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患有其他复杂慢性病患者的慢性疼痛经历与管理

Experience and management of chronic pain among patients with other complex chronic conditions.

作者信息

Butchart Amy, Kerr Eve A, Heisler Michele, Piette John D, Krein Sarah L

机构信息

Department of Veterans Affairs Health Services Research and Development Center of Excellence, VA Ann Arbor Healthcare System, Ann Arbor, MI 48113, USA.

出版信息

Clin J Pain. 2009 May;25(4):293-8. doi: 10.1097/AJP.0b013e31818bf574.

Abstract

OBJECTIVE

Managing multiple chronic health conditions is a significant challenge. The purpose of this study was to examine the experience and management of chronic pain among adult patients with other complex chronic conditions, specifically diabetes and heart failure (HF).

METHODS

We surveyed 624 US Department of Veterans Affairs primary care patients in 3 study groups: 184 with HF, 221 with diabetes, and 219 general primary care users. We compared health status and function between those with and without chronic pain within the 3 study groups. Among those with chronic pain, we compared pain location, severity, and treatment across groups.

RESULTS

More than 60% in each group reported chronic pain, with the majority reporting pain in the back, hip, or knee. In all groups, patients with chronic pain were more likely to report fair or poor health than those without pain (P<0.05). In the HF and diabetes groups, a higher percentage of patients with pain were not working because of health reasons. Of those with pain, more than 70% in each group took medications for pain; more than one-half managed pain with rest or sedentary activities; and less than 50% used exercise for managing their pain.

DISCUSSION

Chronic pain is a prevalent problem that is associated with poor functioning among multimorbid patients. Better management of chronic pain among complex patients could lead to significant improvements in health status, functioning, and quality of life and possibly also improve the management of their other major chronic health conditions.

摘要

目的

管理多种慢性健康状况是一项重大挑战。本研究的目的是调查患有其他复杂慢性疾病(特别是糖尿病和心力衰竭(HF))的成年患者的慢性疼痛体验和管理情况。

方法

我们对3个研究组中的624名美国退伍军人事务部初级保健患者进行了调查:184名患有心力衰竭,221名患有糖尿病,219名是普通初级保健使用者。我们比较了3个研究组中患有和未患有慢性疼痛的患者的健康状况和功能。在患有慢性疼痛的患者中,我们比较了各组之间的疼痛部位、严重程度和治疗方法。

结果

每组中超过60%的患者报告有慢性疼痛,大多数患者报告背部、臀部或膝盖疼痛。在所有组中,患有慢性疼痛的患者比没有疼痛的患者更有可能报告健康状况一般或较差(P<0.05)。在心力衰竭和糖尿病组中,因健康原因而无法工作的疼痛患者比例更高。在那些有疼痛的患者中,每组超过70%的患者服用止痛药物;超过一半的患者通过休息或久坐活动来缓解疼痛;不到50%的患者通过锻炼来缓解疼痛。

讨论

慢性疼痛是一个普遍存在的问题,与多病患者的功能不佳有关。更好地管理复杂患者的慢性疼痛可能会显著改善健康状况、功能和生活质量,也可能改善他们其他主要慢性健康状况的管理。

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