Velázquez Rivera Ignacio, García Escobar Modesto, Moya Riera Jorge Juan, Del Saz de la Torre Javier Manuel, Fenollosa Vázquez Pedro, González Mesa José Manuel, Casado Alfonso, Martín Fuentes Mayte, de Andrés Ares Javier
Pain Unit, Alta Resolución de Guadix Hospital, Granada, Spain.
Pain Unit, San Juan de Alicante University Hospital, Alicante, Spain.
Pain Pract. 2015 Sep;15(7):633-42. doi: 10.1111/papr.12231. Epub 2014 Sep 22.
Large-scale observational studies can provide useful information on changes in health outcomes over time. The aim of this study was to investigate the effect of 3 months of usual care on quality of life (QOL) and pain outcomes in noncancer chronic pain patients managed by pain specialists and to examine factors associated with changes in QOL. This was assessed using the EQ-5D and pain outcomes using the Brief Pain Inventory (BPI). Changes in QOL and pain were studied for the overall sample and in subgroups defined by baseline pain severity. Multivariate regression was used to investigate factors associated with change on EQ-5D. Three thousand and twenty-nine patients were included for analysis. After 3 months of usual care, a mean of 40.9% of patients showed improvement on individual EQ-5D dimensions, with the highest rates of improvement seen on the pain/discomfort (50.8%) and anxiety/depression (48.3%) dimensions. The EQ-5D Index increased from a mean (SD) of 0.35 (0.2) to 0.58 (0.21) points between baseline and month 3, and the thermometer from 41.5 (19.4) to 58.7 (17.8), indicating a large effect. Improvements in QOL were larger in those with severe baseline pain. The BPI severity summary score improved from a mean (SD) of 6.5 (1.4) to 4.1 (1.7) and the interference summary score from 6.6 (1.5) to 4.2 (1.9). Changes on the BPI severity and interference scores were associated with changes in the EQ-5D Index and thermometer. In conclusion, 3 months of usual care in noncancer pain patients led to substantial improvements in QOL and pain outcomes.
大规模观察性研究可以提供有关健康结果随时间变化的有用信息。本研究的目的是调查3个月常规护理对由疼痛专科医生管理的非癌性慢性疼痛患者生活质量（QOL）和疼痛结果的影响，并检查与生活质量变化相关的因素。使用欧洲五维度健康量表（EQ-5D）评估生活质量，使用简明疼痛评估量表（BPI）评估疼痛结果。研究了总体样本以及根据基线疼痛严重程度定义的亚组中生活质量和疼痛的变化。使用多变量回归研究与EQ-5D变化相关的因素。纳入3029例患者进行分析。经过3个月的常规护理，平均40.9%的患者在EQ-5D各维度上有所改善，其中疼痛/不适维度（50.8%）和焦虑/抑郁维度（48.3%）的改善率最高。EQ-5D指数在基线至第3个月期间从平均（标准差）0.35（0.2）分增加到0.58（0.21）分，温度计评分从41.5（19.4）增加到58.7（17.8），表明效果显著。基线疼痛严重的患者生活质量改善更大。BPI严重程度总分从平均（标准差）6.5（1.4）改善到4.1（1.7），干扰总分从6.6（1.5）改善到4.2（1.9）。BPI严重程度和干扰评分的变化与EQ-5D指数和温度计评分的变化相关。总之，非癌性疼痛患者3个月的常规护理导致生活质量和疼痛结果有显著改善。
