What factors affect worsening disability in patients with chronic pain? Prospective observational st

Background & Aims

The primary treatment goal of patients experiencing chronic pain has shifted from pain reduction to functional status improvement. However, the associated factors which related to deterioration of disability in patients with chronic pain remain unknown. We examined the effect of the COVID-19 pandemic on disability in patients with chronic pain and there was no significant change in short-term (1). In this study, we examined the change of disability in patients with chronic pain in long-term and factors which related to worsen disability prospectively.

Methods

This prospective study included outpatients with chronic pain undergoing treatment at the Pain Center of Nara Medical University Hospital. Individuals aged ?50 years who visited the Pain Center at Nara Medical University with chronic pain from April 2019 to March 2021. The patients were asked to complete questionnaires every three months for one year. The questionnaire covered changes in disability, pain intensity, anxiety, depression, catastrophic thinking, and the presence/absence of exercise habits. The patients whose WHODAS score increased 9 or more at one year compared to baseline were assigned to the worsened group. We compared pain intensity, anxiety, depression, catastrophic thinking, and the presence/absence of exercise habits at baseline between worsened group and the not worsened group which includes no changed or improved patients. Moreover, we compared the presence/absence of exercise habits at 1 year.

Results

Four hundred six with a median age of 71.5 years completed 1-year follow up. Among the 406 patients, 35 patients (8.6%) increased WHODAS score 9 or more at one year compared to baseline (the worsened group). Pain intensity, anxiety, depression, catastrophic thinking, and the presence/absence of exercise habits at baseline were not significantly different between the groups. Regarding the presence/absence exercise habits at 1 year, there was no significant difference between the groups.

Conclusions

This longitudinal study revealed that 8.6% of patients worsened their disability despite continuing pain management at our pain center. There is no factor associated with worsening disability.

References

(1) Fujiwara A, Watanabe K, Ida M, et al. The short-term effect of COVID-19 pandemic on disability, pain intensity, psychological status, and exercise habits in patients with chronic pain. J Anesth. 2021 Dec;35(6):862-869. doi: 10.1007/s00540-021-02992-y.

Presenting Author

Aki Fujiwara

Poster Authors

Aki Fujiwara

Nara Medical University

Lead Author

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