Watkins Emmeline, Wollan Peter C, Melton L Joseph, Yawn Barbara P
Department of Epidemiology, AstraZeneca, Wilmington, Deleware, USA.
Mayo Clin Proc. 2006 Feb;81(2):167-71. doi: 10.4065/81.2.167.
To evaluate the proportion and characteristics of patients with chronic pain who do not seek treatment and assess whether these patients have unmet pain care needs.
We performed a cross-sectional survey of residents of Olmsted County, Minnesota, from March through June 2004, with additional visit and diagnosis data from the Rochester Epidemiology Project database. Study participants were a random, population-based sample of eligible adult (>30 years) residents of Olmsted County with at least 1 visit to a local health care facility in the past 3 years.
Of the 5897 eligible participants, 3575 people (60.6%) responded. Of the respondents who reported pain of more than 3 months' duration, 497 (22.4%) of the 2211 patients stated that they had not informed their physician about their pain. Of these silent sufferers, 70.6% (351/497) reported having moderate or severe pain, 49.2% (243/497) reported having frequent pain (>8 days per month), and 40.6% (202/497) met both criteria. Silent sufferers also reported that pain interfered with their general activity and sleep to a level only slightly less than the chronic pain sufferers who reported discussing their pain with a physician. Silent sufferers made an average of 5.2 ambulatory physician visits per year, which was less than those who sought physician help for their pain (8.6 ambulatory visits per year; P < .001). Men and younger participants were more likely to be silent about their pain (P < .001).
More than 1 in 5 people with chronic pain did not seek physician care for their pain. This group is unknown to physicians and therefore represents an unreported patient group with an unmet need for pain care.
评估未寻求治疗的慢性疼痛患者的比例及特征，并评估这些患者是否存在未满足的疼痛护理需求。
我们于2004年3月至6月对明尼苏达州奥尔姆斯特德县的居民进行了一项横断面调查，并从罗切斯特流行病学项目数据库获取了额外的就诊和诊断数据。研究参与者是从奥尔姆斯特德县符合条件的成年（>30岁）居民中随机抽取的、基于人群的样本，这些居民在过去3年中至少去过一次当地医疗机构。
在5897名符合条件的参与者中，3575人（60.6%）做出了回应。在报告疼痛持续超过3个月的受访者中，2211名患者中有497名（22.4%）表示他们未将自己的疼痛告知医生。在这些默默忍受疼痛的患者中，70.6%（351/497）报告有中度或重度疼痛，49.2%（243/497）报告疼痛频繁（每月>8天），40.6%（202/497）符合这两个标准。默默忍受疼痛的患者还报告称，疼痛对他们日常活动和睡眠的干扰程度仅略低于那些报告与医生讨论过疼痛的慢性疼痛患者。默默忍受疼痛的患者平均每年门诊就诊5.2次，低于那些因疼痛寻求医生帮助的患者（每年门诊就诊8.6次；P <.001）。男性和年轻参与者更有可能对自己的疼痛保持沉默（P <.001）。
超过五分之一的慢性疼痛患者未因疼痛寻求医生治疗。这一群体不为医生所知，因此代表了一个未报告的患者群体，其疼痛护理需求未得到满足。
