Institute for Allied Health Research, Glasgow Caledonian University, UK.
Eur J Pain. 2018 Jan;22(1):5-18. doi: 10.1002/ejp.1090. Epub 2017 Aug 17.
Chronic widespread pain (CWP) is a significant burden in communities. Understanding the impact of population-dependent (e.g., age, gender) and contextual-dependent (e.g. survey method, region, inequality level) factors have on CWP prevalence may provide a foundation for population-based strategies to address CWP. Therefore, the purpose of this study was to estimate the global prevalence of CWP and evaluate the population and contextual factors associated with CWP. A systematic review of CWP prevalence studies (1990-2017) in the general population was undertaken. Meta-analyses were conducted to determine CWP prevalence, and study population data and contextual factors were evaluated using a meta-regression. Thirty-nine manuscripts met the inclusion criteria. Study CWP prevalence ranged from 1.4% to 24.0%, with CWP prevalence in men ranging from 0.8% to 15.3% and 1.7% to 22.1% in women. Estimated overall CWP prevalence was 9.6% (8.0-11.2%). Meta-regression analyses showed gender, United Nations country development status, and human development index (HDI) influenced CWP prevalence, while survey method, region, methodological and reporting quality, and inequality showed no significant effect on the CWP estimate. Globally CWP affects one in ten individuals within the general population, with women more likely to experience CWP than men. HDI was noted to be the socioeconomic factor related to CWP prevalence, with those in more developed countries having a lower CWP prevalence than those in less developed countries. Most CWP estimates were from developed countries, and CWP estimates from countries with a lower socioeconomic position is needed to further refine the global estimate of CWP.
This systematic review and meta-analysis updates the current global CWP prevalence by examining the population-level (e.g. age, gender) and contextual (e.g. country development status; survey style; reporting and methodologic quality) factors associated with CWP prevalence. This analyses provides evidence to support higher levels of CWP in countries with a lower socioeconomic position relative to countries with a higher socioeconomic position.
慢性广泛性疼痛（CWP）是社区中一个重大的负担。了解人口相关因素（如年龄、性别）和情境相关因素（如调查方法、地区、不平等程度）对 CWP 患病率的影响，可能为基于人群的策略提供基础，以解决 CWP 问题。因此，本研究的目的是估计全球 CWP 的患病率，并评估与 CWP 相关的人口和情境因素。对 1990 年至 2017 年期间一般人群中 CWP 患病率的研究进行了系统回顾。进行荟萃分析以确定 CWP 的患病率，并使用荟萃回归评估研究人群数据和情境因素。符合纳入标准的有 39 篇文献。研究 CWP 的患病率范围为 1.4%至 24.0%，男性的 CWP 患病率为 0.8%至 15.3%，女性的 CWP 患病率为 1.7%至 22.1%。估计的总体 CWP 患病率为 9.6%（8.0-11.2%）。荟萃回归分析表明，性别、联合国国家发展状况和人类发展指数（HDI）影响 CWP 的患病率，而调查方法、地区、方法学和报告质量以及不平等对 CWP 估计没有显著影响。全球范围内，每 10 个人中就有 1 个人患有 CWP，女性比男性更容易患有 CWP。注意到 HDI 是与 CWP 患病率相关的社会经济因素，较发达国家的 CWP 患病率低于欠发达国家。大多数 CWP 估计来自发达国家，需要来自社会经济地位较低的国家的 CWP 估计来进一步完善全球 CWP 估计。
本系统回顾和荟萃分析通过检查与 CWP 患病率相关的人口水平（如年龄、性别）和情境（如国家发展状况；调查方式；报告和方法学质量）因素，更新了当前全球 CWP 的患病率。该分析为社会经济地位较低的国家的 CWP 水平相对较高提供了证据。
