Article

Health and quality of life associated with chronic pain of predominantly neuropathic origin in the community

Department of General Practice and Primary Care, University of Aberdeen, Aberdeen, Scotland, UK.
Clinical Journal of Pain (Impact Factor: 2.7). 03/2007; 23(2):143-9. DOI: 10.1097/01.ajp.0000210956.31997.89
Source: PubMed

ABSTRACT To assess the health and quality of life associated with chronic pain of predominantly neuropathic origin (POPNO) on health and daily activity in the general population.
The Self-complete Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) questionnaire, recently validated for identifying pain of predominantly neuropathic origin, was sent to 6000 adults identified from general practices in the United Kingdom, along with chronic pain identification and severity questions, the Brief Pain Inventory (BPI), the Neuropathic Pain Scale, and the SF-36 general health questionnaire.
With a corrected response rate of 52%, 3 groups of respondents were identified: those without chronic pain ("No Chronic Pain" group, n=1537); those with chronic pain who were S-LANSS positive indicating the presence of POPNO ("Chronic POPNO" group, n =241); and those with chronic pain who were S-LANSS negative ["Chronic Pain (non-POPNO)" group, n=1179]. The chronic POPNO group reported higher pain severity and had significantly poorer scores for all interference items of the BPI than those with chronic pain (non-POPNO). Mean scores from the Neuropathic Pain Scale were also significantly higher for the Chronic POPNO group. There were significant differences between the groups in all domains of the SF-36, with the Chronic POPNO group reporting the worst health. After adjusting for pain severity, age, and sex, the chronic POPNO group was still found to have poorer scores than the other Chronic Pain (non-POPNO) group in all domains of the SF-36 and all interference items in the BPI, indicating poorer health and greater disability.
This study confirms the importance of identifying neuropathic pain in the community, and the need for multidimensional management strategies that address all aspects of health.

Download full-text

Full-text

Available from: Michael I Bennett, Mar 29, 2015
0 Followers
 · 
123 Views
 · 
6 Downloads
  • Source
    • "It is important that these measures are valid, 66 appropriate to the disease, and particularly for clinical trials, sensi- 67 tive to detect changes. Although a disease-specific measure for 68 neuropathic pain has been developed [39], many studies use a gen- 69 eric HRQoL measure alongside clinical assessment or a validated 70 neuropathic pain screening tool [2] [43]. A single summary score 71 of overall HRQoL is generated by weighting responses to mental 72 and physical health states by their perceived importance, using 73 patient or general population preferences. "
  • Source
    • "It is important that these measures are valid, 66 appropriate to the disease, and particularly for clinical trials, sensi- 67 tive to detect changes. Although a disease-specific measure for 68 neuropathic pain has been developed [39], many studies use a gen- 69 eric HRQoL measure alongside clinical assessment or a validated 70 neuropathic pain screening tool [2] [43]. A single summary score 71 of overall HRQoL is generated by weighting responses to mental 72 and physical health states by their perceived importance, using 73 patient or general population preferences. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The EQ-5D and SF-12 are widely used generic Health-Related Quality of Life (HRQoL) questionnaires. They can be used to derive health utility index scores, on a scale where 0 is equivalent to 'death' and 1 represents 'full health', with scores less than zero representing states 'worse than death'. We compared EQ-5D or SF-6D health utility index scores in patients with no chronic pain, and chronic pain with and without neuropathic characteristics (NC), and to explore their discriminant ability for pain severity. Self-reported health and chronic pain status was collected as part of a UK general population survey (n=4,451). We found moderate agreement between individual dimensions of EQ-5D and SF-6D with most highly correlated dimensions found for mental health and anxiety/depression; role limitations and usual activities; and pain and pain/discomfort. Overall 43% reported 'full health' on EQ-5D, compared to only 4.2% on SF-6D. There were significant differences in mean utilities for chronic pain with NC (EQ-5D 0.47 vs. SF-6D 0.62) and especially for severe pain (EQ-5D 0.33 vs. SF-6D 0.58). 17% of those with chronic pain with NC and 3% without NC scored 'worse than death' on EQ-5D; a state which is not possible using the SF-6D. Health utilities derived from EQ-5D and SF-12/36 can discriminate between group differences for chronic pain with and without NC and greater pain severity. However, the instruments generate widely differing HRQoL scores for the same patient groups. The choice between using the EQ-5D or SF-6D matters greatly when estimating the burden of disease.
    Pain 07/2014; 155(10). DOI:10.1016/j.pain.2014.07.001 · 5.84 Impact Factor
  • Source
    • "All the QoL domains are harmed to a greater extent in individuals who report chronic pain with neuropathic characteristics [20]. Individuals that had chronic pain with neuropathic characteristics presented low scores in all the domains when compared with the scores presented by patients with other serious somatic diseases, as in the case of cardiopathies [14, 23]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: One of the chief complaints of individuals who frequent the Family Health Units is chronic pain which, in Salvador, affects over 40% of the population. However, little is known about the type of pain and its impact on quality of life (QoL) at population level. The aim of the study is to evaluate the impact of neuropathic pain on QoL in a community. A descriptive cross-sectional study was conducted from March to October 2012, in a Family Health Unit, Salvador, Bahia, Brazil. The DN-4 (type of pain), body map (location), VAS (intensity) and SF-36 (QoL) instruments were applied. The Chi-square (univariate analysis) and logistic regression (multivariate) tests were used, with IC 95% and P < 0.05. In a sample of 191 individuals with chronic pain, predominantly women (86.4%), single (48.7%), nonwhite (93.2%), low educational (46.6%) and low economic (100%) level. The most affected locations of the body were knees, lumbar region and head. In 60.2% of interviewees, neuropathic pain, of high intensity (VAS = 7.09 ± 3.0) predominated, with duration of 8.53 ± 8.8 years and mean QoL was reduced in 47.13%. Intense pain in the dorsal region and type of neuropathy are independent predictors for greater compromise of QoL.
    Journal of Clinical Medicine Research 04/2014; 6(2):111-9. DOI:10.14740/jocmr1675w
Show more