scholarly journals The Pain Divide: a cross-sectional analysis of chronic pain prevalence, pain intensity and opioid utilisation in England

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e023391 ◽  
Author(s):  
Adam Todd ◽  
Nasima Akhter ◽  
Joanne-Marie Cairns ◽  
Adetayo Kasim ◽  
Nick Walton ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Local Authority ◽  
Opioid Analgesics ◽  
Opioid Use ◽  
Cross Sectional ◽  
Individual Level ◽  
The North ◽  
Pain Prevalence ◽  
Health Survey For England

ObjectivesOur central research question was, in England, are geographical inequalities in opioid use driven by health need (pain)? To answer this question, our study examined: (1) if there are regional inequalities in rates of chronic pain prevalence, pain intensity and opioid utilisation in England; (2) if opioid use and chronic pain are associated after adjusting for individual-level and area-level confounders.DesignCross-sectional study design using data from the Health Survey for England 2011.SettingEngland.Primary and secondary outcome measuresChronic pain prevalence, pain intensity and opioid utilisation.ParticipantsParticipant data relating to chronic pain prevalence, pain intensity and opioid usage data were obtained at local authority level from the Health Survey for England 2011; in total, 5711 respondents were included in our analysis.MethodsRegional and local authority data were mapped, and a generalised linear model was then used to explore the relationships between the data. The model was adjusted to account for area-level and individual-level variables.ResultsThere were geographical variations in chronic pain prevalence, pain intensity and opioid utilisation across the English regions—with evidence of a ‘pain divide’ between the North and the South, whereby people in the North of England more likely to have ‘severely limiting’ or ‘moderately limiting’ chronic pain. The intensity of chronic pain was significantly and positively associated with the use of opioid analgesics.ConclusionsThere are geographical differences in chronic pain prevalence, pain intensity and opioid utilisation across England—with evidence of a ‘pain divide’. Given the public health concerns associated with the long-term use of opioid analgesics—and their questionable activity in the management of chronic pain—more guidance is needed to support prescribers in the management of chronic pain, so the initiation of opioids can be avoided.

Collecting patient reported outcomes to facilitate prescription opioid management: Development and testing of the Opioid Management App (OM-App) (Preprint)

2020 ◽  
Author(s):  
Jessica Robinson-Papp ◽  
Gabriela Cedillo ◽  
Richa Deshpande ◽  
Mary Catherine George ◽  
Qiuchen Yang ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Risk Behaviors ◽  
Digital Health ◽  
Monitoring Program ◽  
Prescription Opioid ◽  
Research Database ◽  
Cross Sectional ◽  
Study Duration ◽  
Patient Reported

BACKGROUND Collecting patient-reported data needed by clinicians to adhere to opioid prescribing guidelines represents a significant time burden. OBJECTIVE We developed and tested an opioid management app (OM-App) to collect these data directly from patients. METHODS OM-App used a pre-existing digital health platform to deliver daily questions to patients via text-message and organize responses into a dashboard. We pilot tested OM-App over 9 months in 40 diverse participants with HIV who were prescribed opioids for chronic pain. Feasibility outcomes included: ability to export/integrate OM-App data with other research data; patient-reported barriers and adherence to OM-App use; capture of opioid-related harms, risk behaviors and pain intensity/interference; comparison of OM-App data to urine drug testing, prescription drug monitoring program data, and validated questionnaires. RESULTS OM-App data was exported/integrated into the research database after minor modifications. Thirty-nine of 40 participants were able to use OM-App, and over the study duration 70% of all OM-App questions were answered. Although the cross-sectional prevalence of opioid-related harms and risk behaviors reported via OM-App was low, some of these were not obtained via the other measures, and over the study duration all queried harms/risks were reported at least once via OM-App. Clinically meaningful changes in pain intensity/interference were captured. CONCLUSIONS OM-App was used by our diverse patient population to produce clinically relevant opioid- and pain-related data, which was successfully exported and integrated into a research database. These findings suggest that OM-App may be a useful tool for remote monitoring of patients prescribed opioids for chronic pain. CLINICALTRIAL NCT03669939 INTERNATIONAL REGISTERED REPORT RR2-doi:10.1016/j.conctc.2019.100468

Pan-Canadian Estimates of Chronic Pain Prevalence From 2000 to 2014: A Repeated Cross-Sectional Survey Analysis

2019 ◽  
Vol 20 (5) ◽  
pp. 557-565 ◽  
Author(s):  
Matthew S. Shupler ◽  
John K. Kramer ◽  
Jacquelyn J. Cragg ◽  
Catherine R. Jutzeler ◽  
David G.T. Whitehurst
Keyword(s):  
Chronic Pain ◽  
Survey Analysis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Pain Prevalence

scholarly journals Prevalence and Characteristics of Chronic Pain in Buprenorphine and Methadone-Maintained Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Jessica Delorme ◽  
Lucie Pennel ◽  
Georges Brousse ◽  
Jean-Pierre Daulouède ◽  
Jean-Michel Delile ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Illicit Drugs ◽  
Opioid Analgesics ◽  
Cross Sectional Study ◽  
Opioid Agonist ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Chronic Pain Patients ◽  
Associated Risk Factors ◽  
Pain Patients

Chronic pain and substance use disorders frequently co-occur. Indeed, chronic pain is highly prevalent, affecting 23–68% of patients receiving opioid agonist treatments (OAT) worldwide. The majority of available estimates come from American studies, but data are still lacking in Europe. We aim to provide European estimates of the prevalence of chronic pain in patients receiving OAT using French data, since France is the first European country in terms of number of patients with OAT. The secondary objectives were to characterize the features and management of chronic pain, as well identify associated risk factors. We conducted a multicenter, cross-sectional study, recruiting patients treated either with buprenorphine or methadone in 19 French addiction centers, from May to July 2016. All participants had to complete a semi-directed questionnaire that collected sociodemographic and medical data, pain characteristics, and licit or illicit drug consumption. In total, 509 patients were included. The prevalence of chronic pain was estimated at 33.2% (95% CI: 29.1–37.3). Compared to non-chronic pain patients, chronic pain patients were older (38.4 vs. 36.1 years, p = 0.006), were more unemployed (66 vs. 52%, p = 0.003), had more psychiatric comorbidities (50 vs. 39%, p = 0.02), and split their OAT for pain management more frequently (24 vs. 7%, p = 0.009). Pain intensity was moderate or severe in 75% of chronic pain patients. Among patients with chronic pain, 15.4% were not prescribed, and did not self-medicate with, any analgesic drugs, 52.1% were prescribed analgesics (non-opioid analgesics, 76.3%; codeine, tramadol, opium, 27.2%; and morphine, fentanyl, oxycodone, 11.8%), and 32.5% exclusively self-medicated with analgesics. Moreover, 20.1% of patients with chronic pain also used illicit drugs for pain relief. On multivariate analysis, variables that remained significantly associated with chronic pain were age [OR = 1.03 (95% CI: 1.00–1.05], p = 0.02], anxiety [OR = 1.52 (1.15–2.02), p = 0.003], and depression [OR = 1.25 (1.00–1.55), p = 0.05]. Chronic pain is a highly prevalent condition in patients receiving OAT, and its appropriate management remains uncertain, since insufficient relief and frequent additional self-medications with analgesics or illicit drugs were reported by these patients. Increased awareness among caregivers is urgently needed regarding a systematic and careful assessment, along with an adequate management of chronic pain in patients receiving OAT.

scholarly journals Loneliness, social isolation, and pain following the COVID-19 outbreak: data from a nationwide internet survey in Japan

2021 ◽  
Author(s):  
Keiko Yamada ◽  
Kenta Wakaizumi ◽  
Yasuhiko Kubota ◽  
Hiroshi Murayama ◽  
Takahiro Tabuchi
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Social Isolation ◽  
Multinomial Logistic Regression ◽  
Short Form ◽  
Analysis Of Covariance ◽  
Internet Survey ◽  
Pain Prevalence ◽  
Pain History ◽  
Perceived Social Isolation

Abstract The aim of cross-sectional study was to investigate the association between pain and loneliness and increased social isolation during the COVID-19 pandemic. A total of 25,482 participants, aged 15–79 years, were assessed using an internet survey; the University of California, Los Angeles Loneliness Scale (Version 3), Short Form 3-item (UCLA-LS3-SF3) was used to assess loneliness, and a modified item of the UCLA-LS3-SF3 was used to measure the perception of increased social isolation during the pandemic. The outcome measures included the prevalence/incidence of pain (i.e., headache, neck or shoulder pain, upper limb pain, low back pain, and leg pain), pain intensity, and chronic pain history/prevalence. Pain intensity was measured by the pain/discomfort item of the 5-level version of the EuroQol 5 Dimension scale. Odds ratios of pain prevalence/incidence and chronic pain history/prevalence according to the UCLA-LS3-SF3 scoring groups (tertiles) and the frequency of the perceived increase in social isolation (categories 1–5) were calculated using multinomial logistic regression analysis. The mean pain intensity values among different loneliness and social isolation levels were tested using an analysis of covariance. Increased loneliness and the severity of the perceived social isolation were positively associated with pain prevalence/incidence, intensity, and the history/prevalence of chronic pain.

Impact of Perioperative Pain Intensity, Pain Qualities, and Opioid Use on Chronic Pain After Surgery

2012 ◽  
Vol 37 (1) ◽  
pp. 19-27 ◽  
Author(s):  
Elizabeth G. VanDenKerkhof ◽  
Wilma M. Hopman ◽  
David H. Goldstein ◽  
Rosemary A. Wilson ◽  
Tanveer E. Towheed ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Opioid Use ◽  
Perioperative Pain

scholarly journals Pain intensity as a moderator of the association between opioid use and insomnia symptoms among adults with chronic pain

2018 ◽  
Vol 52 ◽  
pp. 98-102 ◽  
Author(s):  
Mary Beth Miller ◽  
Wai Sze Chan ◽  
Ashley F. Curtis ◽  
Jeff Boissoneault ◽  
Michael Robinson ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Opioid Use ◽  
Insomnia Symptoms

Association of sleep sufficiency and duration with chronic pain prevalence: A population-based cross-sectional study

2019 ◽  
Vol 120 ◽  
pp. 74-80 ◽  
Author(s):  
Keiko Yamada ◽  
Yasuhiko Kubota ◽  
Yuji Shimizu ◽  
Masahiko Shibata ◽  
Nobuo Morotomi
Keyword(s):  
Chronic Pain ◽  
Population Based ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pain Prevalence

scholarly journals Prevalence and Determinants of Pain and Pain-Related Disability in Urban and Rural Settings in Southeastern Ontario

2006 ◽  
Vol 11 (4) ◽  
pp. 225-233 ◽  
Author(s):  
Dean A Tripp ◽  
Elizabeth G VanDenKerkhof ◽  
Margo McAlister
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Health Status ◽  
Health Care Utilization ◽  
Pain Intensity ◽  
Pain Interference ◽  
Urban Region ◽  
Care Utilization ◽  
The Past ◽  
Pain Prevalence

BACKGROUND: Canadian chronic pain prevalence estimates range from 11% to 66%, are affected by sampling and measurement bias, and largely represent urban settings.OBJECTIVES: To estimate chronic pain prevalence and factors associated with pain in southeastern Ontario, a region with a larger rural than urban residence.METHODS: A systematic sampling with a random start was used to contact households. A telephone-administered questionnaire using the Graded Chronic Pain Scale, with questions on health care and medication use, health status, depression and demographics, was administered to consenting adults (18 to 94 years of age; mean age 50.2±16.6 years).RESULTS: The response rate was 49% (1067 of 2167), with 76% reporting some pain over the past six months. Low pain intensity with low pain interference prevalence was 34% (grade I), high pain intensity with low pain interference was 26% (grade II), and high pain intensity with high pain interference was 17% (grades III and IV). Of those reporting pain, 49% reported chronic pain (ie, pain for a minimum of 90 days over the past six months) representing 37% of the sample. Being female, unmarried, lower income, poorer self-reported health status and rural residence were associated with increasing pain. Once depression was considered in this pain analysis, residence was no longer significant. Lower rates of health care utilization were reported by rural residents. In those reporting the highest pain grades, poor health, greater medication and health care use, depression and more pain sites were associated with higher odds for pain-related disability.CONCLUSION: There is an elevated prevalence of pain in this almost equally split rural/urban region. Further examination of health care utilization and depression is suggested in chronic pain prevalence research.

Opioid Pharmacotherapies for Chronic Pain (DRAFT)

2018 ◽  
Author(s):  
Thien C. Pham ◽  
Courtney Kominek ◽  
Abigail Brooks ◽  
Jeffrey Fudin
Keyword(s):  
Chronic Pain ◽  
Extended Release ◽  
Opioid Analgesics ◽  
Chronic Pain Management ◽  
Opioid Use ◽  
Daily Dose ◽  
Long Acting ◽  
Conversion Tool ◽  
Morphine Equivalent

Chronic pain management employing opioids is divided into subtopics, including: risk–benefit balance; a review of the mode of action of opioid analgesics (Chap. 8); the suitability of synthetic opioids for neuropathic pain; endocrinopathy proceeding from opioid use; the use of the morphine-equivalent daily dose as a conversion tool for managing multiple opioids; the place of extended-release and long-acting opioids; current technology in abuse deterrence; and an overview of the challenges entailed in prescribing. This last section details the complex components of a decision to prescribe opioids for chronic pain. A table is provided of the classification of common opioid analgesics and their duration of activity. A text box gives the table of contents of Appendix B, supportive tables and figures therein for this chapter; there is also a text box listing additional resources.

The buffering role of positive affect on the association between pain intensity and pain related outcomes

2017 ◽  
Vol 14 (1) ◽  
pp. 91-97 ◽  
Author(s):  
Ivan S.K. Thong ◽  
Gabriel Tan ◽  
Mark P. Jensen
Keyword(s):  
Chronic Pain ◽  
Depressive Symptoms ◽  
Negative Affect ◽  
Positive Affect ◽  
Pain Intensity ◽  
Sleep Problems ◽  
Cross Sectional Study ◽  
Pain Interference ◽  
Cross Sectional ◽  
The Impact

AbstractObjectivesChronic pain is a significant problem worldwide and is associated with significant elevations in negative affect, depressive symptoms, sleep problems, and physical dysfunction. Positive affect could potentially buffer the impact of pain on patient functioning. If it does, then positive affect could be directly targeted in treatment to benefit individuals with chronic pain. The purpose of this study was to test for such moderating effects.MethodsThis was a cross-sectional study, we administered measures of pain intensity, depressive symptoms, sleep problems, pain interference, and positive and negative affect to 100 individuals with chronic back or knee pain in a single face-to-face assessment session.ResultsThe associations between pain intensity and negative affect, and between pain intensity and depressive symptoms were moderated by positive affect. This moderation effect was explained by the fact that participants with low positive affect evidenced strong associations between pain intensity and both depression and negative affect; participants with high positive affect, on the other hand, evidenced weak and non-significant associations between pain intensity and both depression and negative affect. Positive affect did not moderate the associations between pain intensity and either sleep problems or pain interference.ConclusionThe findings are consistent with the possibility that positive affect may buffer the impact of pain intensity on negative affect and depressive symptoms. Longitudinal and experimental research is needed to determine the potential benefits of treatments that increase positive affect on negative affect and depressive symptoms in chronic pain populations.ImplicationsThe study findings suggest the possibility that “positive psychology” interventions which increase positive affect could benefit individuals with chronic pain by reducing the impact of pain on negative outcomes. Research to test this possibility is warranted.

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