Chronic pain epidemiology and its clinical relevance

Hecke, Oliver van; Torrance, Nicola; Smith, Blair H.

doi:10.1093/bja/aet123

Cited by 521 publications

(384 citation statements)

References 68 publications

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“…It was possible that the acute event leading to hospitalization exacerbated one's baseline chronic pain, necessitating the use of opioids for pain control at discharge. [77][78][79][80][81] Prior research shows that chronic opioid therapy is associated with hospital readmissions. 82 In our patients, increased 'number of hospital readmissions' was correlated with 'opioid receipt' at discharge.…”

Section: Discussionmentioning

confidence: 99%

Opioid Prescribing at Hospital Discharge Contributes to Chronic Opioid Use

et al. 2015

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BACKGROUND: Chronic opioid therapy for chronic pain treatment has increased. Hospital physicians, including hospitalists and medical/surgical resident physicians, care for many hospitalized patients, yet little is known about opioid prescribing at hospital discharge and future chronic opioid use. OBJECTIVE: We aimed to characterize opioid prescribing at hospital discharge among 'opioid naïve' patients. Opioid naïve patients had not filled an opioid prescription at an affiliated pharmacy 1 year preceding their hospital discharge. We also set out to quantify the risk of chronic opioid use and opioid refills 1 year post discharge among opioid naïve patients with and without opioid receipt at discharge. DESIGN: This was a retrospective cohort study. PARTICIPANTS: From 1 January 2011 to 31 December 2011, 6,689 opioid naïve patients were discharged from a safety-net hospital. MAIN MEASURE: Chronic opioid use 1 year post discharge. KEY RESULTS: Twenty-five percent of opioid naïve patients (n=1,688) had opioid receipt within 72 hours of discharge. Patients with opioid receipt were more likely to have diagnoses including neoplasm (6.3 % versus 3.5 %, p<0.001), acute pain (2.7 % versus 1.0 %, p<0.001), chronic pain at admission (12.1 % versus 3.3 %, p<0.001) or surgery during their hospitalization (65.1 % versus 18.4 %, p<0.001) compared to patients without opioid receipt. Patients with opioid receipt were less likely to have alcohol use disorders (15.7 % versus 20.7 %, p<0.001) and mental health disorders (23.9 % versus 31.4 %, p<0.001) compared to patients without opioid receipt. Chronic opioid use 1 year post discharge was more common among patients with opioid receipt (4.1 % versus 1.3 %, p<0.0001) compared to patients without opioid receipt. Opioid receipt was associated with increased odds of chronic opioid use (AOR=4.90, 95 % CI 3.22-7.45) and greater subsequent opioid refills (AOR=2.67, 95 % CI 2.29-3.13) 1 year post discharge compared to no opioid receipt. CONCLUSION:Opioid receipt at hospital discharge among opioid naïve patients increased future chronic opioid use. Physicians should inform patients of this risk prior to prescribing opioids at discharge.

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Section: Discussionmentioning

confidence: 99%

Opioid Prescribing at Hospital Discharge Contributes to Chronic Opioid Use

et al. 2015

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“…Although various medical and mental conditions, such as diabetes mellitus, hypertension, cardiovascular disease [32] and depression [9,11] are recognized as risk factors for SD, chronic pain is not typically regarded as one of them. The higher levels of pain reported by patients with SD as compared to those who did not report SD in the present study may suggest that chronic pain could also be considered a risk factor for SD, as suggested by others [9][10][11][12][13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Sexual Dysfunction in Patients with Chronic Pain

Gruenwald¹

2017

UNOAJ

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Objective: Restricted normal activities associated with chronic pain are well documented. In contrast, there is a paucity of reports regarding the association between chronic pain patients and their sexual function. The aim of the present "snapshot" study was to evaluate the prevalence and severity of sexual dysfunction (SD) in a cohort of patients suffering from chronic pain.Methods: 709 patients with chronic pain completed questionnaires assessing demographics, pain-intensity, disability and severity of their SD. A subgroup also completed questionnaires relating to depression and anxiety as well as specific gender-related SD questionnaires.Results: 404 patients (58%) reported pain related SD. No differences in demographic parameters were found between those with and without SD. In contrast, patients with SD exhibited significantly higher scores in pain intensity (VAS), Short-form McGill Pain questionnaire and the Oswestry Disability Index. Patients with SD also consumed significantly higher doses of pain medications. On both numerical and categorical self-report scales of SD severity, women scored slightly but significantly higher than men. A significant correlation was found between pain intensity and SD severity (Pearson's test: r=0.349; p<0.001). The questionnaires completed by a sub-group of patients with SD revealed a mild degree of depression, a moderate anxiety level and a moderate degree of SD in both genders. Conclusion:A significant number of patients with chronic pain suffer from moderate to severe SD, which correlates with pain intensity. These findings are congruent with previous reports and highlight the importance of increased awareness to SD in patients with chronic pain.

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“…Pain is a symptom of two of the three largest causes of death throughout the world, which in many cases cause extreme suffering which is frequently unrelieved (Van den Beuken-van Everdingen et al 2007, Goldberg and McGee 2011, van Hecke et al 2013. Nurses have a fundamental duty to both care for patients and relieve suffering, however this review of undergraduate pre-registration nursing education in the UK demonstrates that pain is an infrequent component of the curriculum.…”

Section: Discussionmentioning

confidence: 93%

“…Chronic pain effects around 20% of the adult population in Europe (van Hecke et al 2013) with chronic lower back pain alone identified as one of the top 10 diseases in the Global Burden of Disease Study (2010) and accounting the for highest number of Disability Adjusted Lost years (DALYS) globally (Murry et al 2012, World Health Organisation 2013. Incidence of acute pain prevalence across a range of conditions in inpatient settings also remains high (Ogboli-Nwasor et al 2012, Jabusch et al 2015, with estimates of 40-65% of inpatients reporting moderate to severe "worst pain.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Pain: A content review of undergraduate pre-registration nurse education in the United Kingdom

Mackintosh-Franklin

2017

Nurse Education Today

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Chronic pain epidemiology and its clinical relevance

Cited by 521 publications

References 68 publications

Opioid Prescribing at Hospital Discharge Contributes to Chronic Opioid Use

Opioid Prescribing at Hospital Discharge Contributes to Chronic Opioid Use

Sexual Dysfunction in Patients with Chronic Pain

Pain: A content review of undergraduate pre-registration nurse education in the United Kingdom

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