Sturgeon John A, Hah Jennifer M, Sharifzadeh Yasamin, Middleton Stephanie K, Rico Thomas, Johnson Kevin A, Mackey Sean C
Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pain Medicine, Stanford University School of Medicine, Stanford Systems Neuroscience and Pain Laboratory, 1070 Arastradero, Suite 200, MC 5596, Palo Alto, CA, USA.
Int J Behav Med. 2018 Apr;25(2):252-258. doi: 10.1007/s12529-017-9686-8.
A key component to chronic pain management regimens is the use of analgesic medications. Psychological factors, such as mood states, may also affect the use of pain medications for individuals with chronic pain, but few observational studies have examined how these factors may predict pain medication use at the daily level.
Daily assessments from 104 individuals with back pain were used to examine fluctuations in daily pain intensity, mood, sleep quality, and physical activity as predictors of the likelihood of pain medication (opioid and non-opioid) use and levels of medication use on the same day.
Pain intensity and mood ratings significantly predicted whether participants used pain medication on the same day, while only pain intensity predicted whether participants used more medication than usual. Further, current opioid users were more likely to increase the amount of their medication use on days of higher pain.
This article identifies fluctuations in daily pain intensity and mood as salient predictors of daily pain medication use in individuals with recurrent back pain. The current study is among the first to highlight both pain and mood states as predictors of daily pain medication use in individuals with back pain, though future studies may expand on these findings through the use of higher-resolution daily medication use variables.
慢性疼痛管理方案的一个关键组成部分是使用止痛药物。心理因素，如情绪状态，也可能影响慢性疼痛患者使用止痛药物，但很少有观察性研究探讨这些因素如何在日常水平上预测止痛药物的使用情况。
对104名背痛患者进行每日评估，以检查每日疼痛强度、情绪、睡眠质量和身体活动的波动情况，作为同一天使用止痛药物（阿片类和非阿片类）可能性及药物使用水平的预测指标。
疼痛强度和情绪评分显著预测了参与者当天是否使用止痛药物，而只有疼痛强度预测了参与者是否比平时使用更多药物。此外，当前的阿片类药物使用者在疼痛较高的日子里更有可能增加药物使用量。
本文确定了每日疼痛强度和情绪的波动是复发性背痛患者每日使用止痛药物的重要预测指标。本研究是最早将疼痛和情绪状态都作为背痛患者每日使用止痛药物预测指标的研究之一，不过未来的研究可能会通过使用更高分辨率的每日药物使用变量来扩展这些发现。
