Abstract
BackgroundIncorporating the patient's view on care and treatment has become increasingly important for health care. Patients describe the variety of consequences of their chronic pain conditions as significant pain intensity, depression, and anxiety. We hypothesised that intensities of common symptoms in chronic pain conditions carry important information that can be used to identify clinically relevant subgroups. This study has three aims: 1) to determine the importance of different symptoms with respect to participation and ill-health; 2) to identify subgroups based on data concerning important symptoms; and 3) to determine the secondary consequences for the identified subgroups with respect to participation and health factors.Methods and SubjectsThis study is based on a cohort of patients referred to a multidisciplinary pain centre at a university hospital (n = 4645, participation rate 88%) in Sweden. The patients answered a number of questionnaires concerning symptoms, participation, and health aspects as a part of the Swedish Quality Registry for Pain Rehabilitation (SQRP).ResultsCommon symptoms (such as pain intensity, depression, and anxiety) in patients with chronic pain showed great variability across subjects and 60% of the cohort had normal values with respect to depressive and anxiety symptoms. Pain intensity more than psychological symptoms showed stronger relationships with participation and health. It was possible to identify subgroups based on pain intensity, depression, and anxiety. With respect to participation and health, high depressive symptomatology had greater negative consequences than high anxiety.ConclusionsCommon symptoms (such as pain intensity and depressive and anxiety symptoms) in chronic pain conditions carry important information that can be used to identify clinically relevant subgroups.
Highlights
Chronic pain is influenced by and interacts with physical, emotional, psychological, and social factors and often results in significant suffering [1,2,3]
IMMPACT suggests a number of simultaneous outcomes for clinical trials [11], one-dimensional pain measures can be reliable indicators of treatment outcomes in chronic pain conditions even though such a measure does not take into account the whole complexity of the patient’s experience [13]
We hypothesised that intensities of common symptoms in patients with chronic pain conditions carry important information that can be used to identify clinically relevant subgroups
Summary
Chronic pain is influenced by and interacts with physical, emotional, psychological, and social factors and often results in significant suffering [1,2,3]. To address these issues, health care professionals have increasingly used a holistic or a bio-psychosocial (BPS) framework [4,5] that considers their patients’ views when developing care and treatment strategies [6]. We hypothesised that intensities of common symptoms in chronic pain conditions carry important information that can be used to identify clinically relevant subgroups. This study has three aims: 1) to determine the importance of different symptoms with respect to participation and ill-health; 2) to identify subgroups based on data concerning important symptoms; and 3) to determine the secondary consequences for the identified subgroups with respect to participation and health factors
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