Ferguson Meaghan, Svendrovski Anton, Katz Joel
Department of Psychology, Faculty of Health, York University, Toronto, Ontario, Canada.
Department of Psychology, UZIK Consulting Inc, Toronto, Ontario, Canada.
J Pain Res. 2020 Nov 20;13:3045-3057. doi: 10.2147/JPR.S269648. eCollection 2020.
Disease multimorbidity and pain is a complex, yet common, problem for the aging population, and a significant burden on the health-care systems around the world. Despite this, disease comorbidity and the association with pain in a complex chronic care population is not well understood. This study examined the most prevalent disease combinations and their association with pain.
The study initially included 139,920 residents, aged 18-101 years, admitted to publicly funded hospital facilities for complex chronic care in Canada between the years 2006 and 2016. Data were acquired through the Canadian Institute for Health Information (CIHI) Facility-Based Continuing Care Reporting System (CCRS). Descriptive and chi-square statistics were used to summarize and compare the sample characteristics. Binary logistic regression analyses were used to examine the association between multimorbid disease categories and pain outcomes.
The sample consisted of 139,573 residents (57% female), mostly older (mean age = 77.32 years), married (40%), or widowed (36%). Residents took an average of 11.9 medications and 77% were using analgesic medications. On average, residents had diagnoses from 3.06 disease categories (SD = 1.43). Heart/circulation diseases were the most prevalent among the sample (73%), with neurological second (46%) and musculoskeletal third (44%). Overall, 73% of residents reported pain, with 43% reporting moderate pain severity. Residents with multiple disease categories were more likely to report the presence of pain (OR = 1.08, 95% CI: 1.07-1.08, < 0.001), with each additional disease category associated with an 8% increase in the odds of reporting pain.
The findings from this study help identify common comorbid disease patterns related to pain in an institutionalized, complex chronic care population. This information contributes to both the pain and multimorbidity literature, and is invaluable for creating care plans to meet the demands of a challenging population.
疾病共病和疼痛是老年人群中一个复杂但常见的问题，也是全球医疗保健系统的重大负担。尽管如此，在复杂的慢性病护理人群中，疾病共病及其与疼痛的关联尚未得到充分理解。本研究调查了最常见的疾病组合及其与疼痛的关联。
该研究最初纳入了2006年至2016年间在加拿大公立资助医院设施接受复杂慢性病护理的139,920名18至101岁的居民。数据通过加拿大卫生信息研究所（CIHI）基于机构的持续护理报告系统（CCRS）获取。描述性统计和卡方统计用于总结和比较样本特征。二元逻辑回归分析用于检验多病共患疾病类别与疼痛结果之间的关联。
样本包括139,573名居民（57%为女性），大多年龄较大（平均年龄 = 77.32岁），已婚（40%）或丧偶（36%）。居民平均服用11.9种药物，77%正在使用镇痛药。居民平均有3.06种疾病诊断（标准差 = 1.43）。心脏/循环系统疾病在样本中最为常见（73%），其次是神经系统疾病（46%）和肌肉骨骼疾病（44%）。总体而言，73%的居民报告有疼痛，43%报告疼痛严重程度为中度。患有多种疾病类别的居民更有可能报告有疼痛（比值比 = 1.08，95%置信区间：1.07 - 1.08，P < 0.001），每增加一种疾病类别，报告疼痛的几率增加8%。
本研究结果有助于识别在机构化的复杂慢性病护理人群中与疼痛相关的常见共病疾病模式。这些信息对疼痛和共病文献都有贡献，对于制定护理计划以满足这一具有挑战性人群的需求非常宝贵。
