Affiliation(s)
- Saud M Alrawaili
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Khalid M Alkhathami
- Department of Health Rehabilitation, Shaqra University, Shaqra, Saudi Arabia
| | - Mohamed G Elsehrawy
- Department of Nursing, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Sakher M Obaidat
- Department of Physical Therapy and Occupational Therapy, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Norah A Alhwoaimel
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Aqeel M Alenazi
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
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Putranto R, Shatri H, Irawan C, Gondhowiardjo S, Finkelstein E, Malhotra C, Ozdemir S, Teo I, Yang GM. The association of prognostic awareness with quality of life, spiritual well-being, psychological distress, and pain severity in patients with advanced cancer: Results from the APPROACH Study in Indonesia. Palliat Support Care 2024:1-7. [PMID: 38450453 DOI: 10.1017/s1478951524000269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
BACKGROUND AND OBJECTIVES Advanced cancer patients' understanding of their illness is key for making informed treatment decisions. Despite the known importance of patients' awareness of their disease prognosis, it is debatable whether this awareness is positively, negatively, or not associated with clinical and psychological outcomes among patients with advanced cancer. This paper aims to determine the prevalence of and factors associated with prognostic awareness and its association with quality of life (QoL), spiritual well-being, pain control, and psychological distress in patients with advanced cancer in Indonesia. METHODS This cross-sectional questionnaire-based survey was part of a multicountry study titled "Asian Patient Perspectives Regarding Oncology Awareness, Care and Health (APPROACH)." Patients were asked what they knew about their cancer and treatment. QoL and spiritual well-being were measured using the Functional Assessment of Cancer Therapy - General (FACT-G) and Functional Assessment of Chronic Illness Therapy - Spiritual Well-being (FACIT-Sp) questionnaire. Psychological distress experienced by patients was recorded via the Hospital Anxiety and Depression Scale. Pain severity was also assessed. Data from 160 patients were analyzed using descriptive statistics and multivariable regression models. RESULTS Of the 160 patients who participated, 55 (34.4%) were unaware of their cancer stage. Those who were aware of their stage of cancer were younger than those who were not aware (45.7 years vs 50.4 years, p = .015). There was no significant difference in spiritual well-being and other domains of QoL between those who were aware and those who were not aware of their advanced cancer stage. There was also no significant difference in anxiety depression or pain severity, even after adjustment for demographic and clinical characteristics. SIGNIFICANT OF RESULTS Given the high prevalence of patients who wrongly thought their cancer was curable, more could be done to improve disease and prognostic understanding among patients with advanced cancer in Indonesia. Those who were aware of their advanced cancer stage did not have a poorer QoL, nor did they have more anxiety or depression than those who were unaware. This finding suggests that concerns about the negative impact of prognostic disclosure may be unfounded.
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Affiliation(s)
- Rudi Putranto
- Department of Internal Medicine, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Hamzah Shatri
- Department of Internal Medicine, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Cosphiadi Irawan
- Department of Internal Medicine, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Soehartati Gondhowiardjo
- Department of Radiotherapy, Comprehensive Cancer Center, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Eric Finkelstein
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | - Semra Ozdemir
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | - Irene Teo
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre, Singapore
| | - Grace Meijuan Yang
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre, Singapore
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Taş S, Kaynak BA, Salkin Y, Karakoç ZB, Dağ F. An investigation of the changes in mechanical properties of the orofacial and neck muscles between patients with myogenous and mixed temporomandibular disorders. Cranio 2024; 42:150-159. [PMID: 34061722 DOI: 10.1080/08869634.2021.1934795] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To investigate the possible changes in the mechanical properties of the orofacial and neck muscles in patients with temporomandibular disorders (TMD). METHODS The study included a total of 98 females. Females were divided into three groups as myogenous TMD, mixed TMD, and healthy controls. The frequency (indicator of muscle tone), stiffness, and decrement (related to muscle elasticity) values of the sternocleidomastoid, upper trapezius, cervical extensor, and masseter muscles were measured using a portable myotonometer. RESULTS The frequency, stiffness, and decrement values of the masseter muscle were higher in the mixed and myogenous TMD groups than those of the control group (p < 0.017). The mixed TMD group had higher frequency and stiffness values in the upper trapezius muscle compared with the control group (p < 0.017). DISCUSSION The results suggest that the mechanical properties of the oral and neck muscles may be affected in patients with TMD.
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Affiliation(s)
- Serkan Taş
- School of Health Science, Alanya Alaaddin Keykubat University, Department of Physical Therapy and Rehabilitation, Antalya, Turkey
| | - Besime Ahu Kaynak
- Department of Physiotherapy and Rehabilitation, Toros University, School of Health Sciences, Mersin, Turkey
| | - Yasemin Salkin
- Vocational School of Medical Services, Department of Health Care Services, Mersin University, Mersin, Turkey
| | - Zehra Betül Karakoç
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Marmara University, Istanbul, Turkey
| | - Figen Dağ
- School of Medicine, Department of Physical Medicine and Rehabilitation, Mersin University, Mersin, Turkey
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Sawicki CM, Janal MN, Gonzalez SH, Wu AK, Schmidt BL, Albertson DG. Measurement of the Association of Pain with Clinical Characteristics in Oral Cancer Patients at Diagnosis and Prior to Cancer Treatment. J Pain Res 2024; 17:501-508. [PMID: 38328017 PMCID: PMC10848821 DOI: 10.2147/jpr.s423318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/25/2023] [Indexed: 02/09/2024] Open
Abstract
Aim Oral cancer patients suffer pain at the site of the cancer, which degrades quality of life (QoL). The University of California San Francisco Oral Cancer Pain Questionnaire (UCSFOCPQ), the only validated instrument specifically designed for measuring oral cancer pain, measures the intensity and nature of pain and the level of functional restriction due to pain. Purpose The aim of this study was to compare pain reported by untreated oral cancer patients on the UCSFOCPQ with pain they reported on the Brief Pain Inventory (BPI), an instrument widely used to evaluate cancer and non-cancer pain. Patients and Methods The correlation between pain measured by the two instruments and clinical characteristics were analyzed. Thirty newly diagnosed oral cancer patients completed the UCSFOCPQ and the BPI. Results Pain severity measurements made by the UCSFOCPQ and BPI were concordant; however, the widely used BPI average pain over 24 hours score appeared less sensitive to detect association of oral cancer pain with clinical characteristics of patients prior to treatment (nodal status, depth of invasion, DOI). A BPI average score that includes responses to questions that measure both pain severity and interference with function performs similarly to the UCSFOCPQ in detection of associations with nodal status, pathologic T stage (pT stage), stage and depth of invasion (DOI). Conclusion Pain assessment instruments that measure sensory and interference dimensions of oral cancer pain correlate with biologic features and clinical behavior.
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Affiliation(s)
- Caroline M Sawicki
- Department of Pediatric Dentistry, New York University College of Dentistry, New York, NY, USA
| | - Malvin N Janal
- Department of Epidemiology & Health Promotion New York University College of Dentistry, New York, NY, USA
| | - Sung Hye Gonzalez
- NYU Dentistry Translational Research Center, New York University College of Dentistry, New York, NY, USA
| | - Angie K Wu
- NYU Dentistry Translational Research Center, New York University College of Dentistry, New York, NY, USA
| | - Brian L Schmidt
- NYU Dentistry Translational Research Center, New York University College of Dentistry, New York, NY, USA
- Department of Oral and Maxillofacial Surgery, New York University College of Dentistry, New York, NY, USA
- NYU Pain Research Center, New York University College of Dentistry, New York, NY, USA
| | - Donna G Albertson
- NYU Dentistry Translational Research Center, New York University College of Dentistry, New York, NY, USA
- Department of Oral and Maxillofacial Surgery, New York University College of Dentistry, New York, NY, USA
- NYU Pain Research Center, New York University College of Dentistry, New York, NY, USA
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Buono FD, Larkin K, Zempsky WT, Grau LE, Martin S. Understanding chronic pain in Neurofibromatosis Type 1 using the Neurofibromatosis Pain Module (NFPM). Am J Med Genet A 2024. [PMID: 38234177 DOI: 10.1002/ajmg.a.63541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/13/2023] [Accepted: 01/05/2024] [Indexed: 01/19/2024]
Abstract
Neurofibromatosis Type 1 (NF1) is an autosomal dominant genetic disorder that can cause an individual significant chronic pain (CP). CP affects quality of life and daily functioning, yet there are limited effective treatments for CP within NF1. The current study describes the impact of CP using the Neurofibromatosis Pain Module (NFPM). The NFPM is a self-reported clinical assessment that evaluates the impact of CP across multiple domains (e.g., interference, severity, tolerance, and symptomology) and three prioritized pain regions. A cross-sectional study (N = 242) asked adults with NF1 to describe and rate their pain using the NFPM. The results indicated that they reported moderate pain severity (M = 6.6, SD = 2.0) on a 0-10 scale, that 54% (n = 131) had been in pain at least 24 days in the last 30, for 75% (n = 181) sleep was affected, and 16% reported that nothing was effective in reducing their CP for their primary pain region. The current results extend previously published work on CP within adults with NF1 and indicate that more emphasis on understanding and ameliorating CP is required. The NFPM is a sensitive clinical measure that provides qualitative and quantitative responses to inform medical providers about changes in CP.
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Affiliation(s)
- Frank D Buono
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | - William T Zempsky
- Connecticut Children's Medical Center, Hartford, Connecticut, USA
- University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | | | - Staci Martin
- National Cancer Institute, Bethesda, Maryland, USA
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Axon DR, Aliu O. Association between self-reported pain severity and characteristics of United States adults (age ≥50 years) who used opioids. Scand J Pain 2024; 24:sjpain-2023-0076. [PMID: 38452178 DOI: 10.1515/sjpain-2023-0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/28/2023] [Indexed: 03/09/2024]
Abstract
OBJECTIVE The aim of this study was to assess the associations between the characteristics of United States (US) adults (≥50 years) who used opioids and self-reported pain severity using a nationally representative dataset. METHODS This retrospective cross-sectional database study used 2019 Medical Expenditure Panel Survey data to identify US adults aged ≥50 years with self-reported pain within the past 4 weeks and ≥1 opioid prescription within the calendar year (n = 1,077). Weighted multivariable logistic regression analysis modeled associations between various characteristics and self-reported pain severity (quite a bit/extreme vs less/moderate pain). RESULTS The adjusted logistic regression model indicated that greater odds of reporting quite a bit/extreme pain was associated with the following: age 50-64 vs ≥65 (adjusted odds ratio [AOR] = 1.76; 95% confidence interval [CI] = 1.22-2.54), non-Hispanic vs Hispanic (AOR = 2.0; CI = 1.18-3.39), unemployed vs employed (AOR = 2.01; CI = 1.33-3.05), no health insurance vs private insurance (AOR = 6.80; CI = 1.43-32.26), fair/poor vs excellent/very good/good health (AOR = 3.10; CI = 2.19-4.39), fair/poor vs excellent/very good/good mental health (AOR = 2.16; CI = 1.39-3.38), non-smoker vs smoker (AOR = 1.80; CI = 1.19-2.71), and instrumental activity of daily living, yes vs no (AOR = 2.27; CI = 1.30-3.96). CONCLUSION Understanding the several characteristics associated with pain severity in US adults ≥50 years who used an opioid may help transform healthcare approaches to prevention, education, and management of pain severity in later life.
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Affiliation(s)
- David R Axon
- Department of Pharmacy Practice & Science, R. Ken Coit College of Pharmacy, University of Arizona, 1295 N Martin Ave, PO Box 210202, Tucson, Arizona, 85721, USA
- Center for Health Outcomes and PharmacoEconomic Research (HOPE Center), R. Ken Coit College of Pharmacy, University of Arizona, 1295 N Martin Ave, PO Box 210202, Tucson, Arizona, 85721, USA
| | - Oiza Aliu
- Department of Pharmacy Practice & Science, R. Ken Coit College of Pharmacy, University of Arizona, 1295 N Martin Ave, PO Box 210202, Tucson, Arizona, 85721, USA
- Center for Health Outcomes and PharmacoEconomic Research (HOPE Center), R. Ken Coit College of Pharmacy, University of Arizona, 1295 N Martin Ave, PO Box 210202, Tucson, Arizona, 85721, USA
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Kenney MO, Wilson S, Shah N, Bortsov A, Smith WR, Little J, Lanzkron S, Kanter J, Padrino S, Owusu-Ansah A, Cohen A, Desai P, Manwani D, Rehman SSU, Hagar W, Keefe F. Biopsychosocial Factors Associated With Pain and Pain-Related Outcomes in Adults and Children With Sickle Cell Disease: A Multivariable Analysis of the GRNDaD Multicenter Registry. J Pain 2024; 25:153-164. [PMID: 37544393 DOI: 10.1016/j.jpain.2023.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/08/2023]
Abstract
Pain is the primary symptomatic manifestation of sickle cell disease (SCD), an inherited hemoglobinopathy. The characteristics that influence pain experiences and outcomes in SCD are not fully understood. The primary objective of this study was to use multivariable modeling to examine associations of biopsychosocial variables with a disease-specific measure of pain interference known as pain impact. We conducted a secondary analysis of data from the Global Research Network for Data and Discovery national SCD registry. A total of 657 children and adults with SCD were included in the analysis. This sample was 60% female with a median age of 34 (interquartile range 26-42 years) and a chronic pain prevalence of 64%. The model accounted for 58% of the variance in pain impact. Low social (P < .001) and emotional (P < .001) functioning, increasing age (P = .004), low income (P < .001), and high acute painful episodes (P = .007) were most strongly associated with high pain impact in our multivariable model. Additionally, multivariable modeling of pain severity and physical function in 2 comparable samples of registry participants revealed that increasing age and low social functioning were also strongly associated with higher pain severity and low physical functioning. Overall, the results suggest that social and emotional functioning are more strongly associated with pain impact in individuals with SCD than previously studied biological modifiers such as SCD genotype, hemoglobin, and percentage fetal hemoglobin. Future research using longitudinally collected data is needed to confirm these findings. PERSPECTIVE: This study reveals that psychosocial (ie, social and emotional functioning) and demographic (ie, age) variables may play an important role in predicting pain and pain-related outcomes in SCD. Our findings can inform future multicenter prospective longitudinal studies aimed at identifying modifiable psychosocial predictors of adverse pain outcomes in SCD.
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Affiliation(s)
- Martha O Kenney
- Department of Anesthesiology, Division of Pediatric Anesthesiology, Duke University, Durham, North Carolina
| | - Samuel Wilson
- Department of Medicine, Division of Hematology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina; UNC Blood Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Nirmish Shah
- Departments of Pediatrics & Hematology, Duke University, Durham, North Carolina
| | - Andrey Bortsov
- Center for Translational Pain Medicine, Duke University, Durham, North Carolina
| | - Wally R Smith
- Division of General Internal Medicine, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Jane Little
- Department of Medicine, Division of Hematology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina; UNC Blood Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Sophie Lanzkron
- Department of Medicine, Division of Hematology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Julie Kanter
- Division of Hematology and Oncology, University of Alabama, Birmingham, Alabama
| | - Susan Padrino
- School of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Amma Owusu-Ansah
- Department of Pediatrics, Division of Pediatric Hematology Oncology, University Hospitals Rainbow Babies & Children's Hospital, Cleveland, Ohio
| | - Alice Cohen
- Division of Hematology and Oncology, Newark Beth Israel Medical Center, Newark, New Jersey
| | - Payal Desai
- Levin Cancer Institute, Atrium Health, Charlotte, North Carolina
| | - Deepa Manwani
- Department of Pediatrics, Albert Einstein College of Medicine and the Children's Hospital at Montefiore (CHAM), Bronx, New York
| | - Sana Saif Ur Rehman
- Department of Medicine, Division of Hematology, Washington University School of Medicine, St. Louis, Missouri
| | - Ward Hagar
- Department of Pediatrics, UCSF Benioff Children's Hospital, Oakland, California
| | - Francis Keefe
- Pain Prevention and Treatment Research Program, Department of Psychiatry and Behavioral Science, Duke University, Durham, North Carolina
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Catalá P, Gutiérrez L, Écija C, Peñacoba C. How to Generate Self-Efficacy despite Pain: The Role of Catastrophizing and Avoidance in Women with Fibromyalgia. Biomedicines 2023; 12:47. [PMID: 38255154 PMCID: PMC10812908 DOI: 10.3390/biomedicines12010047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 12/16/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Fibromyalgia-related pain is influenced by numerous factors, including severity, as well as cognitive profiles based on pain catastrophizing or activity patterns. In this context, self-efficacy is identified as a potential predictor for explaining certain health outcomes. This study aimed to contribute to exploring the role of pain avoidance (as activity pattern) between pain severity and self-efficacy along pain catastrophizing. METHODS Through a cross-sectional study, a total of 264 women with fibromyalgia completed self-report measures of pain severity, pain avoidance, pain catastrophizing, and self-efficacy. The severity of the symptoms, the time elapsed since diagnosis, and the time elapsed since the onsets of symptoms were included as covariates to control. Regression-based moderated-mediation analysis was used to test the conditional effect of pain severity on self-efficacy via pain avoidance at varying levels of pain catastrophizing. RESULTS Pain avoidance mediated the effect of pain severity on self-efficacy. The indirect effects showed a moderated effect when patients scored high on the pain catastrophizing scale. The model evaluated, where catastrophic pain moderates the indirect effect of pain intensity on self-efficacy through pain avoidance, explained 49% of the variance. CONCLUSIONS Catastrophic beliefs associated with pain as being uncontrollable increase the relationship between pain severity and pain avoidance. In turn, pain avoidance is associated with a low perception of capacity.
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Affiliation(s)
| | | | | | - Cecilia Peñacoba
- Department of Psychology, Rey Juan Carlos University, Avda. de Atenas s/n, 28922 Alcorcón, Madrid, Spain; (P.C.); (L.G.); (C.É.)
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Heikkala E, Oura P, Paananen M, Ho E, Ferreira P, Tanguay-Sabourin C, Karppinen J. Chronic disease clusters are associated with prolonged, bothersome, and multisite musculoskeletal pain: a population-based study on Northern Finns. Ann Med 2023; 55:592-602. [PMID: 36773018 PMCID: PMC9930817 DOI: 10.1080/07853890.2023.2177723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Chronic diseases often accumulate with musculoskeletal (MSK) pain. However, less evidence is available on idiosyncratic patterns of chronic diseases and their relationships with the severity of MSK pain in general MSK pain populations. MATERIAL AND METHODS Questionnaire-based data on physician-diagnosed chronic diseases, MSK pain and its dimensions (frequency, intensity, bothersomeness, and the number of pain sites), and confounders were collected from the Northern Finland Birth Cohort 1966 at the age of 46. Latent Class Analysis (LCA) was used to identify chronic disease clusters among individuals who reported any MSK pain within the previous year (n = 6105). The associations between chronic disease clusters, pain dimensions, and severe MSK pain, which was defined as prolonged (over 30 d within the preceding year), bothersome (Numerical Rating Scale >5), and multisite (two or more pain sites) pain, were analyzed using logistic regression and general linear regression models, adjusted for sex and educational level (n for the full sample = 4768). RESULTS LCA resulted in three clusters: Metabolic (10.8% of the full sample), Psychiatric (2.9%), and Relatively Healthy (86.3%). Compared to the Relatively Healthy cluster, the Metabolic and Psychiatric clusters had higher odds for daily pain and higher mean pain intensity, bothersomeness, and the number of pain sites. Similarly, the odds for severe MSK pain were up to 75% (95% confidence interval: 44%-113%) and 155% (81%-259%) higher in the Metabolic and Psychiatric clusters, respectively, after adjustments for sex and educational level. CONCLUSIONS Distinct patterns of chronic disease accumulation can be identified in the general MSK pain population. It seems that mental and metabolic health are at interplay with severe MSK pain. These findings suggest a potential need to screen for psychiatric and metabolic entities of health when treating working-aged people with MSK pain.Key messagesThis large study on middle-aged people with musculoskeletal pain aimed to examine the idiosyncratic patterns of chronic diseases and their relationships with the severity of musculoskeletal pain. Latent class cluster analysis identified three chronic disease clusters: Psychiatric, Metabolic, and Relatively Healthy. People with accumulated mental (Psychiatric cluster) or metabolic diseases (Metabolic cluster) experienced more severe pain than people who were relatively healthy (Relatively Healthy cluster). These findings suggest a potential need to screen for psychiatric and metabolic entities of health when treating working-aged people with MSK pain.
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Affiliation(s)
- Eveliina Heikkala
- Research Unit of Population Health, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Rovaniemi Health Center, Rovaniemi, Finland
| | - Petteri Oura
- Research Unit of Population Health, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Markus Paananen
- Research Unit of Population Health, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Western Uusimaa Wellbeing Services County, Social and Health Care Services, Espoo, Finland
| | - Emma Ho
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, University of Sydney, Sydney, Australia.,Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, University of Sydney, Sydney, Australia
| | - Paulo Ferreira
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Christophe Tanguay-Sabourin
- Alan Edwards Pain Centre for Research on Pain, McGill University, Montreal, Canada.,Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Jaro Karppinen
- Research Unit of Population Health, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Rehabilitation Services of South Karelia Social and Health Care District, Lappeenranta, Finland
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11
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Bao JD, Rosser MA, Park SH, Baker AK, Martucci KT. Interplay between noxious heat sensitivity and temporal summation magnitude in patients with fibromyalgia and long-term opioid use. Front Neurosci 2023; 17:1275921. [PMID: 37901425 PMCID: PMC10600517 DOI: 10.3389/fnins.2023.1275921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction In chronic pain conditions such as fibromyalgia (FM), pain amplification within the central nervous system, or "central sensitization," may contribute to the development and maintenance of chronic pain. Chronic pain treatments include opioid therapy, and opioid therapy may maladaptively increase central sensitization, particularly in patients who take opioids long-term. However, it has remained unknown how central sensitization is impacted in patients who use opioids long-term. Methods To investigate how long-term opioid therapy affects central sensitization, we used the validated measure of temporal summation. The temporal summation measurement consists of applying a series of noxious stimuli to a patient's skin and then calculating changes in the patient's pain rating to each stimulus. Using this measurement, we evaluated temporal summation in study participants with fibromyalgia who take opioids long-term (i.e., greater than 90 days duration; n = 24, opioid-FM). We compared opioid-FM responses to 2 control groups: participants with fibromyalgia who do not take opioids (n = 33, non-opioid FM), and healthy controls (n = 31). For the temporal summation measurement, we applied a series of 10 noxious heat stimuli (sensitivity-adjusted temperatures) to the ventral forearm (2s duration of each stimulus, applied once every 3 s). Additionally, we collected responses to standard pain and cognitive-affective questionnaires to assess pain severity and other factors. Results and discussion Group differences in sensitivity-adjusted stimulus temperatures were observed, with only the non-opioid FM group requiring significantly lower stimulus temperatures (The opioid-FM group also required lower temperatures, but not significantly different from the control group). However, all 3 groups exhibited similar magnitudes of temporal summation. Across combined FM groups, temporal summation negatively correlated with pain severity (r = -0.31, p = 0.021). Within the opioid-FM group, higher pain sensitivity to heat (i.e., lower sensitivity-adjusted temperatures) showed a trend relationship with higher opioid dosage (r = -0.45, p = 0.036), potentially reflective of opioid-related hyperalgesia. Our findings also indicated that heightened pain severity may skew sensitivity-adjusted temporal summation, thereby limiting its utility for measuring central sensitization. Overall, in participants taking opioids, temporal summation may be influenced by hypersensitivity to heat pain, which appeared to vary with opioid dosage.
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Affiliation(s)
- Jason D. Bao
- Human Affect and Pain Neuroscience Laboratory, Department of Anesthesiology, Duke University Medical Center, Durham, NC, United States
- Center for Translational Pain Medicine, Duke University Medical Center, Durham, NC, United States
| | - Morgan A. Rosser
- Department of Anesthesiology, Biostatistics Group, Duke University School of Medicine, Durham, NC, United States
| | - Su Hyoun Park
- Human Affect and Pain Neuroscience Laboratory, Department of Anesthesiology, Duke University Medical Center, Durham, NC, United States
- Center for Translational Pain Medicine, Duke University Medical Center, Durham, NC, United States
| | - Anne K. Baker
- Human Affect and Pain Neuroscience Laboratory, Department of Anesthesiology, Duke University Medical Center, Durham, NC, United States
- Center for Translational Pain Medicine, Duke University Medical Center, Durham, NC, United States
| | - Katherine T. Martucci
- Human Affect and Pain Neuroscience Laboratory, Department of Anesthesiology, Duke University Medical Center, Durham, NC, United States
- Center for Translational Pain Medicine, Duke University Medical Center, Durham, NC, United States
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12
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Ueareekul S, Changratanakorn C, Tianwibool P, Meelarp N, Wongtanasarasin W. Accuracy of Pain Scales in Predicting Critical Diagnoses in Non-Traumatic Abdominal Pain Cases; a Cross-sectional Study. Arch Acad Emerg Med 2023; 11:e68. [PMID: 38028934 PMCID: PMC10646955 DOI: 10.22037/aaem.v11i1.2131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Introduction Accurate assessment and management of abdominal pain in the emergency department (ED) is crucial, as it can indicate potentially life-threatening conditions requiring timely treatment. This study aimed to evaluate the ability of pain scales to predict critical diagnoses in patients with non-traumatic abdominal pain. Methods This cross-sectional study was conducted at a tertiary university hospital and involved individuals aged 15 years and above who presented to the ED with non-traumatic abdominal pain. Pain severity was evaluated using subjective pain scales, including the Numerical Rating Scale (NRS) and the Face Pain Scale (FPS), as well as objective pain scales, including the Critical Care Pain Observation Tool (CPOT) and the Non-verbal Pain Score (NVPS). The area under the receiver operating characteristic curve (AuROC) was employed to determine the discriminative ability of each pain scale to predict critical diagnosis. Results 264 cases with the mean age of 47.2±19.4 years were studied (53.0% male). The most common location of abdominal pain was epigastric pain (43.9%). Most patients presented with dull-aching pain, and those with critical diagnoses had more of this characteristic than those with non-critical diagnoses. (52.5% vs. 28.3%, p = 0.01). The overall median NRS, FPS, CPOT, and NVPS of included participants were 8 (interquartile range (IQR) 7-10), 8 (IQR 6-8), 3 (IQR 1-4), and 3 (IQR 2-4), respectively. Patients with critical diagnoses had a higher NVPS score than patients with non-critical diagnoses (median score of 4 vs. 3, p = 0.02). The AuROC of NRS, FPS, CPOT, and NVPS were 0.53 (95% CI: 0.45-0.62), 0.55 (95% CI: 0.46-0.63), 0.59 (95% CI: 0.50-0.68), and 0.62 (95% CI: 0.53-0.71), respectively. The correlation coefficients among these scales were considered moderately correlated or higher. Conclusion In evaluating patients with non-traumatic abdominal pain, the NVPS demonstrated the highest accuracy in predicting critical diagnoses. However, all pain scales, whether subjective or objective, exhibited suboptimal performance in predicting critical diagnoses.
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Affiliation(s)
- Supapilai Ueareekul
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Chanon Changratanakorn
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Parinya Tianwibool
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Nattikarn Meelarp
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Wachira Wongtanasarasin
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California 95817, United States of America
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13
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Taub C, Gordon KS, Goulet J, Lee A, Mayhew M, Von Korff M, DeBar L, Kerns RD. Graded chronic pain scale revised: validation in a Veteran sample. Pain Med 2023; 24:1169-1175. [PMID: 37220899 PMCID: PMC10546477 DOI: 10.1093/pm/pnad068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/11/2023] [Accepted: 05/18/2023] [Indexed: 05/25/2023]
Abstract
OBJECTIVE The Graded Chronic Pain Scale (GCPS) is frequently used in pain research and treatment to classify mild, bothersome, and high impact chronic pain. This study's objective was to validate the revised version of the GCPS (GCPS-R) in a US Veterans Affairs (VA) healthcare sample to support its use in this high-risk population. METHODS Data were collected from Veterans (n = 794) via self-report (GCPS-R and relevant health questionnaires) and electronic health record extraction (demographics and opioid prescriptions). Logistic regression, adjusting for age and gender, was used to test for differences in health indicators by pain grade. Adjusted odds ratio (AOR) with 95% confidence intervals (CIs) were reported with CIs not including an AOR of 1 indicating that the difference exceeded chance. RESULTS In this population, the prevalence of chronic pain (pain present most or every day, prior 3 months) was 49.3%: 7.1% with mild chronic pain (mild pain intensity and lower interference with activities); 23.3% bothersome chronic pain (moderate to severe pain intensity with lower interference); and 21.1% high impact chronic pain (higher interference). Results of this study mirrored findings in the non-VA validation study; differences between bothersome and high impact were consistent for activity limitations and present but not fully consistent for psychological variables. Those with bothersome chronic pain or high impact chronic pain were more likely to receive long-term opioid therapy compared to those with no/mild chronic pain. CONCLUSIONS Findings highlight categorical differences captured with the GCPS-R, and convergent validity supports use of the GCPS-R in US Veterans.
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Affiliation(s)
- Chloe Taub
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, United States
- Blue Note Therapeutics, San Fransisco, CA 94104, United States
| | - Kirsha S Gordon
- Pain Research, Informatics, Multimorbidiities, and Education (PRIME) Center of Innovation, VA Connecticut Healthcare System, West Haven, CT 06516, United States
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06511, United States
| | - Joseph Goulet
- Pain Research, Informatics, Multimorbidiities, and Education (PRIME) Center of Innovation, VA Connecticut Healthcare System, West Haven, CT 06516, United States
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT 06511, United States
| | - Allison Lee
- Pain Research, Informatics, Multimorbidiities, and Education (PRIME) Center of Innovation, VA Connecticut Healthcare System, West Haven, CT 06516, United States
- Departments of Psychiatry, Neurology, and Psychology, Yale University, New Haven, CT 06511, United States
| | - Meghan Mayhew
- Kaiser Permanente Center for Health Research, Portland, OR 97227, United States
| | - Michael Von Korff
- Kaiser Permanente Washington Health Research Institute, Seattle, WA 98101, United States
| | - Lynn DeBar
- Kaiser Permanente Center for Health Research, Portland, OR 97227, United States
- Kaiser Permanente Washington Health Research Institute, Seattle, WA 98101, United States
| | - Robert D Kerns
- Pain Research, Informatics, Multimorbidiities, and Education (PRIME) Center of Innovation, VA Connecticut Healthcare System, West Haven, CT 06516, United States
- Departments of Psychiatry, Neurology, and Psychology, Yale University, New Haven, CT 06511, United States
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14
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Čepukienė V, Puzerienė E. Examining pain severity in women with rheumatoid arthritis: the impact of pain self-efficacy and perceived partner's emotional support. Health Psychol Rep 2023; 12:14-25. [PMID: 38425891 PMCID: PMC10900974 DOI: 10.5114/hpr/167803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 05/15/2023] [Accepted: 06/09/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Empirical data suggest that psychosocial factors, such as pain self-efficacy (PSE) and emotional support from a partner, may alleviate the suffering caused by rheumatoid arthritis (RA) pain. However, the data are ambiguous and warrant a more comprehensive investigation into the effect of these factors on the severity of RA pain. The objective of the present study was to assess the significance of PSE and emotional support from a partner in relation to pain severity among women with RA. PARTICIPANTS AND PROCEDURE The study included a sample of 196 women diagnosed with RA with the mean age of 41.54. The study employed the following measures: Rheumatoid Arthritis Pain Scale, Pain Self-efficacy Questionnaire, and Communication Based Emotional Support Scale. RESULTS The analysis revealed that higher PSE emerged as the strongest predictor for lower pain severity across all components of RA pain. However, the impact of the partner's emotional support on pain severity was not as evident and varied depending on the specific pain component. Furthermore, the use of pain medications significantly predicted three out of four pain components. Mediation analysis revealed that perceived emotional support from a partner directly affected women's RA pain intensity, as well as indirectly through the PSE as a mediator. Moderated mediation analysis demonstrated that the association between PSE and pain severity weakened as the duration of RA increased. CONCLUSIONS Enhancing women's PSE and providing appropriate training for their partners to offer effective emotional support may play a crucial role in the treatment of RA.
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Affiliation(s)
| | - Erika Puzerienė
- Department of Psychology, Vytautas Magnus University, Kaunas, Lithuania
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15
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Zalah MA, Alsobayel HI, Algarni FS, Vennu V, Ajeebi ZH, Maeshi HM, Bindawas SM. The Severity of Pain and Comorbidities Significantly Impact the Dependency on Activities of Daily Living among Musculoskeletal Patients in Jizan, Saudi Arabia. Healthcare (Basel) 2023; 11:2313. [PMID: 37628510 PMCID: PMC10454086 DOI: 10.3390/healthcare11162313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/07/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
Limited research has been carried out on the effects of pain, comorbidity, and impaired function in musculoskeletal patients in Jizan, Saudi Arabia. A cross-sectional study was conducted on 115 patients (aged ≥ 55 years) with physician-diagnosed musculoskeletal conditions in Jizan to investigate the association between pain severity, comorbidities, and dependence on activities of daily living (ADLs). Self-reported questionnaires were used to collect data on pain, comorbidities, and physical function measured by ADLs. In ADLs, participants were categorized as dependent (n = 36) or independent (n = 79). Logistic regression analysis was employed to determine the predictors of dependence. The results showed that higher pain severity (adjusted odds ratio (OR): 1.69, 95% confidence interval (CI): 1.21-2.38, p = 0.002) and a greater number of comorbidities (adjusted OR: 1.52, 95% CI: 1.06-2.17, p = 0.021) were independently associated with dependence in ADLs. These associations remained significant even after controlling for covariates. This study concluded that patients with musculoskeletal conditions in Jizan who experience high levels of pain and comorbidities are at risk of dependence on basic daily activities. Therefore, addressing pain and comorbidities is crucial for maintaining independence and improving quality of life. Personalized rehabilitation programs are needed to manage these conditions in this region.
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Affiliation(s)
- Mohammed A. Zalah
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
- Medical Rehabilitation Center, King Fahad Central Hospital, Jazan 82666, Saudi Arabia
| | - Hana I. Alsobayel
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Fahad S. Algarni
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Vishal Vennu
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Zohoor H. Ajeebi
- Department of Physical Therapy, Ahad Al Mosaraha Hospital, Jazan 86289, Saudi Arabia
| | - Hatem M. Maeshi
- Medical Rehabilitation Center, King Fahad Central Hospital, Jazan 82666, Saudi Arabia
| | - Saad M. Bindawas
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
- King Salman Center for Disability Research, Riyadh 11614, Saudi Arabia
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16
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Dowding C, Mikocka-Walus A, Skvarc D, Van Niekerk L, O'Shea M, Olive L, Druitt M, Evans S. The temporal effect of emotional distress on psychological and physical functioning in endometriosis: A 12-month prospective study. Appl Psychol Health Well Being 2023; 15:901-918. [PMID: 36333097 DOI: 10.1111/aphw.12415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
Abstract
Psychological factors of emotional distress and cognition have an important role in the understanding and management of endometriosis; however, their temporal relationship with key pain variables is not fully understood. This exploratory study sought to establish the temporal relationship between psychological and pain-related factors in a 12-month prospective study of 208 Australian women with endometriosis. Participants, aged 18-50 years and living in Australia, were recruited via social media and completed baseline (May 2019) and 12-month follow-up (June 2020) surveys. Participants who reported a diagnosis of endometriosis and menses in the past 12 months were included in the study. Structural equation modelling was used to determine the temporal effects of psychological and pain-related factors in endometriosis. In a covariate-adjusted model, baseline emotional distress was the only variable to predict pain catastrophizing (β = .24, p < .01), functional pain disability (β = .16, p < .05) and concomitant emotional distress (β = .55, p < .001) 12 months later, adjusting for age and chronic illness. Women who exhibit symptoms of distress may be at risk of poorer psychological and physical function at 12 months. Further research is required to understand the impact of psychological management early in the disease course.
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Affiliation(s)
| | - Antonina Mikocka-Walus
- School of Psychology, Deakin University Geelong, Geelong, Australia
- Faculty of Health, The Centre for Social and Early Emotional Development, Deakin University, Geelong, Australia
| | - David Skvarc
- School of Psychology, Deakin University Geelong, Geelong, Australia
| | - Leesa Van Niekerk
- School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - Melissa O'Shea
- School of Psychology, Deakin University Geelong, Geelong, Australia
| | - Lisa Olive
- School of Psychology, Deakin University Geelong, Geelong, Australia
- Faculty of Health, The Centre for Social and Early Emotional Development, Deakin University, Geelong, Australia
- IMPACT Institute, Faculty of Health, Deakin University Geelong, Geelong, Australia
| | - Marilla Druitt
- University Hospital Geelong, Geelong, Australia
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Subhadra Evans
- School of Psychology, Deakin University Geelong, Geelong, Australia
- Faculty of Health, The Centre for Social and Early Emotional Development, Deakin University, Geelong, Australia
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17
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Fisher HM, Hyland KA, Winger JG, Miller SN, Amaden GH, Diachina AK, Kelleher SA, Somers TJ. Effect of Pain Coping Skills Training on Pain and Pain Medication Use for Women With Breast Cancer. J Pain Symptom Manage 2023; 66:70-79. [PMID: 37028732 PMCID: PMC10330043 DOI: 10.1016/j.jpainsymman.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 04/09/2023]
Abstract
CONTEXT Pain is distressing for women with breast cancer. Pain medication may not provide full relief and can have negative side-effects. Cognitive-behavioral pain intervention protocols reduce pain severity and improve self-efficacy for pain management. These interventions' impact on pain medication use is less clear. Intervention length and coping skills use might play a role in pain outcomes. OBJECTIVES Secondary analysis to examine differences in pain severity, pain medication use, pain self-efficacy, and coping skill use after five- and one-session cognitive-behavioral pain intervention protocols. Pain self-efficacy and coping skills use were assessed as mediators of intervention effects on pain and pain medication use. METHODS Women (N = 327) with stage I-III breast cancer were enrolled in a randomized trial comparing individually-delivered, five- and one-session pain coping skills training (PCST). Pain severity, pain medication use, pain self-efficacy, and coping skills use were assessed preintervention and five to eight weeks later (postintervention). RESULTS Pain and pain medication use significantly decreased, while pain self-efficacy increased pre-post for women randomized to both conditions (P's <.05). Five-session PCST participants demonstrated less pain (P =.03) and pain medication use (P =.04), and more pain self-efficacy (P =.02) and coping skills use (P =.04) at postintervention compared to one-session PCST participants. Pain self-efficacy mediated the relationship of intervention condition with pain and pain medication use. CONCLUSION Both conditions led to improvements in pain, pain medication use, pain self-efficacy, and coping skills use, and 5-session PCST showed the greatest benefits. Brief cognitive-behavioral pain intervention improve pain outcomes, and pain self-efficacy may play a role in these effects.
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Affiliation(s)
- Hannah M Fisher
- Department of Psychiatry and Behavioral Sciences (H.M.F, K.A.H., J.G.W., S.N.F., G.H.A., A.K.D. S.A.K., T.J.S.), Duke University Medical Center, Durham, North Carolina, USA.
| | - Kelly A Hyland
- Department of Psychiatry and Behavioral Sciences (H.M.F, K.A.H., J.G.W., S.N.F., G.H.A., A.K.D. S.A.K., T.J.S.), Duke University Medical Center, Durham, North Carolina, USA
| | - Joseph G Winger
- Department of Psychiatry and Behavioral Sciences (H.M.F, K.A.H., J.G.W., S.N.F., G.H.A., A.K.D. S.A.K., T.J.S.), Duke University Medical Center, Durham, North Carolina, USA
| | - Shannon N Miller
- Department of Psychiatry and Behavioral Sciences (H.M.F, K.A.H., J.G.W., S.N.F., G.H.A., A.K.D. S.A.K., T.J.S.), Duke University Medical Center, Durham, North Carolina, USA
| | - Grace H Amaden
- Department of Psychiatry and Behavioral Sciences (H.M.F, K.A.H., J.G.W., S.N.F., G.H.A., A.K.D. S.A.K., T.J.S.), Duke University Medical Center, Durham, North Carolina, USA
| | - Allison K Diachina
- Department of Psychiatry and Behavioral Sciences (H.M.F, K.A.H., J.G.W., S.N.F., G.H.A., A.K.D. S.A.K., T.J.S.), Duke University Medical Center, Durham, North Carolina, USA
| | - Sarah A Kelleher
- Department of Psychiatry and Behavioral Sciences (H.M.F, K.A.H., J.G.W., S.N.F., G.H.A., A.K.D. S.A.K., T.J.S.), Duke University Medical Center, Durham, North Carolina, USA
| | - Tamara J Somers
- Department of Psychiatry and Behavioral Sciences (H.M.F, K.A.H., J.G.W., S.N.F., G.H.A., A.K.D. S.A.K., T.J.S.), Duke University Medical Center, Durham, North Carolina, USA
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18
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Jain D, Bernstein CN, Graff LA, Patten SB, Bolton JM, Fisk JD, Hitchon C, Marriott JJ, Marrie RA. Pain and participation in social activities in people with relapsing remitting and progressive multiple sclerosis. Mult Scler J Exp Transl Clin 2023; 9:20552173231188469. [PMID: 37483527 PMCID: PMC10359714 DOI: 10.1177/20552173231188469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/30/2023] [Indexed: 07/25/2023] Open
Abstract
Background Differences in pain between subtypes of multiple sclerosis are understudied. Objective To compare the prevalence of pain, and the association between pain and: (a) pain interference and (b) social participation in people with relapsing-remitting multiple sclerosis and progressive multiple sclerosis. Methods Participants completed the McGill Pain Questionnaire Short-Form-2, Pain Effects Scale and Ability to Participate in Social Roles and Activities-V2.0 questionnaires. We tested the association between multiple sclerosis subtype, pain severity, and pain interference/social participation using quantile regression. Results Of 231 participants (relapsing-remitting multiple sclerosis: 161, progressive multiple sclerosis: 70), 82.3% were women. The prevalence of pain was 95.2%, of more than mild pain was 38.1%, and of pain-related limitations was 87%; there were no differences between multiple sclerosis subtypes. Compared to participants with relapsing-remitting multiple sclerosis, those with progressive multiple sclerosis reported higher pain interference (mean (standard deviation) Pain Effects Scale; progressive multiple sclerosis: 15[6.0] vs relapsing-remitting multiple sclerosis: 13[5], p = 0.039) and lower social participation (Ability to Participate in Social Roles and Activities T-scores 45[9.0] vs 48.3[8.9], p = 0.011). However, on multivariable analysis accounting for age, physical disability, mood/anxiety and fatigue, multiple sclerosis subtype was not associated with differences in pain interference or social participation. Conclusions Pain was nearly ubiquitous. Over one-third of individuals with relapsing-remitting multiple sclerosis and progressive multiple sclerosis reported pronounced pain, although this did not differ by multiple sclerosis subtype.
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Affiliation(s)
- Dhruv Jain
- Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Charles N Bernstein
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Lesley A Graff
- Department of Clinical Health Psychology, Max Rady College of Medicine Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Scott B Patten
- Departments of Community Health Sciences & Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - James M Bolton
- Department of Psychiatry, Max Rady College of Medicine Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - John D Fisk
- Nova Scotia Health Authority, Departments of Psychiatry, Psychology & Neuroscience, and Medicine, Dalhousie University, Halifax, Canada
| | - Carol Hitchon
- Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - James J Marriott
- Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- St. Michael's Hospital, Toronto, Canada
| | - Ruth Ann Marrie
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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Fjeld MK, Årnes AP, Engdahl B, Morseth B, Hopstock LA, Horsch A, Stubhaug A, Strand BH, Nielsen CS, Steingrímsdóttir ÓA. Consistent pattern between physical activity measures and chronic pain levels: the Tromsø Study 2015 to 2016. Pain 2023; 164:838-847. [PMID: 36083173 PMCID: PMC10026831 DOI: 10.1097/j.pain.0000000000002773] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 01/13/2023]
Abstract
ABSTRACT Epidemiological literature on the relationship between physical activity and chronic pain is scarce and inconsistent. Hence, our aim was to assess the relationship applying comprehensive methodology, including self-reported and accelerometer measures of physical activity and different severity levels of chronic pain. We used data from the Tromsø Study (2015-2016). All residents in the municipality, aged 40 years and older were invited to participate (n = 32,591, 51% women). A total of 21,083 (53%) women reported on questionnaires. Additionally, 6778 participants (54% women) were invited to wear accelerometers (6125 with complete measurements). Our exposure measures were self-reported leisure time physical activity, exercise frequency, duration, and intensity and 2 accelerometer measures (steps per day and minutes of moderate to vigorous physical activity per day). Outcome measurements were chronic pain and moderate-to-severe chronic pain. We used Poisson regression to estimate chronic pain prevalence and prevalence ratios for each physical activity measure, with adjustments for sex, age, education level, smoking history, and occupational physical activity. Our main analyses showed an inverse dose-response relationship between all physical activity measures and both severity measures of chronic pain, except that the dose-response relationship with exercise duration was only found for moderate-to-severe pain. All findings were stronger for the moderate-to-severe pain outcomes than for chronic pain. Robustness analyses gave similar results as the main analyses. We conclude that an inverse dose-response association between physical activity and chronic pain is consistent across measures. To summarize, higher levels of physical activity is associated with less chronic pain and moderate-to-severe chronic pain.
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Affiliation(s)
- Mats Kirkeby Fjeld
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Bo Engdahl
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Laila Arnesdatter Hopstock
- Departments of Department of Health and Care Sciences, UiT The Artic University of Norway, Tromsø, Norway
| | - Alexander Horsch
- Division of Emergencies and Critical Care, Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Audun Stubhaug
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Emergencies and Critical Care, Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Bjørn Heine Strand
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Norwegian National Advisory Unit on Ageing and Health, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Christopher Sivert Nielsen
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Division of Emergencies and Critical Care, Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Ólöf Anna Steingrímsdóttir
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Division of Emergencies and Critical Care, Department of Research and Development, Oslo University Hospital, Oslo, Norway
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20
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Kakati B, Nair N, Chatterjee A. Post mastectomy pain syndrome at an Indian tertiary cancer centre and its impact on quality of life. Indian J Cancer 2023; 60:275-281. [PMID: 37530253 DOI: 10.4103/ijc.ijc_861_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
Background Literature on Post mastectomy pain in the Indian population is scarce. Most literature is from the West. The current study aimed to identify the incidence of post-mastectomy pain syndrome (PMPS), pain severity, and its impact on quality of life in Indian patients. Method Prospective observational study of 120 women undergoing mastectomy between March and December 2017, followed until 6 months after surgery. The Brief Pain Inventory (BPI) questionnaire and the quality of life questionnaire (QLQ) by the European Organization for Research and Treatment of Cancer (EORTC) and known as (EORTC-QLQ 30) were used to identify the impact on function and quality of life. Results A 35.8% PMPS incidence was identified at 6 months after mastectomy. Pain was located in the anterior chest wall (41.8%), axilla (32.6%), and medial upper arm (25.6%). Most (48.8%) patients described it as dull aching and of mild intensity (55.8%). No significant association of age, BMI, surgery, Intercostobrachial nerve (ICBN) dissection, postoperative pain severity, pain history {dysmenorrhea, headache}, and postoperative radiotherapy with PMPS was found. Pain interfered with daily activities and quality of life in those with PMPS, as deduced from BPI and EORTC-QLQ. Conclusion PMPS is very much a problem affecting the quality of life in our set of patients. Most women tried to cope and accept the pain as part of the treatment process. This shows the need for creating awareness about PMPS among healthcare providers and patients alike. Early identification and treatment of post mastectomy pain should be an essential aspect of patient care.
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Affiliation(s)
- Barnali Kakati
- Department of Anesthesia, Critical Care and Pain, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Nita Nair
- Department of Surgery, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Aparna Chatterjee
- Department of Anesthesia, Critical Care and Pain, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, Maharashtra, India
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21
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ALMohiza MA, Reddy RS, Asiri F, Alshahrani A, Tedla JS, Dixit S, Gular K, Kakaraparthi VN. The Mediation Effect of Pain on the Relationship between Kinesiophobia and Lumbar Joint Position Sense in Chronic Low Back Pain Individuals: A Cross-Sectional Study. Int J Environ Res Public Health 2023; 20:ijerph20065193. [PMID: 36982105 PMCID: PMC10049448 DOI: 10.3390/ijerph20065193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 02/27/2023] [Accepted: 03/14/2023] [Indexed: 06/10/2023]
Abstract
(1) Background: Fear of movement (kinesiophobia) and impaired lumbar joint position sense (LJPS) play a vital role in developing and maintaining non-specific chronic low back pain (CLBP). However, how kinesiophobia impacts LJPS is still being determined. The aims of this study are to (1) assess the correlation between kinesiophobia and LJPS in individuals with chronic low back pain; (2) compare LJPS between individuals with CLBP and those who are asymptomatic; and (3) evaluate if pain can mediate the relationship between kinesiophobia and LJPS in CLBP individuals. (2) Methods: Eighty-three individuals (mean age = 48.9 ± 7.5 years) with a diagnosis of CLBP and 95 asymptomatic individuals (mean age = 49.4 ± 7.0 years) were recruited into this cross-sectional study. Fear of movement in CLBP individuals was assessed using the Tampa Scale for Kinesiophobia (TSK). LJPS was determined using the active target repositioning technique using a dual-digital inclinometer. LJPS was evaluated in lumbar flexion, extension, and side-bending left and right directions, and the repositioning accuracy was determined in degrees using a dual digital inclinometer. (3) Results: Kinesiophobia showed a significant (p < 0.001) moderate positive correlation with LJPS (flexion: r = 0.51, extension: r = 0.41, side-bending left: r = 0.37 and side-bending right: r = 0.34). LJPS errors were larger in CLBP individuals compared to asymptomatic individuals (p < 0.05). Mediation analyses showed that pain significantly mediated the relationship between kinesiophobia and LJPS (p < 0.05) in CLBP individuals. (4) Conclusions: Kinesiophobia and LJPS were positively associated. LJPS is impaired in CLBP individuals compared to asymptomatic individuals. Pain may mediate adverse effects on LJPS. These factors must be taken into account when assessing and developing treatment plans for those with CLBP.
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Affiliation(s)
- Mohammad A. ALMohiza
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11362, Saudi Arabia
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Faisal Asiri
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Adel Alshahrani
- Department of Physical Therapy, College of Applied Medical Sciences, Najran University, Najran 55461, Saudi Arabia
| | - Jaya Shanker Tedla
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Snehil Dixit
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Kumar Gular
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Venkata Nagaraj Kakaraparthi
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
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22
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Panisch LS, Rogers RG, Breen MT, Nutt S, Dahud S, Salazar CA. Dissociation Among Women with Chronic Pelvic Pain: Relation to Surgical Treatment, Pelvic Pain Severity, and Health-Related Quality of Life. J Trauma Dissociation 2023; 24:296-311. [PMID: 36744637 DOI: 10.1080/15299732.2023.2168828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Chronic pelvic pain (CPP) is associated with a history of trauma and symptoms of somatoform dissociation. We aimed to describe how somatoform dissociation impacts CPP symptoms, surgical treatment, and health-related quality of life (HRQOL). Patients (N = 133) diagnosed with CPP presenting for an appointment at a women's health clinic between November, 2019 - July, 2021 were recruited to participate in a cross-sectional study and complete a survey assessing symptoms of somatoform dissociation, post-traumatic stress disorder (PTSD), pelvic pain severity, history of CPP-related surgeries, and mental and physical HRQOL. We also conducted a post-hoc analysis assessing correlations of individual symptom items on the Somatoform Dissociation Questionnaire (SDQ-20) with HRQOL outcomes. We did not find a relationship between somatoform dissociation and pelvic pain severity or surgical history. Physical HRQOL outcomes were related to somatoform dissociation, PTSD symptoms, and pelvic pain severity, while mental HRQOL outcomes were connected to somatoform dissociation and PTSD symptoms. Our study reveals preliminary evidence suggesting that among CPP patients, HRQOL outcomes are affected by unique profiles of positive and negative symptoms of somatoform dissociation, including sensory disturbances, localized genital pain, and generalized numbness and bodily analgesia. Addressing specific symptoms of somatoform dissociation may enhance HRQOL among trauma-exposed women with CPP. Replication studies are needed to validate our findings. Integrating trauma-informed approaches, including standardized evaluations of trauma exposure and symptoms of somatoform dissociation into routine care for women with CPP is encouraged.
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Affiliation(s)
- Lisa S Panisch
- School of Social Work, Wayne State University, Detroit, Michigan, USA
| | - Rebecca G Rogers
- Department of Obstetrics and Gynecology, Albany Medical Center, Albany, New York, USA
| | - Michael T Breen
- Department of Women's Health, Dell Medical School, University of Texas at Austin, Health Transformation Building, Austin, Texas, USA
| | - Stephanie Nutt
- Department of Women's Health, University of Texas at Austin, Health Transformation Building, Austin, Texas, USA
| | - Soraya Dahud
- Department of Women's Health, University of Texas at Austin, Health Transformation Building, Austin, Texas, USA
| | - Christina A Salazar
- Department of Obstetrics and Gynecology, Albany Medical Center, Albany, New York, USA
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23
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Schepman P, Robinson R, Blakeman KH, Wilhelm S, Beck C, Hallberg S, Liseth-Hansen J, De Geer A, Rolfson O, Arendt-Nielsen L. Factors influencing quality of life in patients with osteoarthritis: analyses from the BISCUITS study. Scand J Pain 2023; 23:139-148. [PMID: 35787832 DOI: 10.1515/sjpain-2021-0213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 06/14/2022] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Osteoarthritis can have a profound effect on patients' quality of life. The Burden of Disease and Management of Osteoarthritis and Chronic Low Back Pain: Health Care Utilization and Sick Leave in Sweden, Norway, Finland and Denmark (BISCUITS) study aimed to describe the impact of osteoarthritis on quality of life and determine the association with factors such as pain severity and pharmacological treatment. METHODS An observational study was performed with a cross-sectional design including patients with a confirmed osteoarthritis diagnosis enrolled in the National Quality Register for Better management of patients with Osteoarthritis (BOA) between 2016 and 2017 in Sweden. Patient-reported information from BOA was linked to administrative data from three national health registers. The impact of osteoarthritis on quality of life was estimated using the EQ-5D-5L and the first developed experienced-based time-trade-off value set for Sweden to calculate the EQ-5D-5L index scores. EQ-5D-3L index scores were also estimated based on a UK hypothetical value set via a crosswalk method. Ordinary least squares regression models were used to analyse the association between quality of life and potential influencing factors. RESULTS For the 34,254 patients evaluated, mean EQ-5D-5L index score was 0.792 (SD 0.126). Stratifications showed that the index score varied across different levels of pain severity. Increased pain severity and use of pain-relieving medications remained significantly associated with a lower quality of life index score when controlled for potential confounders. The mean EQ-5D-3L index score was 0.605 (SD 0.192). CONCLUSIONS This large population-based study from Sweden highlights the substantial impact of osteoarthritis on quality of life amongst different patient groups and that currently available treatment options for osteoarthritis pain do not appropriately address the needs for many osteoarthritis patients.
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Affiliation(s)
| | | | | | - Stefan Wilhelm
- Eli Lilly International Medical Affairs, Bad Homburg, Germany
| | | | | | | | | | - Ola Rolfson
- University of Gothenburg, Gothenburg, Sweden
| | - Lars Arendt-Nielsen
- Department of Health Science and Technology, Center for Neuroplasticity and Pain (CNAP), SMI, School of Medicine, Aalborg University, Aalborg, Denmark
- Department of Medical Gastroenterology (Mech-Sense), Aalborg University Hospital, Aalborg, Denmark
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24
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Baravarian B, DiDomenico LA, Volteau M, Armstrong DG, Silva R. Exploring the Relationship Between Clinical Presentation in Hallux Valgus and Response to AbobotulinumtoxinA Treatment. J Foot Ankle Surg 2023; 62:556-562. [PMID: 36804286 DOI: 10.1053/j.jfas.2022.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 12/20/2022] [Accepted: 12/27/2022] [Indexed: 01/20/2023]
Abstract
The relationship between pain/disability and angular deviation of the hallux valgus (HV), and the impact of orthotic use, laterality, and pain variability on treatment outcomes remain unclear. This was explored in post hoc analyses of a placebo-controlled trial of abobotulinumtoxinA (aboBoNT-A; Dysport®) for HV-associated pain (NCT03569098). The primary endpoint was not met in this study (change from baseline Numeric Pain Rating Scale [NPRS] score vs placebo at week 8); however, there was a greater reduction from baseline in mean NPRS score at week 12 with aboBoNT-A 500U versus placebo (p = .06). Adults with painful HV without surgery were randomized (1:1:1) to aboBoNT-A 300U, aboBoNT-A 500U, or placebo. NPRS was completed for 7 days before baseline and weeks 4, 8, and 12. Over-the-counter orthoses were permitted. Participants (N = 186) had a mean [standard deviation, SD] age of 48.2 [13.1] years, 18% (33/186) used orthotics, and 67% (124/186) had bilateral HV. No associations between baseline pain severity and angular deviation were identified. Participants with high pain variability at baseline (SD > 2) had a poorer response to aboBoNT-A treatment than those with less variability. In conclusion, no relationship between HV-related pain/disability and angular deviation was observed. PLAIN LANGUAGE SUMMARY: A bunion (medical term: hallux valgus) is a common adult foot problem in which the big toe points inward toward the other toes, and this can be painful. How much the big toe points inward (how deformed the foot is) has been linked to the amount of pain the patient experiences. A better understanding of this foot deformity and bunion pain will help doctors and patients to make the right treatment decisions. A study was completed looking at how injections of a type of botulinum toxin (abobotulinumtoxinA) into specific muscles in the foot may help to reduce bunion pain in patients without surgery. This subsequent analysis of the study data looked at the amount of foot deformity in patients, the bunion pain they experienced, and which factors affected how well abobotulinumtoxinA worked to reduce bunion pain. The results of this study showed that the amount of foot deformity was not linked to the level of bunion pain. When deciding the best treatment option to relieve bunion pain, it is important that doctors not only consider how deformed the foot is, but also other important factors such as foot pain levels.
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Affiliation(s)
| | | | | | - David G Armstrong
- Keck School of Medicine, University of Southern California, Los Angeles, CA
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25
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Redmond BY, Salwa A, Smit T, Ditre JW, Garey L, Zvolensky MJ. Pain Severity and Smoking Abstinence Expectancies among Latinx Individuals Who Smoke Cigarettes: The Moderating Role of Perceived Discrimination. Int J Environ Res Public Health 2023; 20:1079. [PMID: 36673835 PMCID: PMC9859392 DOI: 10.3390/ijerph20021079] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 06/16/2023]
Abstract
Latinx individuals experience significant health disparities related to smoking cessation in the United States (US). Although past works have consistently implicated pain in the maintenance of smoking behavior, limited research has examined the role of social determinants (e.g., perceived discrimination) in pain-smoking relations. The current study sought to examine the moderating role of perceived discrimination in the relation between pain severity and smoking abstinence expectancies (i.e., a cognitive factor related to poor smoking outcomes) among 226 Latinx individuals who currently smoke cigarettes (Mage = 34.95 years; SD = 8.62; 38.5% female). The results indicated a statistically significant interaction between pain severity and perceived discrimination with regard to smoking abstinence expectancies (i.e., negative mood, somatic symptoms, harmful consequences, and positive consequences). Post-hoc analyses revealed the association of pain severity and negative mood, harmful consequences, and positive consequences smoking abstinence expectancies evident for individuals with higher perceived discrimination. Moreover, the association between pain severity and somatic symptoms smoking abstinence expectancies was stronger for individuals with higher perceived discrimination. Overall, these results suggest that clinical and community-based public health strategies may benefit from addressing the role of perceived discrimination among Latinx individuals who smoke cigarettes in the context of pain.
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Affiliation(s)
- Brooke Y. Redmond
- Department of Psychology, University of Houston, Houston, TX 77004, USA
| | - Aniqua Salwa
- Department of Psychology, University of Houston, Houston, TX 77004, USA
| | - Tanya Smit
- Department of Psychology, University of Houston, Houston, TX 77004, USA
| | - Joseph W. Ditre
- Department of Psychology, Syracuse University, Syracuse, NY 13244, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX 77004, USA
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX 77004, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Health Institute, University of Houston, Houston, TX 77004, USA
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26
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Komolsuradej N, Srikrajang S, Rangsiprakarn N, Wongaree A, Wasusathapon C, Kanjanakomut D, Nukaew V, Cheutalay W, Kaewpipat S, Hoonthong S, Ung S, Iamthanaporn K. The Strong Correlation Between Pain Interference and Abnormal Nutritional Status in Older Adults With Chronic Musculoskeletal Pain. J Prim Care Community Health 2023; 14:21501319231174116. [PMID: 37199383 DOI: 10.1177/21501319231174116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023] Open
Abstract
OBJECTIVES Musculoskeletal pain, one of the most common issues faced by older adults, has multidimensional effects including an increased risk of malnutrition. Therefore, this study aimed to investigate the association between pain interference and nutritional status in older adults with chronic musculoskeletal pain. METHODS In this cross-sectional study, data were collected from older adults (age: >60 years) using the brief pain inventory and mini nutritional assessment questionnaire. The correlation between pain interference, pain severity, and nutritional status was assessed using the chi-square test and Spearman's rank correlation. Multiple logistic regression analysis was used to analyze the variables associated with abnormal nutrition status. RESULTS Overall 241 older adults were recruited in the study. The median (IQR) age of the participants was 70 (11) years, pain severity subscale was 4.2 (1.8), and pain interference subscale was 3.3 (3.1). Abnormal nutritional status was positively correlated with pain interference (Odds ratio [OR]: 1.26; 95% confidence interval [CI]: 1.08-1.48; P = .004), pain severity (OR: 1.25; 95% CI: 1.02-1.53; P = .034), age (OR 1.06; 95% CI: 1.01-1.11, P = .011), and hypertension (OR = 2.17; 95% CI: 1.11-4.26; P = .024). CONCLUSIONS This study reports a strong correlation between pain interference and nutritional status. Therefore, pain interference can be a useful pain assessment tool to indicate risk of abnormal nutritional status in older adults. In addition, related factors, including age, underweight, and hypertension, were associated with a higher risk of malnutrition.
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Affiliation(s)
| | | | | | - Arya Wongaree
- Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | | | | | | | | | | | | | - Sochealing Ung
- Prince of Songkla University, Hat Yai, Songkhla, Thailand
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27
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Fisher HM, Stalls J, Winger JG, Miller SN, Plumb Vilardaga JC, Majestic C, Kelleher SA, Somers TJ. Role of self-efficacy for pain management and pain catastrophizing in the relationship between pain severity and depressive symptoms in women with breast cancer and pain. J Psychosoc Oncol 2023; 41:87-103. [PMID: 35311481 PMCID: PMC9489816 DOI: 10.1080/07347332.2022.2046676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE This study evaluated the relationship between pain and depressive symptoms through pain self-efficacy and pain catastrophizing in breast cancer patients with pain. DESIGN Secondary analysis of a randomized trial investigating a cognitive-behavioral pain management protocol. SAMPLE Females (N = 327) with stage I-III breast cancer and report of at least moderate pain. METHODS Pain severity, pain self-efficacy, pain catastrophizing, and depressive symptoms were measured. The proposed model was assessed using structural equation modeling. RESULTS Higher pain severity was significantly related to lower pain self-efficacy and higher pain catastrophizing. Lower pain self-efficacy and higher pain catastrophizing were significantly related to more depressive symptoms. Higher pain severity was significantly associated with more depressive symptoms through lower pain self-efficacy and higher pain catastrophizing. The association between pain severity and depressive symptoms was not significant when specified as a direct effect. CONCLUSION Pain severity related to depressive symptoms in breast cancer patients via pain self-efficacy and pain catastrophizing. IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS Measurement of pain self-efficacy and pain catastrophizing should be incorporated into comprehensive pain assessments for women with breast cancer, as these variables may be relevant therapeutic targets. Psychosocial symptom management interventions should include strategies that increase pain self-efficacy and decrease pain catastrophizing because these pain-related cognitive variables appear to drive the relationship between pain severity and depressive symptoms.
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Affiliation(s)
- Hannah M. Fisher
- Pain Prevention and Treatment Research Program, Duke University Medical Center, Durham, North Carolina, USA
| | - Juliann Stalls
- Pain Prevention and Treatment Research Program, Duke University Medical Center, Durham, North Carolina, USA
| | - Joseph G. Winger
- Pain Prevention and Treatment Research Program, Duke University Medical Center, Durham, North Carolina, USA
| | - Shannon N. Miller
- Pain Prevention and Treatment Research Program, Duke University Medical Center, Durham, North Carolina, USA
| | | | - Catherine Majestic
- Pain Prevention and Treatment Research Program, Duke University Medical Center, Durham, North Carolina, USA
| | - Sarah A. Kelleher
- Pain Prevention and Treatment Research Program, Duke University Medical Center, Durham, North Carolina, USA
| | - Tamara J. Somers
- Pain Prevention and Treatment Research Program, Duke University Medical Center, Durham, North Carolina, USA
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Pierce J, Presto J, Hinckley E, Hassett AL, Dickens J, Schneiderhan JR, Grace K, McAfee J. Perceived social support partially mediates the association between childhood abuse and pain-related characteristics. Front Pain Res (Lausanne) 2022; 3:1075605. [PMID: 36618580 PMCID: PMC9815443 DOI: 10.3389/fpain.2022.1075605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 11/23/2022] [Indexed: 12/24/2022]
Abstract
Higher perceived social support has been shown to buffer the impact of negative stressful events like childhood abuse on health outcomes. Yet, the role of perceived social support as a mediator of the association between childhood abuse and pain-related characteristics is not well understood. The present study explored this premise. Patients (n = 1,542) presenting to a tertiary-care, outpatient pain clinic completed a cross-sectional survey consisting of regularly collected clinical data and validated measures. Path analysis suggested that the impact of childhood abuse on sensory and affective pain-related characteristics was partially explained by perceived emotional support. Survivors of childhood abuse display a more complex clinical pain phenotype and this extends to more negative perceptions of social support. Our findings may reflect processes whereby childhood abuse negatively impacts social relationships across the lifespan, and these negative social perceptions and relationships influence sensory and affective components of pain.
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Affiliation(s)
- Jennifer Pierce
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States,Correspondence: Jennifer Pierce
| | - Jacob Presto
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
| | - Elizabeth Hinckley
- Department of Pediatric Neurology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Afton L. Hassett
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
| | - Joseph Dickens
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
| | - Jill R. Schneiderhan
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Kathryn Grace
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
| | - Jenna McAfee
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
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Catala P, Écija C, Serrano del Moral A, Perez Viejo E, Peñacoba C. Predicting Adherence to Walking from Anxiety, Depression, Disease Impact, Catastrophizing, and Cognitive Fusion in Patients with Fibromyalgia: Does Pain Severity Matter? Int J Environ Res Public Health 2022; 19:16453. [PMID: 36554334 PMCID: PMC9778611 DOI: 10.3390/ijerph192416453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/30/2022] [Accepted: 12/03/2022] [Indexed: 06/17/2023]
Abstract
AIM This study analyzed whether the contribution of several factors associated with walking adherence in fibromyalgia (FM) patients varies across pain severity levels. METHODS Participants were 228 women with FM (mean age 57 years; SD = 8.49). RESULTS Bivariate analyses replicated the expected association between predictors (FM impact, anxiety, depression, catastrophizing, and cognitive fusion) and poorer adherence to walking. Multivariate analyses showed a negative contribution of FM impact, catastrophizing, and depression on walking adherence after controlling for pain levels (all p < 0.01). A moderation effect of pain severity in the relationship between predictors and adherence to walking was only found for cognitive fusion (B = -0.01, t = -2.02, p = 0.040). Specifically, cognitive fusion only contributed to poor walking adherence at moderate and severe pain levels, but not when pain was mild. The contribution of the remaining predictors was not moderated by pain levels, which means that they contributed to walking adherence irrespective of the pain severity of the patient. Pain severity did not contribute to walking adherence when controlling for the predictors. CONCLUSION Clinical implications are discussed from the perspective of personalized interventions and preferable target interventions when attempting to increase adherence to walking in this population.
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Affiliation(s)
- Patricia Catala
- Department of Psychology, Rey Juan Carlos University, Avda. de Atenas s/n, 28922 Madrid, Spain
| | - Carmen Écija
- Department of Psychology, Rey Juan Carlos University, Avda. de Atenas s/n, 28922 Madrid, Spain
| | - Angel Serrano del Moral
- General Surgery and Digestive Surgery Service, Hospital Universitario de Fuenlabrada, 28944 Madrid, Spain
| | - Estibalitz Perez Viejo
- General Surgery and Digestive Surgery Service, Hospital Universitario de Fuenlabrada, 28944 Madrid, Spain
| | - Cecilia Peñacoba
- Department of Psychology, Rey Juan Carlos University, Avda. de Atenas s/n, 28922 Madrid, Spain
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Muacevic A, Adler JR, Nagasubramanyam V, Sharma P, Raj A. Correlation of Severity of Renal Colic With Clinical, Laboratory, and Radiological Parameters: An Emergency Department-Based Prospective Observational Study. Cureus 2022; 14:e31277. [PMID: 36514665 PMCID: PMC9733791 DOI: 10.7759/cureus.31277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction In this study, we investigated the correlation of severity of renal colic with clinical parameters like pain characteristics, haematuria and pyuria, laboratory parameters such as inflammatory markers, and radiological parameters including site and size of stone and hydronephrosis. Methods The Visual Analogue Scale (VAS) determined the pain severity. Detailed history and clinicodemographic profiling of the patient was done, laboratory investigations were done, ultrasound and non-contrast computed tomography of kidney-ureter-bladder were done and all the parameters were duly noted and correlated with the pain severity. Result The mean age of the 183 patients was 43.96 ± 15.16 years, and 62.8% were male. The patients' mean VAS score at presentation was 8.57 ± 1.08. The mean VAS score was found to be statistically higher in patients having a first episode of renal colic, solitary kidney, pyuria, raised creatinine, severe hydronephrosis, and stones located at the renal pelvis. In addition, higher VAS scores led to more surgical interventions. Conclusion The correlation of pain severity of renal colic with various parameters can aid in the development of quick diagnostic and therapeutic protocols for patients presenting to the emergency department with renal stone disease. This study shows that pain scores can correlate with various parameters and predict the outcome and complications in these patients.
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Maarj M, Pacey V, Tofts L, Clapham M, Gironès Garcia X, Coda A. Validation of an Electronic Visual Analog Scale App for Pain Evaluation in Children and Adolescents With Symptomatic Hypermobility: Cross-sectional Study. JMIR Pediatr Parent 2022; 5:e41930. [PMID: 36287606 PMCID: PMC9647467 DOI: 10.2196/41930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/21/2022] [Accepted: 09/23/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Rapid advances in mobile apps for clinical data collection for pain evaluation have resulted in more efficient data handling and analysis than traditional paper-based approaches. As paper-based visual analogue scale (p-VAS) scores are commonly used to assess pain levels, new emerging apps need to be validated prior to clinical application with symptomatic children and adolescents. OBJECTIVE This study aimed to assess the validity and reliability of an electronic visual analogue scale (e-VAS) method via a mobile health (mHealth) App in children and adolescents diagnosed with hypermobility spectrum disorder/hypermobile Ehlers-Danlos syndrome (HSD/HEDS) in comparison with the traditional p-VAS. METHODS Children diagnosed with HSD/HEDS aged 5-18 years were recruited from a sports medicine center in Sydney (New South Wales, Australia). Consenting participants assigned in random order to the e-VAS and p-VAS platforms were asked to indicate their current lower limb pain level and completed pain assessment e-VAS or p-VAS at one time point. Instrument agreement between the 2 methods was determined from the intraclass correlation coefficient (ICC) and through Bland-Altman analysis. RESULTS In total, 43 children with HSD/HEDS aged 11 (SD 3.8) years were recruited and completed this study. The difference between the 2 VAS platforms of median values was 0.20. Bland-Altman analysis revealed a difference of 0.19 (SD 0.95) with limits of agreement ranging -1.67 to 2.04. An ICC of 0.87 (95% CI 0.78-0.93) indicated good reliability. CONCLUSIONS These findings suggest that the e-VAS mHealth App is a validated tool and a feasible method of collecting pain recording scores when compared with the traditional paper format in children and adolescents with HSD/HEDS. The e-VAS App can be reliably used for pediatric pain evaluation, and it could potentially be introduced into daily clinical practice to improve real-time symptom monitoring. Further research is warranted to investigate the usage of the app for remote support in real clinical settings.
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Affiliation(s)
- Muhammad Maarj
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Ourimbah, Australia
| | - Verity Pacey
- Department of Health Sciences, Macquarie University, Sydney, Australia
| | - Louise Tofts
- Department of Health Sciences, Macquarie University, Sydney, Australia
| | - Matthew Clapham
- Hunter Medical Research Institute, Equity in Health and Wellbeing Research Program, New Lambton Heights, New South Wales, Australia
| | - Xavier Gironès Garcia
- Facultat de Ciències de la Salut de Manresa, Universitat de Vic-Universitat Central de Catalunya, Manresa, Spain
| | - Andrea Coda
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Ourimbah, Australia.,Hunter Medical Research Institute, Equity in Health and Wellbeing Research Program, New Lambton Heights, New South Wales, Australia
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Charron E, Okifuji A, Bryan MA, Reese S, Brown JL, Ferguson A, Ghitza UE, Winhusen T, Cochran G. Pain Severity and Interference and Substance Use Among Community Pharmacy Patients Prescribed Opioids: A Secondary Analysis of the PHARMSCREEN Study. J Pain 2022; 23:1448-1459. [PMID: 35417791 PMCID: PMC9356992 DOI: 10.1016/j.jpain.2022.03.238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/31/2021] [Accepted: 03/10/2022] [Indexed: 04/25/2023]
Abstract
This secondary analysis examined relationships between pain severity and interference and substance use among patients filling opioid prescriptions in Indiana and Ohio community pharmacies (n = 1,461). We likewise sought to explore the moderating role of gender in pain-substance use relations. We used patient-reported data from a cross-sectional health survey linked with controlled substance dispensing data from statewide prescription drug monitoring programs. Multivariable logistic regression estimated associations between pain severity and interference and various indices of risky prescription opioid use and non-opioid substance use. Exploratory analyses examined whether gender moderated associations. Increased pain severity was associated with increased odds of moderate- to high-risk opioid use (OR: 1.23; 95% CI: 1.16-1.31) and opioid-benzodiazepine co-use (OR: 1.20; 95% CI: 1.03-1.40). Increased pain interference was associated with greater odds of receiving opioids from multiple pharmacies or providers (OR: 1.15; 95% CI: 1.01-1.31). Increased pain severity and interference were associated with higher odds of any tobacco use (severity: OR: 1.13; 95% CI: 1.06-1.21; interference: OR: 1.07; 95% CI: 1.01-1.12) and weekly to daily sedative use (severity: OR: 1.13; 95% CI: 1.03-1.25; interference: OR: 1.13; 95% CI: 1.04-1.22). Increased pain severity was associated with decreased odds of any alcohol use (OR: 0.93; 95% CI: 0.88-0.99). Gender was a significant effect modifier in associations between pain and alcohol, tobacco, and cannabis use. The study was registered in the database of clinicaltrials.gov (register number NCT03936985). Perspective: This study suggests that pain severity and interference are associated with increased use of non-medical prescription opioids, sedatives, and tobacco and decreased use of alcohol, in ways that are different between women and men. Findings may guide the development of gender-sensitive evidence-based strategies to ameliorate or prevent substance misuse among patients living with pain.
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Affiliation(s)
- Elizabeth Charron
- Program for Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA), Salt Lake City, Utah; Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah.
| | - Akiko Okifuji
- Department of Anesthesiology, University of Utah School of Medicine, Salt Lake City, Utah
| | - M Aryana Bryan
- Program for Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA), Salt Lake City, Utah; Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah
| | - Sarah Reese
- School of Social Work, University of Montana, Missoula, Montana
| | - Jennifer L Brown
- Department of Psychology, University of Cincinnati College of Arts and Sciences, ML 0376 4130N Edwards One Center, Cincinnati, Ohio; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio; Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Andrew Ferguson
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio; Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Udi E Ghitza
- National Institute on Drug Abuse, Center for Clinical Trials Network, Bethesda, Maryland
| | - T Winhusen
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio; Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Gerald Cochran
- Program for Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA), Salt Lake City, Utah; Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah
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Axon DR, Pesqueira T, Jarrell B, Dicochea D. Correlation of self-reported pain severity and healthcare expenditures in older United States adults. Scand J Pain 2022; 22:133-141. [PMID: 34786898 DOI: 10.1515/sjpain-2021-0148] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/29/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Healthcare expenditures of older United States (US) adults with different pain severity levels are important to investigate given the increasing prevalence of pain in this population. This study assessed the correlation of healthcare expenditures among older US adults with different pain severities, hypothesizing that expenditures would increase as pain severity increased. METHODS This retrospective cross-sectional database study used 2018 Medical Expenditure Panel Survey (MEPS) data and included US adults aged ≥50 with self-reported pain in the past four weeks and positive healthcare costs. Adjusted linear regression models with logarithmically transformed expenditure data compared differences in: total; office-based; outpatient; emergency room; inpatient; other; and prescription medication expenditures, between those with little, moderate, quite a bit, and extreme pain. Analyses were weighted to account for the complex MEPS design and to obtain nationally representative estimates. The a priori alpha level was 0.05. RESULTS The eligible sample of 5,123 individuals produced a weighted study population of 57,134,711 US adults aged ≥50 with pain (little = 53.1%, moderate = 21.6%, quite-a-bit = 18.5%, extreme = 6.8%). In adjusted linear regression models, compared to little pain, extreme pain had the greatest level of costs, followed by quite a bit pain and moderate pain, for total, office-based, and prescription medication costs. For instance, compared to little pain, total healthcare costs were 78% greater for those with extreme pain, 51% greater for quite a bit pain, and 37% greater for moderate pain. However, this pattern was not observed for outpatient, emergency room, inpatient, and other costs, where ≥1 comparison for each cost category was not statistically significant. CONCLUSIONS This study found total healthcare costs increased as pain severity increased, yet this was not always the case when analyzing subcategories of healthcare costs. Further research is needed to investigate why some types of healthcare costs are greater with increasing pain severity, yet others are not.
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Affiliation(s)
- David R Axon
- University of Arizona College of Pharmacy, Tucson, AZ, USA
| | | | - Briana Jarrell
- University of Arizona College of Pharmacy, Tucson, AZ, USA
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Harris M, Erridge S, Ergisi M, Nimalan D, Kawka M, Salazar O, Ali R, Loupasaki K, Holvey C, Coomber R, Usmani A, Sajad M, Hoare J, Rucker JJ, Platt M, Sodergren MH. UK Medical Cannabis registry: an analysis of clinical outcomes of medicinal cannabis therapy for chronic pain conditions. Expert Rev Clin Pharmacol 2021; 15:473-485. [PMID: 34937477 DOI: 10.1080/17512433.2022.2017771] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To explore pain-specific, general health-related quality of life (HRQoL), and safety outcomes of chronic pain patients prescribed cannabis-based medicinal products (CBMPs). METHODS A case series was performed using patients with chronic pain from the UK Medical Cannabis Registry. Primary outcomes were changes in Brief Pain Inventory short-form (BPI), Short-form McGill Pain Questionnaire-2 (SF-MPQ-2), Visual Analogue Scale-Pain (VAS), General Anxiety Disorder-7 (GAD-7), Sleep Quality Scale (SQS), and EQ-5D-5L, at 1, 3, and 6 months from baseline. Statistical significance was defined at p-value<0.050. RESULTS 190 patients were included. Median initial Δ9-tetrahydrocannabinol and cannabidiol daily doses were 2.0mg (range:0.0-442.0mg) and 20.0mg (range:0.0-188.0mg) respectively. Significant improvements were observed within BPI, SF-MPQ-2, GAD-7, SQS, EQ-5D-5 L index, and VAS measures at all timepoints (p<0.050). Seventy-five adverse events (39.47%) were reported, of which 37 (19.47%) were rated as mild, 23 (12.11%) as moderate, and 14 (7.37%) as severe. Nausea (n=11; 5.8%) was the most frequent adverse event. CONCLUSION An association was identified between patients with chronic pain prescribed CBMPs and improvements in pain-specific and general HRQoL outcomes. Most adverse events were mild to moderate in severity, indicating CBMPs were well tolerated. Inherent limitations of study design limit its overall applicability.
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Affiliation(s)
| | - Simon Erridge
- Imperial College London, London, UK.,Sapphire Medical Clinics, London, UK
| | | | | | | | | | | | | | | | - Ross Coomber
- Sapphire Medical Clinics, London, UK.,St. George's Hospital NHS Trust, London, UK
| | - Azfer Usmani
- Sapphire Medical Clinics, London, UK.,Dartford and Gravesham Nhs Trust, Kent, UK
| | - Mohammed Sajad
- Sapphire Medical Clinics, London, UK.,Dudley Group of Hospitals Nhs Trust, West Midlands, UK
| | - Jonathan Hoare
- Imperial College London, London, UK.,Sapphire Medical Clinics, London, UK
| | - James J Rucker
- Sapphire Medical Clinics, London, UK.,Department of Psychological Medicine, Kings College London, London, UK.,South London & Maudsley NHS Foundation Trust, London, UK
| | - Michael Platt
- Imperial College London, London, UK.,Sapphire Medical Clinics, London, UK
| | - Mikael H Sodergren
- Imperial College London, London, UK.,Sapphire Medical Clinics, London, UK
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Tait RC, Chibnall JT, Kalauokalani D. Patient Perceptions of Physician Burden in the Treatment of Chronic Pain. J Pain 2021; 22:1060-1071. [PMID: 33727158 DOI: 10.1016/j.jpain.2021.03.140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/22/2021] [Accepted: 03/01/2021] [Indexed: 12/30/2022]
Abstract
While patient perceptions of burden to caregivers is of recognized clinical significance among people with chronic pain, perceived burden to treating physicians has not been studied. This study examined how people with chronic pain perceived levels of medical evidence (low vs high) and pain severity (4,6,8/10) to influence physician burden and how burden then mediated expected clinical judgments. 476 people with chronic pain read vignettes describing a hypothetical patient with varying levels of medical evidence and pain severity from the perspective of a treating physician, rated the burden that patient care would pose, and made a range of clinical judgments. The effect of pain severity on clinical judgments was expected to interact with medical evidence and be conditionally mediated by burden. Although no associations with burden were found for the pain severity x medical evidence interaction or for pain severity alone, low levels of supporting medical evidence yielded higher burden ratings. Burden significantly mediated medical evidence effects on judgments of symptom credibility, clinical improvement, and psychosocial dysfunction. Results indicate that perceived physician burden negatively influenced judgments of patients with chronic pain, beyond the direct effects of medical evidence. Implications are discussed for clinical practice, as well as future research. PERSPECTIVE: : People with chronic pain expect physicians to view the care of patients without supporting medical evidence as burdensome. Higher burden is associated with less symptom credibility, more psychosocial dysfunction, and less treatment benefit. Perceived physician burden appears to impact how patients approach treatment, with potentially adverse implications for clinical practice.
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Affiliation(s)
- Raymond C Tait
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, Missouri.
| | - John T Chibnall
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, Missouri
| | - Donna Kalauokalani
- Chairman of the Board, American Chronic Pain Association, Rocklin, California
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Schepman P, Thakkar S, Robinson R, Malhotra D, Emir B, Beck C. Moderate to Severe Osteoarthritis Pain and Its Impact on Patients in the United States: A National Survey. J Pain Res 2021; 14:2313-2326. [PMID: 34349555 PMCID: PMC8326774 DOI: 10.2147/jpr.s310368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 07/13/2021] [Indexed: 01/02/2023] Open
Abstract
Purpose Osteoarthritis (OA) is one of the most common causes of chronic pain and a leading cause of disability in the US. The objective of this study was to examine the clinical and economic burden of OA by pain severity. Patients and Methods We used nationally representative survey data. Adults ≥18 years with self-reported physician-diagnosed OA and experiencing OA pain were included in the study. OA pain severity was measured using the Short Form McGill Pain Questionnaire Visual Analog Scale (SF-MPQ-VAS). Data were collected for demographics, clinical characteristics, health-related quality of life (HRQoL), productivity, OA treatment, adherence to pain medication, and healthcare resource utilization. Univariate analysis was performed to examine differences between respondents with moderate-to-severe OA pain vs those with mild OA pain. Results Higher proportions of respondents with moderate-to-severe OA pain (n=3798) compared with mild OA pain (n=2038) were female (69.4% vs 57.3%), <65 years of age (54.8% vs 43.4%), and not employed (70.6% vs 64.5%). Respondents with moderate-to-severe OA pain experienced OA pain daily (80.8% vs 48.8%), were obese (53.0% vs 40.5%), had more comorbidities (sleep disturbance, insomnia, depression, and anxiety), and reported significantly poorer health status and HRQoL, and greater productivity and activity impairment (all P<0.05). Moderate-to-severe OA pain respondents were prescribed significantly more pain medications than mild OA pain respondents (41.0% vs 17.0%) and had higher adherence (75.9% vs 64.1%) yet were less satisfied with their pain medications (all P<0.001). Outpatient and emergency room visits, and hospitalizations in the 6 months prior to the survey were significantly higher in moderate-to-severe OA pain respondents vs those with mild OA pain (all P<0.05). Conclusion Patient and clinical burden was significantly greater in moderate-to-severe OA pain respondents vs mild OA pain respondents and may inform decision-making for appropriate resource allocation and effective management strategies that target specific subgroups.
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Akutay S, Yilmaz M. The relationship between pain severity and sleep quality: Posttube thoracostomy. Nurs Forum 2021; 56:860-868. [PMID: 34263967 DOI: 10.1111/nuf.12630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 06/18/2021] [Accepted: 06/19/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The presence of a chest tube is a factor significantly associated with pain and pain posttube thoracostomy that negatively affects sleep quality (SQ). AIM To determine the relationship between the pain severity and SQ of patients who underwent the tube thoracostomy (TT). METHODS This was a descriptive and cross-sectional survey conducted from May 1, 2018, to December 30, 2018, in the thoracic surgery department of Sivas Cumhuriyet University Hospital in Central Anatolia/Turkey. Data were collected using a questionnaire form, a Numerical Rating Scale to determine pain severity, and the Richard-Campbell Sleep Questionnaire to assess SQ. RESULTS The study was carried out with 102 patients who underwent the TT. The mean age of the participants were 48.94 years. The mean scores for the scale items indicated that during the procedure and on the first day of post-TT, the pain severity of the patients was very high, their SQ was low. Pain level decreased gradually in the following days, and the SQ increased. There was a positive, strong correlation between the post-TT first day pain and first night SQ (r = 0.380, p = 0.000), second day pain and second night SQ (r = -0.537, p = 0.000), and third day pain and third night SQ (r = -0.507, p = 0.000). CONCLUSION The results of this study highlight that the pain severity of post-TT significantly affect the quality of the patients' night sleep.
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Affiliation(s)
- Seda Akutay
- Division of Nursing, Department of Surgical Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey
| | - Meryem Yilmaz
- Division of Nursing, Department of Surgical Nursing, Faculty of Health Sciences, Sivas Cumhuriyet University, Sivas, Turkey
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Carlesso LC, Hawker GA, Torner J, Lewis CE, Nevitt M, Neogi T. Association of Intermittent and Constant Knee Pain Patterns With Knee Pain Severity and With Radiographic Knee Osteoarthritis Duration and Severity. Arthritis Care Res (Hoboken) 2021; 73:788-793. [PMID: 32198833 PMCID: PMC7502437 DOI: 10.1002/acr.24194] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 03/17/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To examine the relation of knee pain patterns to pain severity and to radiographic osteoarthritis (OA) severity and duration. METHODS The Multicenter Osteoarthritis Study is a longitudinal cohort of older adults with or at risk of knee OA. Participants' Intermittent and Constant Osteoarthritis Pain (ICOAP) scores were characterized as 1) no intermittent or constant pain, 2) intermittent pain only, 3) constant pain only, and 4) a combination of constant and intermittent pain. Knee pain severity was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale and a visual analog scale (VAS). Radiographic knee OA (ROA) severity was defined as Kellgren/Lawrence grade ≥2, and ROA duration was defined according to the clinic visit at which ROA was first noted. We assessed the relation of ICOAP pain patterns to knee pain severity, ROA severity, and ROA duration using regression models with generalized estimating equations. RESULTS There were 2,322 participants (mean age 68.8 years, body mass index 31.0 kg/m2 , 60% female). Higher ICOAP pain patterns, i.e., a mix of constant and intermittent pain, were associated with greater WOMAC pain severity compared with those patients without either pain pattern (odds ratio [OR] 43.2 [95% confidence interval (95% CI) 26.4-61.3]). Results were similar for the VAS (OR 71.2 [95% CI 45.7-110.9]). Those patients with more severe and longer duration of ROA were more likely to have a mix of constant and intermittent pain compared with those without either pain (OR 3.7 [95% CI 3.1-4.6] and OR 2.9 [95% CI 2.5-3.5], respectively). CONCLUSION Knee pain patterns are associated with radiographic disease stage and duration, as well as pain severity, highlighting the fact that pain patterns are important for understanding symptomatic disease progression.
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Affiliation(s)
- Lisa C. Carlesso
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Gillian A. Hawker
- Institute of Health Policy, Management and Evaluation and the Department of Medicine at the University of Toronto, and Senior Scientist Women’s College Research Institute, Toronto, Ontario,Canada
| | - James Torner
- Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
| | - Cora E. Lewis
- Division of Preventive Medicine, University of Alabama, Birmingham, Division of Preventive Medicine, Birmingham, Alabama, USA
| | - Michael Nevitt
- University of California, San Francisco, California, USA
| | - Tuhina Neogi
- Boston University School of Medicine, Boston, Massachusetts, USA
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Axon DR, Le D. Predictors of pain severity among community-dwelling older adults with pain in the United States: Findings from a cross-sectional, retrospective study using 2017 Medical Expenditure Panel Survey. Medicine (Baltimore) 2021; 100:e26011. [PMID: 34011100 PMCID: PMC8137030 DOI: 10.1097/md.0000000000026011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/20/2021] [Accepted: 04/30/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT The purpose of this study was to determine predictors of pain severity among older United States (US) adults with pain.This cross-sectional, retrospective study utilized 2017 Medical Expenditure Panel Survey data. Eligible participants were alive for the calendar year, aged ≥50 years, and reported pain in the past 4 weeks. Hierarchical logistic regression models, adjusting for the survey design, were used to identify significant predictors of pain severity (i.e., extreme/quite a bit or moderate/little pain).An estimated 14,250,534 adults aged ≥50 with pain reported extreme/quite a bit of pain. Many variables were associated with extreme/quite a bit of pain, including: age 50 to 64 vs ≥65 years (adjusted odds ratio [AOR] = 1.49, 95% confidence interval [95% CI] = 1.22-1.82); males vs females (AOR = 0.80, 95% CI = 0.67-0.95); white race vs others (AOR = 0.75, 95% CI = 0.61-0.92); married vs other marital status (AOR = 1.31, 95% CI = 1.08-1.57); income <200% vs ≥200% federal poverty level (AOR = 1.30, 95% CI = 1.06-1.60); employed vs unemployed (AOR = 0.47, 95% CI = 0.37-0.60); limitation vs no limitation (AOR = 2.64, 95% CI = 2.09-3.33); 0, 1, 3, or 4 vs ≥5 chronic conditions (AOR ranged from 0.39 for 0 conditions to 0.77 for 4 conditions); excellent/very good or good vs fair/poor perceived physical health status (AOR ranged from 0.28 for excellent/very good to 0.40 for good); smokers vs non-smokers (AOR = 1.56, 95% CI = 1.27-1.93); exercise versus no exercise (AOR = 0.74, 95% CI = 0.62-0.88); and South vs West census region (AOR = 1.34, 95% CI = 1.04-1.74).This study found several characteristics could predict pain severity among older US adults who reported extreme/quite a bit of pain. These characteristics may guide specific areas of focus to improve patients' pain management.
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Affiliation(s)
- David R. Axon
- Department of Pharmacy Practice & Science
- Center for Health Outcomes and Pharmacoeconomic Research, University of Arizona College of Pharmacy, Tucson, Arizona
| | - Darlena Le
- Department of Pharmacy Practice & Science
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Zambelli Z, Halstead EJ, Fidalgo AR, Dimitriou D. Good Sleep Quality Improves the Relationship Between Pain and Depression Among Individuals With Chronic Pain. Front Psychol 2021; 12:668930. [PMID: 34025533 PMCID: PMC8138032 DOI: 10.3389/fpsyg.2021.668930] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/09/2021] [Indexed: 11/17/2022] Open
Abstract
Individuals with chronic pain often experience co-existing sleep problems and depression-related states. Chronic pain, sleep problems, and depression interrelate, and have been shown to exacerbate one another, which negatively impacts quality of life. This study explored the relationships between pain severity, pain interference, sleep quality, and depression among individuals with chronic pain. Secondly, we tested whether sleep quality may moderate the relationship between pain and depression. A cross-sectional survey was completed by 1,059 adults with non-malignant chronic pain conditions (M age 43 years, 88% identified as women) and collected measures related to pain severity, pain interference, sleep quality, and depression. Multiple regression analyses found that pain severity, pain interference, and sleep quality are all significantly associated with depression. Secondly, moderated regression analyses revealed that sleep quality moderates the relationship between pain interference and depression among individuals with chronic pain such that good sleep quality attenuates the effect of pain interference on depression, and poor sleep quality amplifies the effect of pain interference on depression. These findings suggest that sleep quality may be a relevant therapeutic target for individuals with chronic pain and co-existing depression.
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Affiliation(s)
- Zoe Zambelli
- Sleep Education and Research Laboratory, Psychology and Human Development, University College London-Institute of Education, London, United Kingdom
| | - Elizabeth J. Halstead
- Sleep Education and Research Laboratory, Psychology and Human Development, University College London-Institute of Education, London, United Kingdom
| | - Antonio R. Fidalgo
- Department of Psychology, University of East London, London, United Kingdom
| | - Dagmara Dimitriou
- Sleep Education and Research Laboratory, Psychology and Human Development, University College London-Institute of Education, London, United Kingdom
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Bakshi SG, Rathod A, Salunkhe S. Influence of interpretation of pain scores on patients' perception of pain: A prospective study. Indian J Anaesth 2021; 65:216-220. [PMID: 33776112 PMCID: PMC7989498 DOI: 10.4103/ija.ija_130_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 02/16/2021] [Accepted: 02/22/2021] [Indexed: 11/12/2022] Open
Abstract
Background and Aims: Assessment of pain using pain scales is essential. In the Numeric Rating Scale (NRS), patients are asked to score their pain intensity on a scale from 0 to 10 (10- worst pain). This requires some abstract thinking by the patient, also the pain scores (PS) may not essentially communicate the patients’ need for more analgesia. We planned a study to evaluate the change in patients’ self-assessed PS after understanding clinical interpretation of the NRS. Methods: This prospective study was registered after approval from our hospital ethics board. Sample size estimated for the trial was 360 patients. All postoperative patients were recruited after informed consent. Patients having prolonged stay in Intensive Care Unit (more than 48 h), or those who underwent emergency surgeries were excluded. During Acute Pain Service (APS) rounds, patients were asked to rate their PS on the NRS. This was followed by a briefing about the clinical interpretation of the scale, and the patients were asked to re score their pain using the same scale. The change in pain severity was compared using Chi-square test. Results: Following explanation, a change in severity was seen for PS at rest [X2 (9, N- 360) = 441, P < 0.001] and at movement [X2 (9, N- 360) = 508, P < 0.001]. Overall, a change in PS severity was seen in 162 patients (45%). A decrease and an increase in the severity of pain was seen in 119 and 41 patients respectively. Conclusion: Explaining the clinical interpretation of PS on a NRS does lead to a change in patients’ self-assessed PS.
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Affiliation(s)
- Sumitra G Bakshi
- Department of Anaesthesia, Critical Care and Pain, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Akanksha Rathod
- Department of Anaesthesia, Critical Care and Pain, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Supriya Salunkhe
- Department of Anaesthesia, Critical Care and Pain, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, Maharashtra, India
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Alhalal E, Jackson KT. Evaluation of the Arabic version of the Chronic Pain Grade scale: Psychometric properties. Res Nurs Health 2021; 44:403-412. [PMID: 33586152 DOI: 10.1002/nur.22116] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 01/06/2021] [Accepted: 02/02/2021] [Indexed: 11/07/2022]
Abstract
To increase our understanding of chronic pain in clinical and research contexts, an assessment of its dimensions using reliable and valid self-reported pain measures is imperative. However, well-validated Arabic chronic pain assessment scales are lacking. The Chronic Pain Grade (CPG) scale has been used worldwide, yet an Arabic version of the CPG scale has not yet been validated. Thus, we conducted this study to demonstrate the psychometric properties, including reliability, convergent validity, and construct validity of the Arabic CPG scale. A cross-sectional study was conducted in two hospitals in Saudi Arabia. Data were collected from a convenience sample of 233 chronic pain patients. The confirmatory factor analysis showed an excellent fit with the factor structure of the CPG scale and, thus, supported construct validity. The two identified subscales were pain intensity and pain disability. Convergent validity was supported by having significant correlations between the short-form McGill Pain Questionnaire and CPG subscales. Internal consistency reliability was demonstrated, as Cronbach's α was 0.916 for pain intensity and 0.815 for pain disability. This study provides evidence that the Arabic CPG scale is a reliable and valid measure of chronic pain dimensions, including pain intensity, and pain-related disability. This Arabic version of the CPG scale has the potential to expand research and clinical assessment in the Arab world. Future studies are required for further validation.
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Affiliation(s)
- Eman Alhalal
- Nursing College, King Saud University, Riyadh, Saudi Arabia
| | - Kimberley T Jackson
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
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Taghian NR, McHugh RK, Griffin ML, Chase AR, Greenfield SF, Weiss RD. Associations between Childhood Abuse and Chronic Pain in Adults with Substance Use Disorders. Subst Use Misuse 2021; 56:87-92. [PMID: 33131372 DOI: 10.1080/10826084.2020.1840590] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Both childhood abuse and chronic pain are common in people with substance use disorders (SUDs). Studies have found that exposure to childhood abuse is associated with chronic pain in adulthood; however, few studies have examined this association in people with SUDs. Objectives: This study aimed to characterize the association between childhood abuse and chronic pain presence and severity in adults with SUDs. Methods: Data were obtained from 672 treatment-seeking participants with SUDs on an inpatient detoxification unit. Regression models evaluated whether childhood physical or sexual abuse was associated with the likelihood of chronic pain and severity of several pain-related characteristics: pain catastrophizing, pain severity, and pain interference. Results: Childhood physical and sexual abuse were significantly associated with a greater likelihood of chronic pain in adulthood. In the adjusted analyses, childhood physical abuse was associated with worse pain severity, whereas childhood sexual abuse was associated with greater pain catastrophizing and worse pain interference. Conclusions: Childhood physical and sexual abuse were associated with a greater likelihood of chronic pain in adults with SUDs. Among those with chronic pain, exposure to childhood abuse was associated with a more severe symptom profile, characterized by greater pain severity, more catastrophic interpretations of pain, and more pain-related interference with daily life. People with SUDs and a history of childhood abuse may benefit from screening for pain and interventions to reduce pain catastrophizing. These findings highlight the importance of longitudinal research to understand mechanisms linking childhood abuse exposure to later pain and substance misuse.
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Affiliation(s)
- Nadine R Taghian
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, Belmont, Massachusetts, USA
| | - R Kathryn McHugh
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, Belmont, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Margaret L Griffin
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, Belmont, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Alexandra R Chase
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, Belmont, Massachusetts, USA
| | - Shelly F Greenfield
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, Belmont, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.,Division of Women's Mental Health, McLean Hospital, Belmont, Massachusetts, USA
| | - Roger D Weiss
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, Belmont, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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Gayatri D, Efremov L, Mikolajczyk R, Kantelhardt EJ. Quality of Life Assessment and Pain Severity in Breast Cancer Patients Prior to Palliative Oncology Treatment in Indonesia: A Cross-Sectional Study. Patient Prefer Adherence 2021; 15:2017-2026. [PMID: 34548783 PMCID: PMC8449683 DOI: 10.2147/ppa.s320972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/14/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Studies assessing quality of life (QOL) in palliative care settings are still scarce. We assessed the QOL score and pain severity in advanced breast cancer patients at the National Cancer Hospital in Indonesia and associations between QOL domains with QOL and pain scores. MATERIALS AND METHODS A total of 160 patients who met the study inclusion criteria (female, >18 years old, diagnosed with stage III or IV breast cancer) answered the European Organization for Research and Treatment of Cancer QOL questionnaire (EORTC QLQ-C15-PAL) and the visual analogue scale (VAS) tool for pain severity, prior to palliative oncology treatment. Additionally, several sociodemographic and clinical characteristics were collected. Linear regression models, adjusted for age, the Karnofsky Performance Status (KPS) score, and specific QOL domains were used to explore the associations between the global QOL and VAS scores with the different QOL domains. RESULTS The patients had a mean age of 50 years (range: 29-76). The overall score for QOL and score for VAS was (mean ± SD) 78.02 ± 15.34 and 2.1 ± 2.4, respectively. The analysis demonstrated that the domains of emotional functioning (effect estimate: 0.25; 95% CI: 0.14 to 0.37), fatigue (-0.21; -0.33 to -0.09), pain (-0.13; -0.25 to -0.01), insomnia (-0.25; -0.37 to -0.13), and appetite loss (-0.13; -0.25 to -0.008) were associated with the QOL score. Only the KPS score (-0.28; -0.46 to -0.11) was associated with the VAS score. CONCLUSION Our study showed high QOL and low VAS scores in advanced breast cancer patients prior to palliative oncology treatment. Several QOL domains (emotional functioning, fatigue, pain, insomnia, and appetite loss) were associated with QOL and the KPS was associated with the pain score. Therefore, these specific QOL domains should be given priority in improving QOL in this patient group.
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Affiliation(s)
- Dwi Gayatri
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Department of Epidemiology, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Ljupcho Efremov
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Department of Radiation Oncology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Eva Johanna Kantelhardt
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Department of Gynecology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Correspondence: Eva Johanna Kantelhardt Department of Gynecology, Martin-Luther-University Halle-Wittenberg, Magdeburger Strasse 8, Halle (Saale), 06112, GermanyTel +49 345 557 4166/557 1891Fax +49 345 557 3580 Email
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Nalamachu S, Robinson RL, Viktrup L, Cappelleri JC, Bushmakin AG, Tive L, Mellor J, Hatchell N, Jackson J. Pain severity and healthcare resource utilization in patients with osteoarthritis in the United States. Postgrad Med 2020; 133:10-19. [PMID: 33131380 DOI: 10.1080/00325481.2020.1841988] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To evaluate healthcare resource utilization (HCRU) by osteoarthritis (OA) pain severity. METHODS Cross-sectional surveys of US physicians and their patients were conducted between February and May 2017. Using the Numeric Rating Scale, patients were classified by self-reported pain intensity in the last week into mild (0-3), moderate (4-6), and severe (7-10) cohorts. Parameters assessed included clinical characteristics, HCRU, and current caregiver support. Descriptive statistics were obtained, and analysis of variance and chi-square tests were performed. RESULTS Patients (n = 841) were mostly female (60.9%) and white (77.8%), with mean age of 64.6 years. Patients reported mild (45.4%), moderate (35.9%), and severe (18.7%) OA pain. Mean number of affected joints varied by pain severity (range mild: 2.7 to severe: 3.6; p < 0.0001). Pain severity was associated with an increased number of physician-reported and patient-reported overall healthcare provider visits (HCPs; both p < 0.001). As pain increased, patients reported an increased need for mobility aids, accessibility modifications to homes, and help with daily activities due to functional disability. The number of imaging tests used to diagnose OA was similar across pain severity but varied when used for monitoring (X-rays: p < 0.0001; computerized tomography scans: p < 0.0447). Hospitalization rates for OA were low but were significantly associated with pain severity (mild: 4.9%; severe: 11.5%). Emergency department visits were infrequent but increasing pain severity was associated with more prior and planned surgeries. CONCLUSION Greater current pain was associated with more prior HCRU including imaging for monitoring progression, HCP visits including more specialty care, hospitalizations, surgery/planned surgery, and loss of independence due to functional disability. Yet rates of hospitalizations and X-ray use were still sizable even among patients with mild pain. These cross-sectional findings warrant longitudinal assessment to further elucidate the impact of pain on HCRU.
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Affiliation(s)
| | - Rebecca L Robinson
- Patient Outcomes and Real-World Evidence, Eli Lilly and Co , Indianapolis, IN, USA
| | - Lars Viktrup
- Lilly Bio-Medicines Core Team, Eli Lilly and Co , Indianapolis, IN, USA
| | | | | | - Leslie Tive
- Medical Affairs, Pfizer Inc , New York, NY, USA
| | | | - Niall Hatchell
- Real World Research, Adelphi Real World , Bollington, UK
| | - James Jackson
- Real World Research, Adelphi Real World , Bollington, UK
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Yang Y, Grol-Prokopczyk H. Chronic Pain and Friendship among Middle-Aged and Older U.S. Adults. J Gerontol B Psychol Sci Soc Sci 2020; 76:2131-2142. [PMID: 33119081 DOI: 10.1093/geronb/gbaa185] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES This study examines how chronic pain affects friendship in later life. We test whether onset of pain leads to social network activation, as suggested by research on other health conditions (Latham- Mintus, Forth.), or whether pain-an unverifiable and often stigmatizing condition-functions as a "threat to the social self" (Karos et al., 2018). METHODS Using longitudinal data from the Health and Retirement Study (HRS; N=4,598; 2006/2008 as Time 1 and 2010/2012 as Time 2), we conducted OLS regressions with the lagged dependent variable approach to assess how new-onset chronic pain predicted (a) respondents' number of close friends and (b) their frequency of in-person meetings with friends, controlling for sociodemographic variables and health conditions. RESULTS New-onset severe pain predicted a decrease in number of friends. New-onset moderate pain, in contrast, predicted more friends and more frequent in-person meetings. (Findings were significant or marginally significant depending on model specifications.) Mild pain showed no significant association with either outcome. Pain had a greater effect on men's friendship outcomes than women's. DISCUSSION The effects of chronic pain on later-life friendships appear to depend on pain severity, and to differ between men and women. Onset of severe pain serves as a "threat to the social self," while onset of moderate pain contributes to social network activation; both associations are significantly more pronounced among men. These findings highlight the complex associations between health and social outcomes.
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Affiliation(s)
- Yulin Yang
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine
| | - Hanna Grol-Prokopczyk
- Department of Sociology, University at Buffalo, State University of New York, Buffalo, NY
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Sucher J, Quenstedt SR, Parnes MF, Brown AD. Pain centrality mediates pain self-efficacy and symptom severity among individuals reporting chronic pain. J Clin Psychol 2020; 76:2222-2231. [PMID: 32567702 DOI: 10.1002/jclp.23012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 05/27/2020] [Accepted: 06/09/2020] [Indexed: 11/11/2022]
Abstract
Chronic pain is consistently associated with the presence of mental health disorders. Although previous research has shown relations between low levels of self-efficacy with chronic pain severity as well as comorbid mental health symptoms, the link between self-efficacy and mental health symptoms in chronic pain is not well understood. This study examined whether pain centrality, the extent to which pain is viewed as central to self-identity, may underlie these associations. Individuals with a diagnosis of chronic pain (N = 89) recruited through MTurkcompleted self-report measures including demographics, self-efficacy, pain centrality, pain severity, depression, and anxiety. Pain severity was associated with higher levels of pain centrality, depression, anxiety, and lower levels of self-efficacy. Path analysis demonstrated pain centrality significantly mediated the relationship between self-efficacy and pain severity, depression, and anxiety. Future studies would benefit from testing whether modifying pain centrality beliefs shift perceptions of control as well as pain and psychological outcomes.
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Affiliation(s)
- Jillian Sucher
- Department of Psychology, The New School for Social Research, New York, New York, USA
| | - Stella R Quenstedt
- Department of Psychology, The New School for Social Research, New York, New York, USA
| | - McKenna F Parnes
- Department of Psychology, Suffolk University, Boston, Massachusetts, USA
| | - Adam D Brown
- Department of Psychology, The New School for Social Research, New York, New York, USA.,Department of Psychiatry, New York University School of Medicine, New York, New York, USA
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Vahdatpour B, Momeni F, Tahmasebi A, Taheri P. The Effect of Extracorporeal Shock Wave Therapy in the Treatment of Patients with Trigger Finger. Open Access J Sports Med 2020; 11:85-91. [PMID: 32210646 PMCID: PMC7069581 DOI: 10.2147/oajsm.s232727] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 02/22/2020] [Indexed: 12/16/2022] Open
Abstract
Introduction Trigger finger disorder is a sudden release or locking of a finger during flexion or extension. Regarding the complications and disadvantages mentioned for the methods used in the treatment of trigger finger disorder, the aim of this study was to investigate the effect of extracorporeal shock wave therapy in the treatment of patients with trigger finger. Methods This study was an interventional study recruiting 19 patients with trigger finger disorder. Evaluation of pain severity, severity of triggering, and functional impact of triggering was carried out using the Visual Analogue Scale, Trigger Finger Score suggested by Quinnell, and Quick-Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, respectively, before intervention, immediately after intervention, and in 6 and 18 weeks after intervention. Each patient was treated with extracorporeal shock wave therapy in three sessions with a 1-week interval. Data were analyzed in Statistical Package for the Social Sciences (SPSS) software using ANOVA to monitor changes in pain severity, severity of triggering, and functional impact of triggering during follow-ups. Results There were statistically significant differences with regard to reduction of the pain severity, severity of triggering, and functional impact of triggering before intervention, immediately after intervention, and in 6 and 18weeks after intervention (P<0.01). However, the effect of extracorporeal shock wave therapy on reducing severity of triggering immediately after intervention did not yield a statistically significant difference compared to before intervention (P>0.01). Conclusion It seems that extracorporeal shock wave therapy leads to a reduction in pain severity, severity of triggering, and functional impact of triggering. These effects persisted until the 18th week after the intervention. It is recommended to use extracorporeal shock wave therapy in terms of a non-invasive intervention with no significant complications for patients with trigger finger.
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Affiliation(s)
- Babak Vahdatpour
- Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Momeni
- Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Tahmasebi
- Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parisa Taheri
- Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran
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Frigstad SO, Høivik ML, Jahnsen J, Cvancarova M, Grimstad T, Berset IP, Huppertz-Hauss G, Hovde Ø, Bernklev T, Moum B, Jelsness-Jørgensen LP. Pain Severity and Vitamin D Deficiency in IBD Patients. Nutrients 2019; 12:nu12010026. [PMID: 31877637 PMCID: PMC7019855 DOI: 10.3390/nu12010026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 12/10/2019] [Accepted: 12/18/2019] [Indexed: 12/22/2022] Open
Abstract
Background: Pain and vitamin D deficiency are common in inflammatory bowel disease (IBD). Disease activity, fatigue, frequent relapses, prior surgery and psychological factors all seem to influence the experience of pain in IBD. Vitamin D deficiency has been associated with muscle and skeletal pain. This study aimed to determine whether there is an association between vitamin D deficiency and severity of pain in patients with IBD, and to investigate the influence of other socio-demographic and psychological variables on the experience of pain. Methods: Patients with IBD were recruited from nine hospitals in Norway in a multicenter cross-sectional study. The Brief Pain Inventory (BPI) questionnaire was used to measure pain. Disease activity was assessed using clinical disease activity indices, C-reactive protein (CRP) and fecal calprotectin. Regression models were fitted to explore a possible association between 25-hydroxyvitamin D and pain severity. Results: Of 407 patients included in the analyses, 229 (56%) had Crohn’s disease (CD) and 178 (44%) had ulcerative colitis (UC). Vitamin D deficiency was present in half (203/407) of patients. Presence of pain was reported by 76% (309/407). More severe pain was associated with female gender and increased disease activity scores, but not with increased CRP or fecal calprotectin. In CD, patients without prior intra-abdominal surgery reported more severe pain. In multivariate analyses, there was no association between 25-hydroxyvitamin D and pain severity. Conclusions: In this study, no significant association between pain severity and vitamin D deficiency was revealed in patients with IBD.
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Affiliation(s)
- Svein Oskar Frigstad
- Department of Research, Østfold Hospital, 1714 Grålum, Norway
- Department of Medicine, Vestre Viken Bærum Hospital, 1346 Gjettum, Norway
- Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; (M.L.H.); (J.J.); (I.P.B.); (Ø.H.); (T.B.); (B.M.)
- Correspondence: ; Tel.: +47-6780-9587
| | - Marte Lie Høivik
- Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; (M.L.H.); (J.J.); (I.P.B.); (Ø.H.); (T.B.); (B.M.)
- Department of Gastroenterology, Oslo University Hospital, 0424 Oslo, Norway;
| | - Jørgen Jahnsen
- Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; (M.L.H.); (J.J.); (I.P.B.); (Ø.H.); (T.B.); (B.M.)
- Department of Gastroenterology, Akershus University Hospital, 1478 Nordbyhagen, Norway
| | - Milada Cvancarova
- Department of Gastroenterology, Oslo University Hospital, 0424 Oslo, Norway;
- Department of Biostatistics, Oslo Metropolitan University, 0130 Oslo, Norway
| | - Tore Grimstad
- Department of Gastroenterology, Stavanger University Hospital, 4068 Stavanger, Norway;
| | - Ingrid Prytz Berset
- Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; (M.L.H.); (J.J.); (I.P.B.); (Ø.H.); (T.B.); (B.M.)
| | | | - Øistein Hovde
- Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; (M.L.H.); (J.J.); (I.P.B.); (Ø.H.); (T.B.); (B.M.)
- Department of Medicine, Innlandet Hospital, 2819 Gjøvik, Norway
| | - Tomm Bernklev
- Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; (M.L.H.); (J.J.); (I.P.B.); (Ø.H.); (T.B.); (B.M.)
- Department of Research and Development, Vestfold Hospital, 3103 Tønsberg, Norway
| | - Bjørn Moum
- Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway; (M.L.H.); (J.J.); (I.P.B.); (Ø.H.); (T.B.); (B.M.)
- Department of Gastroenterology, Oslo University Hospital, 0424 Oslo, Norway;
| | - Lars-Petter Jelsness-Jørgensen
- Department of Gastroenterology, Østfold Hospital, 1714 Grålum, Norway;
- Department of Health Sciences, Østfold University College, 1757 Halden, Norway
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Yue L, Wang J, Enomoto H, Fujikoshi S, Alev L, Cheng YY, Skljarevski V. The Clinical Relevance of Pain Severity Changes: Is There Any Difference Between Asian and Caucasian Patients With Osteoarthritis Pain? Pain Pract 2019; 20:129-137. [PMID: 31505082 PMCID: PMC7027917 DOI: 10.1111/papr.12835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 07/24/2019] [Accepted: 08/07/2019] [Indexed: 11/28/2022]
Abstract
The objective of the present analysis was to determine whether changes in Brief Pain Inventory (BPI) average pain scores by patient global impression of improvement (PGI‐I) category and the cut‐off for clinically important difference (CID) were different between Asian and Caucasian patients with chronic pain due to osteoarthritis. This analysis used data from 3 (Caucasian) and 2 (Asian) randomized, placebo‐controlled, 10‐ to 14‐week duloxetine studies for the treatment of patients ≥40 years of age with osteoarthritis pain. The receiver operating characteristic (ROC) analysis was used to characterize the association between changes in BPI average pain scores and PGI‐I levels at study endpoint. The CID was characterized by PGI‐I, and the cut‐off point for CID in BPI average pain scores was determined by the intersection of a 45‐degree tangent line with each ROC curve. Data from 668 Asian and 868 Caucasian patients were available for analysis. Baseline BPI average pain ratings including worst and least pain were comparable between Asians and Caucasians. Ratings for percentage change from baseline to endpoint for BPI average pain scores in Asian patients and Caucasian patients were similar across the 7 PGI‐I categories, regardless of age, gender, study, and treatment. The ROC analysis results of cut‐off points in BPI average pain scores demonstrated the raw change cut‐off was −3.0, and percentage change cut‐off was −40% for both Asian and Caucasian patients. Overall, the present analysis concludes changes in BPI average pain scores by PGI‐I category and the cut‐off for CID were similar for Asian and Caucasian patients with chronic pain due to osteoarthritis.
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Affiliation(s)
- Li Yue
- Medical Department, Lilly Suzhou Pharmaceutical Co. Ltd. Shanghai Branch, Shanghai, China
| | - Jianing Wang
- Medical Department, Lilly Suzhou Pharmaceutical Co. Ltd. Shanghai Branch, Shanghai, China
| | - Hiroyuki Enomoto
- Medicine Development Unit-Japan, Eli Lilly Japan K.K., Tokyo, Japan
| | - Shinji Fujikoshi
- Medicine Development Unit-Japan, Eli Lilly Japan K.K., Kobe, Japan
| | - Levent Alev
- TR Medical Mgmt, Eli Lilly Turkey, Istanbul, Turkey
| | - Yan Yolanda Cheng
- Medical Department, Lilly Suzhou Pharmaceutical Co. Ltd. Shanghai Branch, Shanghai, China
| | - Vladimir Skljarevski
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, U.S.A
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