Witt Edward A, Kenworthy James, Isherwood Gina, Dunlop William C N
a Kantar Health , Princeton , NJ , USA ;
b Mundipharma , Cambridge , UK ;
J Med Econ. 2016 Sep;19(9):858-65. doi: 10.1080/13696998.2016.1178127. Epub 2016 May 4.
The goal of this research was to quantify the association between pain severity and several health outcomes in a large sample of patients diagnosed with some form of pain.
Responses from patients who had been diagnosed with some form of pain (n = 14,459) were drawn from the 2013 EU National Health and Wellness Survey (NHWS; n = 62,000). Respondents reported their subjective pain severity in the past week on a numerical rating scale (0-10) as well as the Medical Outcomes Study Short Form (SF-36), Work Productivity and Activity Impairment Questionnaire (WPAI), and healthcare resource utilization in the past 6 months (healthcare professional (HCP) visits, emergency room (ER) visits, and hospitalizations). Associations between pain severity and health outcomes were examined via a series of regression models controlling for a set of demographic and health-related covariates.
After controlling for demographics and comorbidities, pain severity in the past week was shown to be significantly negatively associated with Health Utilities (b = -0.022, p < 0.001) and positively associated with overall WPAI scores (b = 0.18, p < 0.001) and healthcare resource use (Hospitalizations: b = 0.13, p < 0.001; ER Visits: b = 0.14, p < 0.001; HCP Visits: b = 0.08, p < 0.001). The nature of these relationships (linear, curvilinear, etc.) is also explored.
This study was a self-report cross-sectional study which may have biased the results and does not allow for causal inferences to be made. Finally, the regression models run were limited to available covariates and, hence, some potentially important covariates may not have been included in these models.
The findings suggest that reducing pain severity could result in an increase in patients' quality-of-life and work productivity, and a decrease in healthcare resource use. The equations, linking pain and outcomes, were presented in an accessible format so they could be readily applied in healthcare decision-making.
本研究的目的是在大量被诊断患有某种形式疼痛的患者样本中,量化疼痛严重程度与几种健康结果之间的关联。
从2013年欧盟国家健康与幸福调查(NHWS;n = 62,000)中提取被诊断患有某种形式疼痛的患者(n = 14,459)的回复。受访者报告了他们在过去一周内主观疼痛严重程度的数字评分量表(0 - 10),以及医学结果研究简表(SF - 36)、工作效率和活动障碍问卷(WPAI),以及过去6个月的医疗资源利用情况(医疗专业人员(HCP)就诊、急诊室(ER)就诊和住院)。通过一系列控制一组人口统计学和健康相关协变量的回归模型,研究疼痛严重程度与健康结果之间的关联。
在控制了人口统计学和合并症后,过去一周的疼痛严重程度与健康效用显著负相关(b = -0.022,p < 0.001),与总体WPAI评分显著正相关(b = 0.18,p < 0.001)以及医疗资源使用(住院:b = 0.13,p < 0.001;急诊室就诊:b = 0.14,p < 0.001;HCP就诊:b = 0.08,p < 0.001)。还探讨了这些关系的性质(线性、曲线等)。
本研究是一项自我报告的横断面研究,可能使结果产生偏差,且不允许进行因果推断。最后,所运行的回归模型仅限于可用的协变量,因此,一些潜在重要的协变量可能未包含在这些模型中。
研究结果表明,降低疼痛严重程度可能会提高患者的生活质量和工作效率,并减少医疗资源的使用。以易于理解的形式呈现了将疼痛与结果联系起来的方程,以便它们能够很容易地应用于医疗决策。