Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, United States.
Blue Note Therapeutics, San Fransisco, CA 94104, United States.
Pain Med. 2023 Oct 3;24(10):1169-1175. doi: 10.1093/pm/pnad068.
The Graded Chronic Pain Scale (GCPS) is frequently used in pain research and treatment to classify mild, bothersome, and high impact chronic pain. This study's objective was to validate the revised version of the GCPS (GCPS-R) in a US Veterans Affairs (VA) healthcare sample to support its use in this high-risk population.
Data were collected from Veterans (n = 794) via self-report (GCPS-R and relevant health questionnaires) and electronic health record extraction (demographics and opioid prescriptions). Logistic regression, adjusting for age and gender, was used to test for differences in health indicators by pain grade. Adjusted odds ratio (AOR) with 95% confidence intervals (CIs) were reported with CIs not including an AOR of 1 indicating that the difference exceeded chance.
In this population, the prevalence of chronic pain (pain present most or every day, prior 3 months) was 49.3%: 7.1% with mild chronic pain (mild pain intensity and lower interference with activities); 23.3% bothersome chronic pain (moderate to severe pain intensity with lower interference); and 21.1% high impact chronic pain (higher interference). Results of this study mirrored findings in the non-VA validation study; differences between bothersome and high impact were consistent for activity limitations and present but not fully consistent for psychological variables. Those with bothersome chronic pain or high impact chronic pain were more likely to receive long-term opioid therapy compared to those with no/mild chronic pain.
Findings highlight categorical differences captured with the GCPS-R, and convergent validity supports use of the GCPS-R in US Veterans.
分级慢性疼痛量表(GCPS)常用于疼痛研究和治疗中,以对轻度、困扰和高影响慢性疼痛进行分类。本研究的目的是在美国退伍军人事务部(VA)医疗保健样本中验证 GCPS 的修订版(GCPS-R),以支持其在这一高风险人群中的使用。
通过自我报告(GCPS-R 和相关健康问卷)和电子健康记录提取(人口统计学和阿片类药物处方)从退伍军人(n=794)中收集数据。使用逻辑回归,根据年龄和性别进行调整,检验疼痛等级与健康指标之间的差异。报告调整后的优势比(AOR)及其 95%置信区间(CI),CI 中不包含 AOR 为 1 的情况,表示差异超过了机会。
在该人群中,慢性疼痛(过去 3 个月内多数或每天存在疼痛)的患病率为 49.3%:轻度慢性疼痛(疼痛强度较轻且对活动的干扰较小)为 7.1%;困扰性慢性疼痛(中度至重度疼痛强度且对活动的干扰较小)为 23.3%;高影响慢性疼痛(更高的干扰)为 21.1%。本研究的结果与非 VA 验证研究的结果一致;困扰性和高影响之间的差异在活动受限方面一致,但在心理变量方面并不完全一致。与无/轻度慢性疼痛相比,困扰性慢性疼痛或高影响慢性疼痛患者更有可能接受长期阿片类药物治疗。
研究结果突出了 GCPS-R 所捕捉到的分类差异,且收敛效度支持在美退伍军人中使用 GCPS-R。