Prevalence and associated factors of disability in patients with chronic pain: An observational study

Aki Fujiwara, Mitsuru Ida, Keisuke Watanabe, Hideaki Kawanishi, Katsuhiro Kimoto, Kie Yoshimura, Kozue Shinohara, Masahiko Kawaguchi, Aki Fujiwara, Mitsuru Ida, Keisuke Watanabe, Hideaki Kawanishi, Katsuhiro Kimoto, Kie Yoshimura, Kozue Shinohara, Masahiko Kawaguchi

Abstract

The primary treatment goal of patients experiencing chronic pain has shifted from pain reduction to functional status improvement. However, the prevalence of disability and its associated factors in patients with chronic pain remain unknown.Individuals aged ≥50 years who visited the Pain Center at Nara Medical University with chronic pain from June 2019 to May 2020 were eligible for enrollment. Patients were asked to complete the Japanese version of the 12-item World Health Organization Disability Assessment Schedule 2.0. Patient demographics, pain intensity, level of catastrophizing, anxiety, depression, and exercise habits were assessed. Multivariate logistic regression analysis was used to identify the factors associated with disability.Of the 551 patients with a median age of 73 years, 51.5% experienced disability. Fixed factors such as age (odds ratio [OR], 1.03; 95% confidence interval [CI] 1.01-1.06, P = .002) and lumbar and lower limb pain (OR, 3.10; 95% CI, 1.83-5.24, P < .001) and some modifiable factors, including anxiety (OR, 2.06; 95% CI, 1.06-3.98, P = .03), depression (OR, 3.62; 95% CI, 1.92-6.82, P < .001), pain catastrophizer (OR, 2.94; 95% CI, 1.88-4.61, P < .001), numeric rating scale at the most painful site (OR, 1.29; 95% CI, 1.18-1.42, P < .001), exercise habits (walking (OR, 0.52; 95% CI, 0.33-0.83, P = .006) and working out (OR, 0.58; 95% CI, 0.34-0.99, P = .046), were found to be independently associated with disability.This cross-sectional study revealed a high prevalence of disability in patients with chronic pain and identified the factors associated with disability.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

Figures

Figure 1
Figure 1
Flow diagram of participation.

References

    1. World Health Organization. Ageing and health [World Health Organization Web site]. World Health Organization: 2018. Available from: . Accessed Jan 21, 2021.
    1. Miu DKY, Chan KC. Under-detection of pain in elderly nursing home residents with moderate to severe dementia. J Clin Gerontol Geriatr 2014;5:23–7.
    1. Manchikanti L, Kaye AM, Knezevic NN, et al. . Responsible, safe, and effective prescription of opioids for chronic non-cancer pain: American Society of Interventional Pain Physicians (ASIPP) guidelines. Pain Physician 2017;20:S3–92.
    1. The committee for the Guidelines for the Pharmacologic Management of Neuropathic Pain (Revised) of JSPC. Guidelines for the Pharmacologic Management of Neuropathic Pain Second Edition. Japan, Tokyo: Shinko Trading Co. Ltd. July 2016; 123–260. Available from: . Accessed Jan 21, 2021.
    1. Roland M, Morris R. A study of the natural history of back pain. part 1: development of a reliable and sensitive measure of disability in low back pain. Spine (Phila Pa 1976) 1983;8:141–4.
    1. Pincus T, Summey JA, Soraci SA, Jr, Wallston KA, Hummon NP. Assessment of patient satisfaction in activities of daily living using a modified Stanford Health Assessment Questionnaire. Arthritis Rheum 1983;26:1346–53.
    1. Cruz DL, Ayres EW, Spiegel MA, et al. . Validation of the recently developed total disability index: a single measure of disability in neck and back pain patients. J Neurosurg Spine 2019;6:01–9.
    1. Ustün TB, Chatterji S, Kostanjsek N, et al. . WHO/NIH joint project. Developing the World Health Organization disability assessment schedule 2.0. Bull World Health Organ 2010;88:815–23.
    1. Fujiwara A, Ida M, Kimoto K, Watanabe K, Masahiko K. Feasibility, reliability and validity of the 12-item World Health Organization Disability Assessment Schedule 2.0 in patients attending the pain clinic. J Anesthesia 2020.
    1. Silva AG, Queiros A, Cerqueira M, Rocha NP. Pain intensity is associated with both performance-based disability and self-reported disability in a sample of older adults attending primary health care centers. Disabil Health J 2014;7:457–65.
    1. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361–70.
    1. Sullivan MJ, Bishop SR, Pivik J. Pain catastrophizing scale: development and validation. Psychol Assess 1995;7:524–32.
    1. Ustün TB, Kostanjesek N, Chatterji S, et al. . Measuring Health and Disability: Manual for WHO Disability Assessment Schedule (WHODAS 2.0). [World Health Organization web site]. 2010. Available at: . Accessed January 21, 2021.
    1. Shulman MA, Myles PS, Chan MT, Mcllroy DR, Wallace S, Ponsford J. Measurement of disability-free survival after surgery. Anesthesiology 2015;122:524–36.
    1. Kamiyama T, Muratani H, Kimura Y, et al. . Factors related to impairment of activities of daily living. Intern Med 1999;38:698–704.
    1. Guccione AA, Felson DT, Anderson JJ, et al. . The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. Am J Public Health 1994;84:351–8.
    1. Boult C, Kane RL, Louis TA, Boult L, McCaffrey D. Chronic conditions that lead to functional limitation in the elderly. J Gerontol 1994;49:M28–36.
    1. Kuroda Y, Iwasa H, Orui M, et al. . Risk factor for incident functional disability and the effect of a preventive exercise program: a 4-year prospective cohort study of older survivors from the great east Japan earthquake and nuclear disaster. Int J Environ Res Public Health 2018;15:1430.
    1. Busse JW, Mahmood H, Maqbool B, et al. . Characteristics of patients receiving long-term opioid therapy for chronic noncancer pain: a cross-sectional survey of patients attending the Pain Management Center at Hamilton General Hospital, Hamilton. Ontario CMAJ Open 2015;3:E324–330. doi:10.9778/cmajo.20140126. Accessed January 21, 2021.
    1. Turner JA, Shortreed SM, Saunders KW, LeResche L, Von Korff M. Association of levels of opioid use with pain and activity interference among patients initiating chronic opioid therapy: a longitudinal study. Pain 2016;157:849–57.
    1. Gray SL, LaCroix AZ, Hanlon JT, et al. . Benzodiazepine use and physical disability in community-dwelling older adults. J Am Geriatr Soc 2006;54:224–30.
    1. Ćwirlej-Sozańska A, Wilmiwska-Pietruszyńska A, Sozański B, Wiśniowska-Szurlej A. Analysis of chronic illness and disability in a community-based sample of elderly people in south-eastern Poland. Med Sci Monit 2018;24:1387–98.
    1. Yoshida D, Ninomiya T, Doi Y, et al. . Prevalence and causes of functional disability in an elderly general population of Japanese: The Hisayama study. J Epidemiol 2012;22:222–9.
    1. GBD., 2015 Disease, Injury Incidence, Prevalence collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries 2015: a systematic analysis for the Global Burden of Disease Study. Lancet 2016;388:1545–602.
    1. Scott KM, Von Koff M, Alonso J, et al. . Mental-physical co-morbidity and its relationship with disability: results from the World Mental Health Surveys. Psychol Med 2009;39:33–43.
    1. Geneen LJ, Martin DJ, Adams N, et al. . Effects of education to facilitate knowledge about chronic pain for adults: a systematic review with meta-analysis. Syst Rev 2015.
    1. Malfliet A, Ickmans K, Huysmans E, et al. . Best evidence rehabilitation for chronic pain part 3; low back pain. J Clin Med 2019.
    1. Solé E, Racine M, Tomé-Pires C, Galán S, Jensen MP, Miró J. Social factors, disability, and depressive symptoms in adults with chronic pain. Clin J Pain 2020;36:371–8.

Source: PubMed

Подписаться