Department of Physical Therapy, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Department of Family and Preventive Medicine, Prince of Songkla University, Songkhla, Thailand.
Prim Health Care Res Dev. 2024 Oct 14;25:e43. doi: 10.1017/S1463423624000367.
This study aimed to investigate the effects of pain management according to the World Health Organization (WHO) analgesic ladder on pain severity, pain interference, and blood pressure (BP) in treated hypertensive patients with chronic musculoskeletal pain.
Pain management can affect BP control owing to the proposed mechanism by which persistent pain contributes to increased BP. However, there are inadequate studies investigating the benefit of pain management in controlling both pain and BP in hypertensive patients who have chronic pain.
In this cross-sectional study, demographic data and pain characteristics (resting pain score on the numerical pain rating scale, pain severity, and pain interference subscale of the Brief Pain Inventory) were collected via face-to-face interviews. BP was measured thrice on the same day. Data on pain medications taken in the previous 1 month were retrieved from the medical records. Participants were categorized into three groups following pain management patterns according to the WHO analgesic ladder: no, partial, and complete treatment. Multivariate logistic regression analysis (MLRA) was used to analyse the association between the variables and uncontrolled BP.
Among 210 participants, the mean (standard deviation) age was 68 (15.5) years, and 60.47% had uncontrolled BP. The resting pain score, pain severity, and pain interference subscale scores of the complete treatment group were significantly lower than that of the partial treatment group ( = 0.036, 0.026, and 0.044, respectively). The MLRA revealed that pain management patterns were associated with uncontrolled BP (adjusted odds ratio [AOR]: 6.75; 95% confidence interval [CI]: 2.71-16.78; < 0.001) and resting pain scores (AOR: 1.17; 95% CI: 1.04-1.38; = 0.048). Our findings suggest that pain management patterns adhering to the WHO analgesic ladder can reduce pain severity and pain interference and also control BP in hypertensive patients with chronic musculoskeletal pain.
本研究旨在探讨根据世界卫生组织（WHO）镇痛阶梯对慢性肌肉骨骼疼痛的治疗高血压患者的疼痛严重程度、疼痛干扰和血压（BP）的影响。
由于持续疼痛导致 BP 升高的拟议机制，疼痛管理可能会影响 BP 控制。然而，关于疼痛管理在控制患有慢性疼痛的高血压患者的疼痛和 BP 方面的益处的研究还不够充分。
在这项横断面研究中，通过面对面访谈收集人口统计学数据和疼痛特征（数字疼痛评分量表上的静息疼痛评分、疼痛严重程度和简明疼痛量表的疼痛干扰子量表）。同日测量三次 BP。从病历中检索前一个月服用的疼痛药物的数据。根据 WHO 镇痛阶梯，将参与者按照疼痛管理模式分为三组：无、部分和完全治疗。采用多变量逻辑回归分析（MLRA）分析变量与未控制 BP 之间的关系。
在 210 名参与者中，平均（标准差）年龄为 68（15.5）岁，60.47%的人 BP 未得到控制。完全治疗组的静息疼痛评分、疼痛严重程度和疼痛干扰子量表评分均明显低于部分治疗组（=0.036、0.026 和 0.044）。MLRA 显示，疼痛管理模式与未控制的 BP（调整后的优势比[OR]：6.75；95%置信区间[CI]：2.71-16.78；<0.001）和静息疼痛评分（OR：1.17；95%CI：1.04-1.38；=0.048）相关。我们的研究结果表明，遵循 WHO 镇痛阶梯的疼痛管理模式可以减轻疼痛严重程度和疼痛干扰，同时控制高血压合并慢性肌肉骨骼疼痛患者的 BP。
